[Experience with 303 operations in nonspecific aorto-arteritis (Takayasu syndrome)]

From analysis of his personal 25-year experience the author suggests a classification of aorto-arteritis and discusses the incidence of various clinical syndromes. Among the 303 operations only 14 were nephrectomies, the remaining were reconstructive vascular operations. Most interventions were conducted on the branches of the aortic arch (115 operations), renal (112 operations) and visceral (73 operations) arteries. In reconstruction of the branches of the aortic arch, preference is given to extrathoracic shunting (64 operations), in the absence of the necessary conditions a bifurcation carotid or carotid-subclavian shunt from the ascending aorta is carried out (42 operations). In reconstruction of the thoracoabdominal aorta preference is given to a thoracophrenolumbotomy approach suggested by the author and the method of transaortic endarterectomy. The author describes a new method for the management of inflammation in patients with aortitis by means of cyclophosphamide and methylprednisolone. The good late-term results occur due to arrest of the inflammation. The results of the surgical methods are much more effective than those of nonoperative therapy alone.