Related Experiment Videos

Disease progression after initial surgical intervention for Takayasu arteritis

Sung Wan Ham1, S Ram Kumar, Vincent L Rowe

  • 1Aortic Center, University of Southern California Cardio-Vascular Thoracic Institute, Los Angeles, CA 90033, USA.

Journal of Vascular Surgery
|August 13, 2011
PubMed

Insights

Takayasu arteritis (TA) often progresses after initial revascularization, necessitating further procedures. Lifelong vascular surveillance is crucial for patients with TA undergoing surgical intervention.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Rheumatology

Background:

  • Takayasu arteritis (TA) is a large-vessel vasculitis.
  • TA can lead to end-organ ischemia requiring revascularization.
  • Long-term outcomes after revascularization for TA are not well-defined.

Purpose of the Study:

  • To determine the incidence of disease progression in patients with TA.
  • To assess the need for subsequent revascularization procedures in TA patients.
  • To evaluate long-term outcomes and survival after revascularization for TA.

Main Methods:

  • Retrospective review of patients with TA undergoing initial revascularization from 1980-2009.
  • Analysis of incidence of revascularization in new vascular beds or revision of initial procedures.
  • Assessment of postoperative morbidity, mortality, and actuarial survival.

Main Results:

  • Forty patients underwent initial revascularization for indications including hypertension, renal dysfunction, extremity ischemia, and stroke.
  • Disease progression or revascularization failure occurred in 40% of patients during a mean 6.4-year follow-up.
  • Subsequent procedures were required for renal, cerebrovascular, and extremity ischemia, among others. Postoperative morbidity was 14% with one operative death.

Conclusions:

  • Disease progression is common in Takayasu arteritis patients requiring revascularization.
  • Lifelong global vascular surveillance is essential for TA patients post-intervention.
  • The impact of immunosuppressive therapy on reoperation rates warrants further investigation.
Abstract

Related Concept Videos

Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...