Clinical, angiographic profile and percutaneous endovascular management of Takayasu's arteritis - A single centre
H S Natraj Setty1, Murali Rao1, K H Srinivas1
1Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
Insights
Takayasu
Area of Science:
- Cardiology
- Vascular Medicine
- Rheumatology
Background:
- Takayasu's arteritis is a rare, chronic inflammatory vasculitis affecting the aorta and its major branches.
- While more common in Asia, it has a worldwide distribution with varied presentations.
- The condition can manifest with diverse vascular involvement patterns and clinical symptoms.
Purpose of the Study:
- To evaluate the clinical and angiographic characteristics of Takayasu's arteritis.
- To assess the effectiveness of percutaneous endovascular management strategies.
Main Methods:
- A prospective study of 50 consecutive Takayasu's arteritis patients from January 2010 to April 2016.
- Detailed analysis of clinical presentations and angiographic findings.
- Evaluation of treatment outcomes for endovascular and medical management.
Main Results:
- The study analyzed 50 patients, predominantly female (86%), with an average age of 26.92 years.
- Common symptoms included claudication (74%), musculoskeletal pain (48%), and fatigue (46%).
- Absent pulses (80%) and blood pressure differences (80%) were frequent findings; angiographic type I was most common (40%).
- Percutaneous transluminal angioplasty was the primary treatment in 66% of patients.
Conclusions:
- Takayasu's arteritis primarily affects women and presents with a wide spectrum of symptoms, from asymptomatic findings to severe neurological impairment.
- It is a significant cause of renovascular hypertension, with angiography being the gold standard for diagnosis.
- Percutaneous transluminal angioplasty with stenting is a valuable treatment option for selected Takayasu's arteritis patients.
Objective:
Aim of the study was to evaluate clinical, angiographic profile and percutaneous endovascular management of Takayasu's arteritis.
Background:
Takayasu's arteritis is a chronic inflammatory vasculitis affecting the aorta and its major branches. Although it is more prevalent in Asia, the distribution of the disease is worldwide with different vascular involvement patterns and clinical manifestations.
Methods:
In this prospective study a total of 50 consecutive patients who were reported as having Takayasu's arteritis between January 2010 and April 2016 were evaluated. Detailed clinical presentation and angiograms of all patients were analysed.
Results:
50 patients were analysed during study period. Among 50 patients, 43(86%) were female and 7 (14%) were male. Average age of presentation was 26.92years. Most common clinical presentation was claudication (74%) followed by, musculoskeletal symptoms (48%), fatigue (46%), weight loss (22%), headache (22%), visual disturbances (16%), syncope (10%), dyspnoea (20%). Most common features were absent/diminished pulses (80%), difference in blood pressure (80%), followed by bruit (70%)hypertension (64%), cerebrovascular accident (8%),heart failure (8%) and aortic regurgitation (4%). According to the new angiographic classification, angiographic type I (40%) was encountered most frequently, followed by type III (30%), type V (16%), type IIb (8%), type IIa (2%), and type IV is (4%). Angioplasty was the main stay of treatment in 66% of the patients, remaining 34% of them were treated medically either with corticosteroids or methotrexate.
Conclusion:
Takayasu's arteritis is a rare disease, affects mainly women, manifestations range from asymptomatic disease, found as a result of impalpable pulses or bruits, to catastrophic neurological impairment. Takayasu's arteritis is the common cause of renovascular hypertension. Angiography remains the gold standard for diagnosis. Angiographic evaluation and percutaneous transluminal angioplasty with stenting is useful in selected cases.
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