Upper limb arteritis in Takayasu's disease. Surgical treatment and results

Non specific inflammatory involvement of the subclavian arteries due to Takayasu's disease is rare, compared to the frequency of atherosclerosis. A personal series of 23 cases of brachiocephalic arteritis, observed between 1967 and 1980 is presented. Mean age of the patients is 30 years, 60% are females. Supra-aortic trunks are only involved in 15 patients and associated with abdominal aorta and renal arteries in 8. By passes with prosthetic grafts or saphenous veins have been most frequently used in revascularization techniques performed in 23 patients, 2 patients have shown progressive evolution with multiple involvement between 4 and 6 years. One death occurred during recurrent active process with occlusion of all brachiocephalic arteries. With a mean follow up of 8 years, 80% of the surgical patients are stabilized with a satisfactory clinical and anatomical result. Operative indication must take into account the sites of occlusive lesions, symptoms and anatomical stage of arteritis.