Diagnosis and Successful Surgical Treatment in a Patient with Takayasu Arteritis: Literature Review and Case Report

Takayasu arteritis is a rare large-vessel vasculitis that often presents with asymmetric or absent pulses, vascular bruits, intermittent claudication, and cerebrovascular symptoms in over 50% of cases. Surgical intervention becomes essential in patients with severe, refractory disease. We report the case of a 30-year-old female presenting with upper limb claudication and decreased visual acuity in the right eye. Physical examination revealed bilateral carotid and subclavian bruits, significant blood pressure discrepancy between upper and lower limbs, and episodes of limb shaking. Vascular imaging demonstrated extensive involvement of the brachiocephalic trunk, common carotid, and vertebral arteries, with marked arterial wall thickening and gadolinium enhancement. Despite high-dose corticosteroids and tocilizumab therapy, the patient showed a poor clinical response. A successful aortobicarotid bypass was performed. This case underscores the importance of surgical revascularization in medically refractory Takayasu arteritis, offering symptom relief and improved quality of life.