Takayasu Arteritis Presenting With Upper Extremity Ischemia Treated by Carotid-Humeral Bypass: A Case-Based Review

Takayasu's arteritis is a chronic large-vessel vasculitis that can lead to progressive arterial stenosis and occlusion, resulting in significant ischemic complications. We report the case of a 41-year-old woman with hypertension and a history of Takayasu's arteritis diagnosed at 12 years of age who presented with worsening left upper extremity claudication. Computed tomography angiography demonstrated complete occlusion of the left subclavian and axillary arteries. Given the severity of symptoms and extent of arterial disease, a carotid-to-mid humeral bypass using a polytetrafluoroethylene graft was performed. The procedure resulted in complete resolution of ischemic symptoms and restoration of functional capacity. Long-term follow-up demonstrated sustained graft patency and excellent limb preservation. This case highlights the challenges associated with the diagnosis and long-term management of Takayasu's arteritis. Although immunosuppressive therapy remains the mainstay of treatment during active disease, surgical revascularization can provide durable symptom relief and excellent outcomes in selected patients with advanced occlusive lesions.