Takayasu's arteritis: possible dysgenesic etiology

A 31-year-old female patient with Takayasu's arteritis and vascular abnormalities is presented. Her dominant symptom was intermittent claudication in the left upper extremity. The arch aortogram and selective angiogram showed obstruction of the left subclavian and axillary arteries, and run-off in the proximal brachial artery. An anomalous common trunk for the innominate and left carotid arteries and a markedly narrowed left vertebral artery were found. A direct surgical attempt at improving the blood supply of the left upper extremity was not deemed feasible. A transthoracic cervicodorsal sympathectomy was done without lasting functional results. The relatively frequent association of aortic arch branching abnormalities, also abnormalities of the thoracic, abdominal aorta, of the coronary, visceral arteries with aortic arch syndrome and other arteriopathies had been noted in several reports. It appears that such uncommon vascular malformations are not without influence upon the development of these forms of obstructive arteritis. The mechanism of the obstructive process is unclear. The possible dygenesic etiology of Takayasu's disease is herein postulated.