Takayasu's arteritis: management of a complex case and literature review

Takayasu's arteritis, also known as pulseless disease, is an unusual cause of symptomatic peripheral vascular disease. It was first reported in 1908 by a Japanese ophthalmologist who described retinal arteriovenous shunts which appeared in a wreath-like distribution around the optic disc and microaneurysms of the retinal vessels in a 19-year-old Japanese woman. Onishi found similar findings in association with cool, pulseless upper extremities. Since that time the syndrome has been described as Takayasu's arteritis. The current report is of a 36-year-old black woman who presented with the complaints of blurred vision, dysphagia, headaches, and near syncopal episodes who had been diagnosed with Takayasu's arteritis 12 years previously. The presentation and operative management is described and this report also reviews the literature on the management of this syndrome.