Background Takayasu's Arteritis (TA) is a chronic arteritis of the aorta and its major branches. Patients may require endovascular repair in long term follow-up.
Objectives The aim of this retrospective study was to report our long term follow-up results of endovascular repair in the management of arterial stenosis caused by TA.
Methods We retrospectively analyzed the outcome of endovascular interventions including angioplasty and angioplasty with stenting in patients with arterial stenosis caused by TA. The patients were followed-up in the Rheumatology out-patient clinic at 3 monthly intervals. Each visit included the evaluation of clinical symptoms, acute-phase reactants and regulation of the medical treatment including glucocorticoids and immunosuppressive drugs. For the evaluation of outcome of the interventional procedure, patients underwent Doppler ultrasonography and MR angiography routinely at every 6 months. Catheter angiography was performed if there was any suspicion of restenosis or occlusion
Results This study included 35 patients with TA (31 female, mean age: 42.5 years) who fulfilled the American College of Rheumatology 1990 Criteria for the diagnosis of TA. All patients had symptomatic arterial stenosis proven by catheter angiography. A total of 67 endovascular procedures were performed for 49 arterial stenotic lesions of the patients. Clinical inactivity of the disease was provided with immunosuppressive treatment before any interventions. Treatment of recurrent stenosis by a second endovascular procedure was performed in 11 (22.5%) lesions.
The mean follow-up interval after endovascular procedure was 81 months (range 12-144 months). Twenty two (33%) of total 67 endovascular interventions resulted in restenosis or occlusion. Among all 49 arterial lesion, only four (8%) lesions (one common iliac, one renal, one celiac and one thoracic aortic) were occluded at the time of the final evaluation. Kaplan-Meier survival analyses of the renal arterial lesions showed that the overall 1- and 8-year restenosis-free survival rates of renal arterial interventions were 74% and 57%, respectively.
Conclusions This study suggests that long term patency of TA lesions is related with control of the disease activity by optimal immunosuppressive therapy before and after the initial endovascular procedure. Performing reinterventions with close monitoring of the arterial lesion should not be avoided for better outcomes.
Disclosure of Interest None declared