Staged Combined Endovascular and Open Surgical Approach in a Patient with Takayasu's Arteritis.

Abstract:

:Takayasu's arteritis (TA) is a systemic large vessel vasculitis that affects the aorta and its branches. Most patients with TA respond to medical therapy with a minority of patients requiring surgical intervention. In our report, we describe the case of a 59-year-old Caucasian female with TA who underwent revascularization due to cerebrovascular symptoms refractory to medical therapy. She initially presented with amaurosis fugax and developed episodes of syncope and slurred speech during corticosteroid tapering. Vascular studies showed right common carotid artery (RCCA), left internal carotid artery (LICA), and left subclavian artery (LSA) occlusion with the right vertebral artery (RVA) ostium stenosis, and retrograde flow through the left vertebral artery (LVA). The sole source of cerebral perfusion flowed through her stenosed RVA, so it was decided to first stent the RVA to restore adequate posterior cerebral circulation before creating a right subclavian artery to RCCA bypass to restore anterior circulation. This case represents the successful management of TA utilizing a two-staged combined endovascular and surgical approach.

journal_name

Ann Vasc Surg

authors

Varzari A,Rathore A,Shah RM,Panneton JM

doi

10.1016/j.avsg.2019.09.019

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

461.e11-461.e14

eissn

0890-5096

issn

1615-5947

pii

S0890-5096(19)30857-X

journal_volume

63

pub_type

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