Takayasu's arteritis surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farnaz Khalighinejad, MD [2]

Overview

Surgical options may need to be explored for those who do not respond to steroids. Re-perfusion of tissue can be achieved by large vessel reconstructive surgery such as bypass grafting.

Indications

Surgical intervention is recommended for the management of Takayasu’s arteritis. Indications for surgical repair or angioplasty are as follow:^[1]
- Renovascular stenosis causing hypertension
- Coronary artery stenosis leading to myocardial ischemia
- Extremity claudication induced by routine activity
- Cerebral ischemia
- Critical stenosis of 3 or more cerebral vessels
- Aortic regurgitation
- Thoracic or abdominal aneurysms larger than 5 cm in diameter
- Severe coarctation of the aorta

Surgery

Surgery is not the first-line treatment option for patients with Takayasu’s arteritis.
Different surgical techniques might be used in patients with severe stenotic lesions during periods of remission such as:
- Bypass graft surgery
- Angioplasty
- Surgical revascularization

References

↑ Arend WP, Michel BA, Bloch DA, Hunder GG, Calabrese LH, Edworthy SM, Fauci AS, Leavitt RY, Lie JT, Lightfoot RW (August 1990). “The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis”. Arthritis Rheum. 33 (8): 1129–34. PMID 1975175.

[pmid1975175-1] Arend WP, Michel BA, Bloch DA, Hunder GG, Calabrese LH, Edworthy SM, Fauci AS, Leavitt RY, Lie JT, Lightfoot RW (August 1990). “The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis”. Arthritis Rheum. 33 (8): 1129–34. PMID 1975175.

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