1
|
The Role of Cardiovascular Magnetic Resonance in Inflammatory Arthropathies and Systemic Rheumatic Diseases. CURRENT RADIOLOGY REPORTS 2020. [DOI: 10.1007/s40134-020-0346-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
2
|
Ziadi J, Ben Hammamia M, Sobhi M, Ben Mrad M, Denguir R. [Revascularization of supra-aortic trunks in Takayasu's arteritis]. JOURNAL DE MÉDECINE VASCULAIRE 2019; 44:260-265. [PMID: 31213298 DOI: 10.1016/j.jdmv.2019.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 04/08/2019] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Takayasu's disease is an inflammatory arteritis mainly affecting the aorta, its main divisional branches and pulmonary arteries. The arterial damage during Takayasu's disease is essentially occlusive and preferentially affects supra-aortic trunks. Indications for revascularization of supra-aortic trunks are clear but results are rarely reported. The purpose of this study was to evaluate the results of supra-aortic trunk revascularization in Takayasu's arteritis. PATIENTS AND METHODS We report a retrospective study conducted between 2012 and 2018 about patients with Takayasu's arteritis who underwent revascularization of supra-aortic trunks. RESULTS Our series consisted of six patients. All patients were female. The average age was 29 (range 18-48) years. The operative indication was cerebrovascular ischemic symptoms in five patients and intermittent claudication of the upper limb in one. We performed aorto-bi-carotid bypass in four patients, a subclavian artery angioplasty in one and a vertebral artery angioplasty in one. At 1 month, operative mortality was zero and morbidity was marked by hemorrhagic stroke in one patient operated by conventional surgery. The average follow-up was 4 years (1.8). During the follow-up, one patient was reoperated after 18 months for an anastomotic false aneurysm in the ascending aorta. We noted a favorable outcome with total resolution of the symptomatology for the other patients and Doppler ultrasound confirmed patency during follow-up. CONCLUSION Surgical revascularization of supra-aortic trunks in Takayasu's arteritis can be associated with a risk of stroke and a risk of anastomotic pseudoaneurysms. Endovascular revascularization appears to be less invasive but its long-term results are rarely reported.
Collapse
Affiliation(s)
- Jalel Ziadi
- Service de chirurgie cardiovasculaire, La Rabta, Tunis, Tunisie
| | | | - Mleyhi Sobhi
- Service de chirurgie cardiovasculaire, La Rabta, Tunis, Tunisie
| | - Malek Ben Mrad
- Service de chirurgie cardiovasculaire, La Rabta, Tunis, Tunisie
| | - Raouf Denguir
- Service de chirurgie cardiovasculaire, La Rabta, Tunis, Tunisie
| |
Collapse
|
3
|
Large-Vessel Vasculitides. Clin Immunol 2019. [DOI: 10.1016/b978-0-7020-6896-6.00059-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
4
|
Liu M, Liu W, Li H, Shu X, Tao X, Zhai Z. Evaluation of takayasu arteritis with delayed contrast-enhanced MR imaging by a free-breathing 3D IR turbo FLASH. Medicine (Baltimore) 2017; 96:e9284. [PMID: 29390488 PMCID: PMC5758190 DOI: 10.1097/md.0000000000009284] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The primary aim of our case-control study was to observe delayed contrast-enhanced magnetic resonance imaging (DCE-MRI) in patients with Takayasu arteritis (TA) in comparison with magnetic resonance angiography (MRA). Twenty-seven patients including 15 with active TA and 12 with stable TA who underwent both aortic MRA and DCE-MRI were included. A total of 27 sex- and age-matched healthy volunteers were enrolled as the control group. MRA were obtained with T1WI-volume-interpolated breath-hold examination sequence or fast low-angle shot (FLASH) sequence. DCE-MRI was acquired with a free-breathing three-dimensional inversion recovery Turbo fast low-angle shot (3D IR Turbo FLASH). Neither stenosis nor delayed enhancement of arterial wall was shown in the control group. In patients with stable TA, arterial stenosis was observed on MRA. On DCE-MR, delayed enhancement of arterial walls could be observed in the active TA group but not in the stable TA group or the control group. Stenotic arteries on MRA were comparable in the active TA and stable TA (χ = 2.70, P = .259); however, delayed enhancement of arterial walls in the active-TA group were more than those in the stable group (χ = 27.00, P < .001). Our results suggest that DCE-MRI with the free-breathing 3D IR Turbo FLASH sequence could assess TA and delayed enhancement on DCE-MRI is one characteristics of the active TA.
Collapse
Affiliation(s)
| | | | | | | | - Xincao Tao
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Zhenguo Zhai
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
| |
Collapse
|
5
|
Abstract
In this chapter we review the optimal imaging modalities for subacute and chronic stroke. We discuss the utility of computed tomography (CT) and multimodal CT imaging. Further, we analyze the importance of specific magnetic resonance imaging sequences, such as diffusion-weighted imaging for acute ischemic stroke, T2/fluid-attenuated inversion recovery for subacute and chronic stroke, and susceptibility imaging for detection of intracranial hemorrhages. Different ischemic stroke mechanisms are reviewed, and how these imaging modalities may aid in the determination of such. Further, we analyze how topographic patterns in ischemic stroke may provide important clues to the diagnosis, in addition to the temporal evolution of the stroke. Lastly, specific cerebrovascular occlusive diseases are reviewed, with emphasis on the optimal imaging modalities and their findings in each condition.
Collapse
|
6
|
Dubrey SW, Grocott-Mason R, Ghonim S, Mittal T. Takayasu's arteritis in an active man: burnt out or quiescent? Br J Hosp Med (Lond) 2015; 76:364-5. [PMID: 26053909 DOI: 10.12968/hmed.2015.76.6.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Simon W Dubrey
- Consultant Cardiologist, Hillingdon Hospital, Uxbridge, Middlesex UB8 3NN
| | | | - Sarah Ghonim
- Cardiology Specialist Registrar in the Department of Cardiology, Hillingdon Hospital, Uxbridge, Middlesex UB8 3NN
| | - Tarun Mittal
- Consultant Radiologist in the Department of Radiology, Royal Brompton and Harefield Hospitals, Harefield Hospital, Harefield, Middlesex
| |
Collapse
|
7
|
Jeon CH, Kim YK, Chun EJ, Kim JA, Yong HS, Doo KW, Choi SI. Coronary artery vasculitis: assessment with cardiac multi-detector computed tomography. Int J Cardiovasc Imaging 2015; 31 Suppl 1:59-67. [DOI: 10.1007/s10554-015-0652-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 03/23/2015] [Indexed: 10/23/2022]
|
8
|
Ammirati E, Moroni F, Pedrotti P, Scotti I, Magnoni M, Bozzolo EP, Rimoldi OE, Camici PG. Non-invasive imaging of vascular inflammation. Front Immunol 2014; 5:399. [PMID: 25183963 PMCID: PMC4135304 DOI: 10.3389/fimmu.2014.00399] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 08/05/2014] [Indexed: 11/16/2022] Open
Abstract
In large-vessel vasculitides, inflammatory infiltrates may cause thickening of the involved arterial vessel wall leading to progressive stenosis and occlusion. Dilatation, aneurysm formation, and thrombosis may also ensue. Activated macrophages and T lymphocytes are fundamental elements in vascular inflammation. The amount and density of the inflammatory infiltrate is directly linked to local disease activity. Additionally, patients with autoimmune disorders have an increased cardiovascular (CV) risk compared with age-matched healthy individuals as a consequence of accelerated atherosclerosis. Molecular imaging techniques targeting activated macrophages, neovascularization, or increased cellular metabolic activity can represent effective means of non-invasive detection of vascular inflammation. In the present review, novel non-invasive imaging tools that have been successfully tested in humans will be presented. These include contrast-enhanced ultrasonography, which allows detection of neovessels within the wall of inflamed arteries; contrast-enhanced CV magnetic resonance that can detect increased thickness of the arterial wall, usually associated with edema, or mural enhancement using T2 and post-contrast T1-weighted sequences, respectively; and positron emission tomography associated with radio-tracers such as [18F]-fluorodeoxyglucose and the new [11C]-PK11195 in combination with computed tomography angiography to detect activated macrophages within the vessel wall. Imaging techniques are useful in the diagnostic work-up of large- and medium-vessel vasculitides, to monitor disease activity and the response to treatments. Finally, molecular imaging targets can provide new clues about the pathogenesis and evolution of immune-mediated disorders involving arterial vessels.
Collapse
Affiliation(s)
- Enrico Ammirati
- Cardiothoracic Department, San Raffaele Scientific Institute and University , Milan , Italy ; Cardiovascular and Thoracic Department, AO Ospedale Niguarda Ca' Granda , Milan , Italy
| | - Francesco Moroni
- Cardiothoracic Department, San Raffaele Scientific Institute and University , Milan , Italy
| | - Patrizia Pedrotti
- Cardiovascular and Thoracic Department, AO Ospedale Niguarda Ca' Granda , Milan , Italy
| | - Isabella Scotti
- Cardiothoracic Department, San Raffaele Scientific Institute and University , Milan , Italy
| | - Marco Magnoni
- Cardiothoracic Department, San Raffaele Scientific Institute and University , Milan , Italy
| | - Enrica P Bozzolo
- Unit of Medicine and Clinical Immunology, Department of Medicine, San Raffaele Scientific Institute and University , Milan , Italy
| | - Ornella E Rimoldi
- Cardiothoracic Department, San Raffaele Scientific Institute and University , Milan , Italy ; CNR Istituto di Bioimmagini e Fisiologia Molecolare , Segrate, Milan , Italy
| | - Paolo G Camici
- Cardiothoracic Department, San Raffaele Scientific Institute and University , Milan , Italy
| |
Collapse
|
9
|
Isobe M. Takayasu arteritis revisited: Current diagnosis and treatment. Int J Cardiol 2013; 168:3-10. [DOI: 10.1016/j.ijcard.2013.01.022] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 12/21/2012] [Accepted: 01/19/2013] [Indexed: 11/29/2022]
|
10
|
Abstract
Takayasu arteritis (TA) is a chronic nonspecific granulomatous vasculitis affecting aorta and its main branches, coronary and pulmonary arteries. TA often occurs in young women and has a characteristic heterogeneity depending on ethnicity and geographical location. Although the pathogenesis of TA remains unclear, the interaction of many factors, such as autoimmunity, inflammation, genetic and environmental factors and so on, is involved in the occurrence and development of TA. Angiography, which is recognized as the gold standard in evaluating vascular lesions in TA, combined with computer tomography angiography (CTA), magnetic resonance angiography (MRA), ultrasonography, (18)Fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET) could not only provide important information for early diagnosis but also detect disease activity, and thus further guide the treatment in TA. In addition, beside the commonly used corticosteroids, immunosuppressive agents, percutaneous transluminal angioplasty (PTA) and surgical revascularization, anti-tumor necrosis factor (TNF) agent has been more widely used in refractory cases of TA. The objective of this review is to systemically describe the pathogenesis, clinical characteristics, diagnosis, treatment and prognosis of TA.
Collapse
Affiliation(s)
- Dan Wen
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, China
| | | | | |
Collapse
|
11
|
Mavrogeni S, Dimitroulas T, Chatziioannou SN, Kitas G. The Role of Multimodality Imaging in the Evaluation of Takayasu Arteritis. Semin Arthritis Rheum 2013; 42:401-12. [DOI: 10.1016/j.semarthrit.2012.07.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Revised: 06/30/2012] [Accepted: 07/14/2012] [Indexed: 11/26/2022]
|
12
|
Weyand CM, Goronzy JJ. Large-vessel vasculitides. Clin Immunol 2013. [DOI: 10.1016/b978-0-7234-3691-1.00072-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
13
|
Keo HH, Caliezi G, Baumgartner I, Diehm N, Willenberg T. Increasing echogenicity of diffuse circumferential thickening ("macaroni sign") of the carotid artery wall with decreasing inflammatory activity of Takayasu arteritis. JOURNAL OF CLINICAL ULTRASOUND : JCU 2013; 41:59-62. [PMID: 22105177 DOI: 10.1002/jcu.20894] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 10/03/2011] [Indexed: 05/31/2023]
Abstract
We report a case of sonographic follow-up showing brightening of the diffuse circumferential thickening (halo) of the carotid artery wall (the so-called "macaroni sign") in a patient with decreasing inflammatory activity of Takayasu arteritis over a 6-month period. Sonographic follow-up in patients with Takayasu arteritis may be a useful complementary tool for evaluation of inflammatory activity. Besides a reduction of halo diameter, an increase in wall echogenicity appears to be a sign of decreasing inflammation.
Collapse
Affiliation(s)
- Hong H Keo
- Swiss Cardiovascular Center, Division of Angiology, Inselspital, University Hospital and University of Bern, Bern, Switzerland
| | | | | | | | | |
Collapse
|
14
|
Holloway BJ, Rosewarne D, Jones RG. Imaging of thoracic aortic disease. Br J Radiol 2012; 84 Spec No 3:S338-54. [PMID: 22723539 DOI: 10.1259/bjr/30655825] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Aortic pathology can be more complex to understand on imaging than is initially appreciated. There are a number of imaging modalities that provide excellent assessment of aortic pathology and enable the accurate monitoring of disease. This review discusses the imaging of the most common disease processes that affect the aorta in adults, with the primary focus being on CT and MRI.
Collapse
Affiliation(s)
- B J Holloway
- University Hospital Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK.
| | | | | |
Collapse
|
15
|
Takayasu Arteritis: Intravascular Contrast Medium for MR Angiography in the Evaluation of Disease Activity. AJR Am J Roentgenol 2012; 198:W279-84. [DOI: 10.2214/ajr.11.7360] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
16
|
Abstract
Takayasu arteritis, a rare granulomatous vasculitis affecting young people, is associated with considerable morbidity and premature mortality. In most patients the diagnosis is delayed until after the development of substantial arterial injury. Studies of noninvasive imaging techniques suggest that these approaches might facilitate earlier diagnosis and have a role in monitoring disease progress; however, they remain limited in their ability to accurately quantify inflammatory disease activity in the arterial wall. A lack of controlled clinical trial data complicates the choice of therapy for Takayasu arteritis, and clinical indices for monitoring disease activity are currently suboptimal. Increasing knowledge of the pathogenesis of the large vessel vasculitides might eventually lead to novel targeted therapies. Preliminary data from open-label trials of anti-tumor necrosis factor therapy are encouraging, but there is an urgent need for controlled clinical trials to establish optimum therapeutic approaches for this disease. These trials should include a prospective assessment of the use of noninvasive imaging modalities in the diagnosis and subsequent management of Takayasu arteritis.
Collapse
Affiliation(s)
- Justin C Mason
- Bywaters Centre for Vascular Inflammation, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 ONN, UK.
| |
Collapse
|
17
|
Keenan NG, Mason JC, Maceira A, Assomull R, O'Hanlon R, Chan C, Roughton M, Andrews J, Gatehouse PD, Firmin DN, Pennell DJ. Integrated cardiac and vascular assessment in Takayasu arteritis by cardiovascular magnetic resonance. ACTA ACUST UNITED AC 2009; 60:3501-9. [DOI: 10.1002/art.24911] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
18
|
[Takayasu arteritis in southern Tunisia: a study of 29 patients]. Presse Med 2009; 38:1410-4. [PMID: 19524396 DOI: 10.1016/j.lpm.2008.10.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Revised: 09/25/2008] [Accepted: 10/06/2008] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES This study aimed to assess the clinical, laboratory, and radiological features and course of Takayasu arteritis in Tunisia. METHODS This retrospective study analyzed 29 patients with Takayasu arteritis between 1996 and 2006 who met the criteria for inclusion proposed by the American College of Rheumatology (ACR). RESULTS The file review identified 25 women and 4 men, with a mean age at diagnosis of 35.4 years (range: 18-65 years). Our series included 93% with involvement of the aortic arch and its branches, while only 24% involved renal arteries and 21% the abdominal aorta. We had no case with cardiac or pulmonary involvement. In all, 67.7% had type I disease, 10.7% type IIb, 3.6% type IV and 25% type V. Hypertension was recorded in 38%. No tuberculosis was observed. In all, 22 patients (75.8%) had glucocorticoid treatment, and 5 (17.2%) needed immunosuppressive therapy. Two patients with renal artery stenosis had endoluminal angioplasty and four patients (13.7%) required surgical intervention. Our patients were followed for a mean period of 80 months. Disease remained stable in 18 patients (64.2%). CONCLUSION The clinical manifestations, angiographic data and course of our patients were similar to those in other reported series. We found no relation between Takayasu arteritis and tuberculosis.
Collapse
|
19
|
Peake ST, Mason JC, Mittal T, Amrani M, Mohiaddin R, Bell A, Grocott-Mason R, Dubrey SW. Growing pains--and a heart attack. Lancet 2008; 372:600. [PMID: 18707988 DOI: 10.1016/s0140-6736(08)61238-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Simon Tc Peake
- Department of Cardiology, Hillingdon Hospital, Uxbridge, Middlesex, UK
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Large-vessel vasculitides. Clin Immunol 2008. [DOI: 10.1016/b978-0-323-04404-2.10059-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
21
|
Abstract
The term vasculitis encompasses a number of distinct clinicopathologic disease entities. Final diagnosis should be supported by histologic study in most cases. However, different imaging modalities offer the potential for an early visualization of inflammatory vascular abnormalities, provide some diagnostic clues, and allow for an adequate assessment of therapeutic response. This review discusses recent advances in imaging techniques and refinements in vascular imaging methods, as well as a brief mention of research modalities that are increasingly used in studies of pathogenesis or in the assessment of disease progression.
Collapse
Affiliation(s)
- Luis M Amezcua-Guerra
- Instituto Nacional de Rehabilitación, Avenida México-Xochimilco 289, Colonia Arenal de Guadalupe, Mexico City, Mexico
| | | |
Collapse
|
22
|
Hamdan A, Porter A, Georghiou GP, Mulad Y, Raanani E, Hasdai D, Battler A, Assali AR. Unusual presentation of Takayasu arteritis. Int J Cardiol 2007; 119:249-50. [PMID: 17064787 DOI: 10.1016/j.ijcard.2006.07.136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2006] [Revised: 07/21/2006] [Accepted: 07/29/2006] [Indexed: 11/21/2022]
Abstract
Takayasu arteritis (TA) is an inflammatory arteritis involving large vessels, predominantly the aorta and its main branches. Angina pectoris or myocardial infarction may occur in 3-5% of patients. Symptomatic coronary artery disease may be in rare case the first sign of TA. We describe a case of a young woman in whom acute myocardial infarction and cardiogenic shock and stroke were the initial presentations of TA.
Collapse
|
23
|
El Mesnaoui A, Sedki N, Bouarhroum A, Sedki A, El Mahi O, Alaoui M, El Idrissi R, Sefiani Y, Lekehal B, Benjelloun A, Ammar F, Bensaïd Y. [Cerebral revascularisation in Takayasu's arteritis]. Ann Cardiol Angeiol (Paris) 2007; 56:130-6. [PMID: 17572173 DOI: 10.1016/j.ancard.2007.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2006] [Accepted: 02/19/2007] [Indexed: 05/15/2023]
Abstract
SUBJECT Supraaortic angioplasty is often not feasible in patients with Takayasu's arteritis because of involvement of long segment of arteries. Consequently, the role of surgical treatment in the management of cerebral ischemia is important in this disease. The objective of this work is to specify the indications and surgical techniques in lesions of arteries to the head in this disease and to report our experience. METHODS Seven patients with cervical arterial lesions due to Takayasu's arteritis were treated by bypass surgery in the department of vascular surgery, Ibn-Sina hospital on one period of 11 years. RESULTS It is about 6 women and one man of middle age at the time of the diagnosis of 33,8 years. The revealing signs were essentially of neurological and ocular order. Six of our patients were in inflammatory thrust at the time of the diagnosis, and required a medical treatment first to basis of corticosteroids. Bypasses from the ascending aorta to the carotid artery were performed in six cases. In one case, the bypass was performed between the brachiocephalic artery and common carotid artery. A death in relation with a cerebral hemorrhage occurred 2 days after the revascularisation. A clean improvement of the functional signs was noted among 3 patients, whereas the improvement was partial at two other. A secondary thrombosis of the bypass surgery occurred in 3 cases. CONCLUSION The natural history of Takayasu's arteritis and its evolution is badly known. The operative indications must not rest solely on the only anatomical balance, but based on a bundle of arguments in which, the assessment of the cerebral blood flow would be useful. Cerebral hyperperfusion syndrom constitutes a major risk that can be reduced by staged revascularisations.
Collapse
Affiliation(s)
- A El Mesnaoui
- Service de chirurgie vasculaire, hôpital Ibn-Sina, Rabat, Maroc
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Yang J, Yang L, Zhang J, Zheng M, Zhao H, Yi D. Patent carotid arteries with nearly occluded aortic arch in Takayasu's arteritis demonstrated by multidetector-row computed tomography. Int J Cardiol 2007; 118:e11-2. [PMID: 17367881 DOI: 10.1016/j.ijcard.2006.11.212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2006] [Accepted: 11/21/2006] [Indexed: 11/19/2022]
|