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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 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.

Authors+Show Affiliations

Eastern Virginia Medical School, Division of Vascular Surgery, Norfolk, VA.Eastern Virginia Medical School, Division of Vascular Surgery, Norfolk, VA. Electronic address: rathore.animesh@gmail.com.Eastern Virginia Medical School, Division of Vascular Surgery, Norfolk, VA.Eastern Virginia Medical School, Division of Vascular Surgery, Norfolk, VA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31629850

Citation

Varzari, Alexander, et al. "Staged Combined Endovascular and Open Surgical Approach in a Patient With Takayasu's Arteritis." Annals of Vascular Surgery, 2019.
Varzari A, Rathore A, Shah RM, et al. Staged combined endovascular and open surgical approach in a patient with Takayasu's arteritis. Ann Vasc Surg. 2019.
Varzari, A., Rathore, A., Shah, R. M., & Panneton, J. M. (2019). Staged combined endovascular and open surgical approach in a patient with Takayasu's arteritis. Annals of Vascular Surgery, doi:10.1016/j.avsg.2019.09.019.
Varzari A, et al. Staged Combined Endovascular and Open Surgical Approach in a Patient With Takayasu's Arteritis. Ann Vasc Surg. 2019 Oct 17; PubMed PMID: 31629850.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Staged combined endovascular and open surgical approach in a patient with Takayasu's arteritis. AU - Varzari,Alexander, AU - Rathore,Animesh, AU - Shah,Rasesh M, AU - Panneton,Jean M, Y1 - 2019/10/17/ PY - 2019/07/25/received PY - 2019/09/09/revised PY - 2019/09/13/accepted PY - 2019/10/21/entrez PY - 2019/10/21/pubmed PY - 2019/10/21/medline JF - Annals of vascular surgery JO - Ann Vasc Surg N2 - 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 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. SN - 1615-5947 UR - https://www.unboundmedicine.com/medline/citation/31629850/Staged_combined_endovascular_and_open_surgical_approach_in_a_patient_with_Takayasu's_arteritis L2 - https://linkinghub.elsevier.com/retrieve/pii/S0890-5096(19)30857-X DB - PRIME DP - Unbound Medicine ER -