Surgical intervention and its role in Takayasu arteritis
File(s)
Accepted version
Author(s)
Mason, JC
Type
Journal Article
Abstract
Vascular surgery remains an important option in the management of Takayasu arteritis (TA). Its use is predominantly confined to the treatment of symptomatic organ ischaemia or life-threatening aneurysm formation. In most cases, this follows the failure of medical therapy to prevent arterial injury. Open surgery and endovascular approaches are used. The choice between them, at least in part, is determined by the site and nature of the lesion. Open surgery, although more invasive, offers enhanced duration of arterial patency, whereas for endovascular intervention, primary angioplasty without stenting is preferred, with stenting reserved for primary or secondary angioplasty failures. Although there is increasing interest in the role of stent grafts and tailor-made endovascular stents, long-term outcomes remain to be reported. Interventional outcomes are improved and complications reduced by therapeutic control of disease activity before and after surgery. The wider use of combined immunosuppression and the introduction of biologic therapy for refractory TA may reduce future requirements for surgical intervention.
Date Issued
2018-08-17
Date Acceptance
2018-07-25
Citation
Best Practice and Research: Clinical Rheumatology, 2018, 32 (1), pp.112-124
ISSN
1521-6942
Publisher
Elsevier
Start Page
112
End Page
124
Journal / Book Title
Best Practice and Research: Clinical Rheumatology
Volume
32
Issue
1
Copyright Statement
© 2018 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor
National Institute for Health Research
Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
Grant Number
RDA07 79560
RDC04 79560
RDA28
Subjects
Science & Technology
Life Sciences & Biomedicine
Rheumatology
Takayasu arteritis
Endovascular
Open surgery
Angioplasty
Restenosis
Stenting
Stent grafts
PERCUTANEOUS CORONARY INTERVENTION
LONG-TERM OUTCOMES
ENDOVASCULAR TREATMENT
IMMUNOSUPPRESSIVE TREATMENT
ANGIOGRAPHIC FINDINGS
AORTIC-ANEURYSM
CT ANGIOGRAPHY
DISEASE
STENOSIS
ANGIOPLASTY
Angioplasty
Endovascular
Open surgery
Restenosis
Stent grafts
Stenting
Takayasu arteritis
Angioplasty
Humans
Takayasu Arteritis
Treatment Outcome
Humans
Treatment Outcome
Angioplasty
Takayasu Arteritis
Arthritis & Rheumatology
1103 Clinical Sciences
Notes
Published online 17 August 2018. Published date of issue is 1 February 2018
Publication Status
Published
Date Publish Online
2018-08-17