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Endovascular Therapy Combined With Immunosuppressive Treatment for Occlusive Arterial Disease in Patients With Takayasu's Arteritis

 Pil-Ki Min  ;  Sungha Park  ;  Jae-Hun Jung  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Won-Heum Shim 
 JOURNAL OF ENDOVASCULAR THERAPY, Vol.12(1) : 28-34, 2005 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Angiography/methods ; Angioplasty, Balloon/methods* ; Arterial Occlusive Diseases/complications ; Arterial Occlusive Diseases/diagnostic imaging ; Arterial Occlusive Diseases/therapy* ; Child ; Cohort Studies ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents/therapeutic use* ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Stents* ; Takayasu Arteritis/complications ; Takayasu Arteritis/diagnostic imaging ; Takayasu Arteritis/therapy* ; Treatment Outcome
Takayasu's arteritis ; vasculitis ; angioplasty ; stents ; immunosuppressive agents
PURPOSE: To evaluate the feasibility and efficacy of endovascular therapy combined with immunosuppression for the treatment of arterial occlusive disease in patients with Takayasu's arteritis (TA). METHODS: From January 1998 to June 2003, 25 patients (22 women; age 37.8+/-15.5 years) with TA were treated with angioplasty for symptomatic lesions or with a hemodynamically significant aortic narrowing. The patients with active disease, defined as an increase in inflammatory markers (e.g., erythrocyte sedimentation rate [ESR]), were treated with immunosuppressive agents before intervention. Angioplasty was performed after the ESR had been normalized. RESULTS: In the 25 patients, 58 vascular territories (7 aortic, 9 carotid, 3 vertebral, 11 subclavian, 2 superior mesenteric, 18 renal, 4 iliac, and 4 coronary arteries) were treated with angioplasty only (19 lesions) or with stents (39 lesions). The mean ESR when the vascular lesions were initially diagnosed was 35.6+/-26.2 mm/h, which fell to 18.5+/-7.8 mm/h after immunosuppressive therapy. The endovascular procedure was performed successfully in 52 (90%) of 58 lesions. During the mean 23.7+/-18.4-month follow-up, 9 (17%) treated segments restenosed; 4 were treated with repeat angioplasty. The overall cumulative primary clinical success rate was 82%; secondary clinical success was 90%. CONCLUSIONS: Endovascular therapy for stenotic lesions in patients with TA is safe and effective when disease activity is strictly controlled with immunosuppressive treatment.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Min, Pil Ki(민필기) ORCID logo https://orcid.org/0000-0001-7033-7651
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Shim, Won Heum(심원흠)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Jung, Jae Hun(정재헌)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
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