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Early and long-term results of subclavian angioplasty in aortoarteritis (takayasu disease): Comparison with atherosclerosis

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Abstract

Purpose: To compare the early and long-term outcomes of subclavian artery angioplasty in patients with aortoarteritis and atherosclerosis.

Methods: Sixty-one subclavian artery angioplasties were performed in 55 consecutive patients with aortoarteritis (n=32) and atherosclerosis (n=23) between 1986 and 1995. An arch aortogram followed by a selective subclavian artery angiogram was done to profile the site and extent of the lesion, its relation to the vertebral artery, and the distal circulation. Percutaneous transluminal angioplasty (PTA) was performed via the femoral route for 56 stenotic lesions and 5 total occlusions.

Results: PTA was successful in 52 (92.8%) stenotic lesions and 3 (60%) total occlusions. Three patients (5.4%) had complications, that could be effectively managed nonsurgically. Compared with atherosclerosis, patients with aortoarteritis were younger (27.4±9.3 years vs 54.5±10.5 years; p<0.001), more often female (75% vs 17.4%; p<0.001), gangrene was uncommon (0% vs 17.4%; p<0.05), and diffuse involvement was seen more often (43.8% vs 4.4%; p<0.001). The luminal diameter stenoses were similar before PTA (88.6±9.7% vs 89.0±9.1%; p=NS). Higher balloon inflation pressure was required to dilate the lesions of aortoarteritis (9.9±4.6 ATM vs 5.5±1.0 ATM; p<0.001). This group had more residual stenosis (15.5±12.4% vs 8.3±9.4%; p<0.05) after PTA. There were no neurological sequelae, even in PTA of prevertebral lesions. On 3–120 months (mean 43.3±28.9 months) follow-up of 40 patients, restenosis was more often observed in patients with aortoarteritis, particularly in those with diffuse arterial narrowing. These lesions could be effectively redilated. Clinical symptoms showed marked improvement after successful angioplasty.

Conclusion: Subclavian PTA is safe and can be performed as effectively in aortoarteritis as in atherosclerosis, with good long-term results. Long-term follow-up shows that it provides good symptomatic relief.

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References

  1. Bachman DM, Kim RM (1980) Transluminal dilatation for subclavian syndrome. AJR 135:995–996

    PubMed  CAS  Google Scholar 

  2. Motarjeme A, Keifer JW, Zuska AJ, Nabawi MD (1985) Percutaneous transluminal angioplasty for treatment of subclavian steal. Radiology 155:611–613

    PubMed  CAS  Google Scholar 

  3. Erbstein RA, Wholey MH, Smoot S (1988) Subclavian artery steal syndrome: Treatment of percutaneous transluminal angioplasty. AJR 151:291–294

    PubMed  CAS  Google Scholar 

  4. Becker CJ, Katzen BT, Date MD (1989) Noncoronary angioplasty. Radiology 170:921–940

    PubMed  CAS  Google Scholar 

  5. Millaire A, Trinca M, Marache P, Pascalde Groote PD, Jabinet JL, Ducloux G (1993) Subclavian angioplasty: Immediate and late results in 50 patients. Cathet Cardiovasc Diagn 29:8–17

    Article  PubMed  CAS  Google Scholar 

  6. Bogey WM, Demasi RJ, Tripp MD, Vithalani R, Johnsrude IS, Powell SC (1994) Percutaneous transluminal angioplasty for subclavian artery stenosis. Ann Surg 60:103–106

    CAS  Google Scholar 

  7. Joseph S, Mandalam KR, Rao VR, Gupta AK, Unni NM, Rao AS, Neelakandhan KS, Unnikrishnan M, Sandhyamani S (1994) Percutaneous transluminal angioplasty of the subclavian artery in nonspecific aortoarteritis: Results of long-term follow-up. J Vasc Interv Radiol 5:573–580

    Article  PubMed  CAS  Google Scholar 

  8. Thompson BW, Read RC, Campbell GS (1980) Operative correction of proximal blocks of the subclavian or innominate arteries. J Cardiovasc Surg 21:125–130

    CAS  Google Scholar 

  9. Vogt DP, Hertzer NR, O’Hara PJ, Benen EG (1982) Brachiocephalic artery reconstruction. Ann Surg 196:541–552

    Article  PubMed  CAS  Google Scholar 

  10. Perler BA, Williams GM (1990) Carotid subclavian bypass: A decade of experience. J Vasc Surg 12:716–720

    Article  PubMed  CAS  Google Scholar 

  11. Branchereau A, Magnan PE, Espinoza H, Bartoli JM (1991) Subclavian artery stenosis: Hemodynamic aspects and surgical outcome. J Cardiovasc Surg 32:604–612

    CAS  Google Scholar 

  12. Ringlestein EB, Zeumer H (1984) Delayed reversal of vertebral artery blood flow following percutaneous transluminal angioplasty for subclavian steal syndrome. Neuroradiology 26:189–192

    Article  Google Scholar 

  13. Tyagi S, Kaul UA, Nair M, Sethi KK, Arora R, Khalillah M (1992) Balloon angioplasty of the aorta in Takayasu’s arteritis: Initial and long-term results. Am Heart J 124:876–882

    Article  PubMed  CAS  Google Scholar 

  14. Tyagi S, Singh B, Kaul UA, Sethi KK, Arora R, Khalilullah M (1993) Balloon angioplasty for renovascular hypertension in Takayasu’s arteritis. Am Heart J 125:1386–1393

    Article  PubMed  CAS  Google Scholar 

  15. Tyagi S, Kaul UA, Satsangi DK, Arora R (1997) Percutaneous transluminal angioplasty for renovascular hypertension in children: Initial and long-term results. Pediatrics 99:44–49

    Article  PubMed  CAS  Google Scholar 

  16. Virmani R, Lande A, McAllister HA Jr (1986) Pathological aspects of Takayasu’s arteritis. In: Lande A, Berkman YM, McAllister HA Jr (eds) Aortitis: Clinical, Pathological and Radiographic Aspects. Raven Press, New York, pp 55–79

    Google Scholar 

  17. Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, Hoffman GG (1994) Takayasu arteritis. Ann Intern Med 120:919–929

    PubMed  CAS  Google Scholar 

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Tyagi, S., Verma, P.K., Gambhir, D.S. et al. Early and long-term results of subclavian angioplasty in aortoarteritis (takayasu disease): Comparison with atherosclerosis. Cardiovasc Intervent Radiol 21, 219–224 (1998). https://doi.org/10.1007/s002709900248

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