Long-term Patency and Complications of Endovascular and Surgical Revascularization for Takayasu Arteritis
Purpose: Takayasu arteritis (TAK) is a rare form of chronic vasculitis that is common in Asian female. As TAK predominantly affects young female with a longer life expectancy than those with atherosclerotic diseases, assessing the specific long-term outcomes of TAK treatment is important. Therefore,...
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| Format: | Article |
| Language: | English |
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Medrang
2024-12-01
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| Series: | Vascular Specialist International |
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| Online Access: | http://www.vsijournal.org/journal/view.html?doi=10.5758/vsi.240090 |
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| author | Jiyoung Shin Ara Cho Ahram Han Sanghyun Ahn Sangil Min Seung-Kee Min |
| author_facet | Jiyoung Shin Ara Cho Ahram Han Sanghyun Ahn Sangil Min Seung-Kee Min |
| author_sort | Jiyoung Shin |
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| description | Purpose: Takayasu arteritis (TAK) is a rare form of chronic vasculitis that is common in Asian female. As TAK predominantly affects young female with a longer life expectancy than those with atherosclerotic diseases, assessing the specific long-term outcomes of TAK treatment is important. Therefore, this study aimed to evaluate the long-term outcomes and post-procedural complications of surgical and endovascular treatment for TAK. Materials and Methods : This single-center retrospective observational study reviewed 545 consecutive patients diagnosed with TAK between 1983 and 2020 at Seoul National University Hospital. Of these, 56 patients who underwent 73 extracardiac interventions were enrolled in the study. The data included clinical features, angiographic and laboratory findings, treatment modalities, and clinical outcomes. Results : The mean age of the participants was 40.3±20.3 years, with a predominance of female (75.0%). The mean follow-up duration was 147.7±111.6 months. The most common comorbidity was hypertension (n=42, 75.0%), followed by heart failure (n=12, 21.4%). The most frequent symptom of TAK was uncontrolled hypertension (n=36, 64.3%). The renal artery (n=23, 31.5%) was the most frequently revascularized vessel, followed by the supra-aortic branches, including the innominate, subclavian, vertebral, and carotid arteries (n=19; 26.0%). In the endovascular group, the primary patency rates at 5, 10, and 20 years were 42.2%, 31.7%, and 17.0%, respectively. The rates in the surgical group were 84.4%, 75.7%, and 59.0%, respectively. This difference was statistically significant (P<0.001). The difference in the secondary patency rates between the two groups was not statistically significant. The most common early complication (≤1 month) was arterial dissection (n=4, 5.5%), whereas the most prevalent late complication (>1 month) was restenosis, which occurred significantly more frequently in the endovascular group than in the surgical group (55.0% vs. 12.1%, P<0.001). Conclusion : Surgical and endovascular treatments for TAK are safe. However, restenosis develops more frequently after endovascular treatment compared to surgical treatment, particularly within the first three years. Increased periodic serial monitoring is recommended during this period. |
| format | Article |
| id | doaj-art-6464ae38efba47cb9cbd137a02b5bf5a |
| institution | Kabale University |
| issn | 2288-7970 2288-7989 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Medrang |
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| series | Vascular Specialist International |
| spelling | doaj-art-6464ae38efba47cb9cbd137a02b5bf5a2025-01-03T12:08:11ZengMedrangVascular Specialist International2288-79702288-79892024-12-014010.5758/vsi.240090vsi.240090Long-term Patency and Complications of Endovascular and Surgical Revascularization for Takayasu ArteritisJiyoung Shin0Ara Cho1Ahram Han2Sanghyun Ahn3Sangil Min4Seung-Kee Min5Division of Vascular Surgery, National Health Insurance Service Ilsan Hospital, Goyang, KoreaDivision of Vascular Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, KoreaDivision of Vascular Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, KoreaDivision of Vascular Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, KoreaDivision of Vascular Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, KoreaDivision of Vascular Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, KoreaPurpose: Takayasu arteritis (TAK) is a rare form of chronic vasculitis that is common in Asian female. As TAK predominantly affects young female with a longer life expectancy than those with atherosclerotic diseases, assessing the specific long-term outcomes of TAK treatment is important. Therefore, this study aimed to evaluate the long-term outcomes and post-procedural complications of surgical and endovascular treatment for TAK. Materials and Methods : This single-center retrospective observational study reviewed 545 consecutive patients diagnosed with TAK between 1983 and 2020 at Seoul National University Hospital. Of these, 56 patients who underwent 73 extracardiac interventions were enrolled in the study. The data included clinical features, angiographic and laboratory findings, treatment modalities, and clinical outcomes. Results : The mean age of the participants was 40.3±20.3 years, with a predominance of female (75.0%). The mean follow-up duration was 147.7±111.6 months. The most common comorbidity was hypertension (n=42, 75.0%), followed by heart failure (n=12, 21.4%). The most frequent symptom of TAK was uncontrolled hypertension (n=36, 64.3%). The renal artery (n=23, 31.5%) was the most frequently revascularized vessel, followed by the supra-aortic branches, including the innominate, subclavian, vertebral, and carotid arteries (n=19; 26.0%). In the endovascular group, the primary patency rates at 5, 10, and 20 years were 42.2%, 31.7%, and 17.0%, respectively. The rates in the surgical group were 84.4%, 75.7%, and 59.0%, respectively. This difference was statistically significant (P<0.001). The difference in the secondary patency rates between the two groups was not statistically significant. The most common early complication (≤1 month) was arterial dissection (n=4, 5.5%), whereas the most prevalent late complication (>1 month) was restenosis, which occurred significantly more frequently in the endovascular group than in the surgical group (55.0% vs. 12.1%, P<0.001). Conclusion : Surgical and endovascular treatments for TAK are safe. However, restenosis develops more frequently after endovascular treatment compared to surgical treatment, particularly within the first three years. Increased periodic serial monitoring is recommended during this period.http://www.vsijournal.org/journal/view.html?doi=10.5758/vsi.240090takayasu arteritisvasculitisendovascular proceduresvascular surgeryvascular patency |
| spellingShingle | Jiyoung Shin Ara Cho Ahram Han Sanghyun Ahn Sangil Min Seung-Kee Min Long-term Patency and Complications of Endovascular and Surgical Revascularization for Takayasu Arteritis Vascular Specialist International takayasu arteritis vasculitis endovascular procedures vascular surgery vascular patency |
| title | Long-term Patency and Complications of Endovascular and Surgical Revascularization for Takayasu Arteritis |
| title_full | Long-term Patency and Complications of Endovascular and Surgical Revascularization for Takayasu Arteritis |
| title_fullStr | Long-term Patency and Complications of Endovascular and Surgical Revascularization for Takayasu Arteritis |
| title_full_unstemmed | Long-term Patency and Complications of Endovascular and Surgical Revascularization for Takayasu Arteritis |
| title_short | Long-term Patency and Complications of Endovascular and Surgical Revascularization for Takayasu Arteritis |
| title_sort | long term patency and complications of endovascular and surgical revascularization for takayasu arteritis |
| topic | takayasu arteritis vasculitis endovascular procedures vascular surgery vascular patency |
| url | http://www.vsijournal.org/journal/view.html?doi=10.5758/vsi.240090 |
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