Long-term successfully endovascular treatment of a complicated Takayasu’s arteritis with thrombectomy and stenting: a case report

Abstract Background Takayasu arteritis is a rare form of large-vessel vasculitis primarily affecting the aorta and its major branches, with a higher prevalence in young women. This inflammatory disease can lead to significant complications, including ischemic stroke and transient ischemic attacks, t...

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Main Authors: Claudio Chirico, Andrea Giorgianni, Veronica Clivio, Silvia Malnati, Tonia Gatta, Francesco Alberto Vizzari, Carlo Pellegrino, Massimo Fusco, Filippo Piacentino, Massimo Venturini, Federico Fontana
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Journal of Medical Case Reports
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Online Access:https://doi.org/10.1186/s13256-024-04989-z
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author Claudio Chirico
Andrea Giorgianni
Veronica Clivio
Silvia Malnati
Tonia Gatta
Francesco Alberto Vizzari
Carlo Pellegrino
Massimo Fusco
Filippo Piacentino
Massimo Venturini
Federico Fontana
author_facet Claudio Chirico
Andrea Giorgianni
Veronica Clivio
Silvia Malnati
Tonia Gatta
Francesco Alberto Vizzari
Carlo Pellegrino
Massimo Fusco
Filippo Piacentino
Massimo Venturini
Federico Fontana
author_sort Claudio Chirico
collection DOAJ
description Abstract Background Takayasu arteritis is a rare form of large-vessel vasculitis primarily affecting the aorta and its major branches, with a higher prevalence in young women. This inflammatory disease can lead to significant complications, including ischemic stroke and transient ischemic attacks, though large-vessel occlusion stroke is an uncommon initial manifestation. Diagnosis relies heavily on vascular imaging, and treatment typically involves high-dose glucocorticoids, revascularization procedures, and close monitoring for restenosis, which occurs frequently after interventions. Case presentation This case report describes a 38-year-old North African woman who presented with acute left-sided hemiparesis and visual disturbances due to large-vessel occlusion involving the common carotid artery and middle cerebral artery. Mechanical thrombectomy and stenting were performed successfully, resulting in complete recanalization without complications. The patient was later diagnosed with Takayasu arteritis, and this was managed with high-dose corticosteroids. During a 2-year follow-up, no complications such as restenosis or re-occlusion were observed, and the patient remained in good health. Conclusion This case is notable for the successful use of dual mechanical thrombectomy and stenting in the acute management of stroke in Takayasu arteritis without short- or long-term complications, a rare outcome not commonly reported in the literature. It highlights the potential efficacy of this approach in carefully selected patients, suggesting that postoperative immunosuppressive therapy may reduce the incidence of restenosis.
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spelling doaj-art-d4caf0eaa58d4eddbdd97c59718556832025-08-20T01:47:32ZengBMCJournal of Medical Case Reports1752-19472025-05-011911710.1186/s13256-024-04989-zLong-term successfully endovascular treatment of a complicated Takayasu’s arteritis with thrombectomy and stenting: a case reportClaudio Chirico0Andrea Giorgianni1Veronica Clivio2Silvia Malnati3Tonia Gatta4Francesco Alberto Vizzari5Carlo Pellegrino6Massimo Fusco7Filippo Piacentino8Massimo Venturini9Federico Fontana10Diagnostic and Interventional Neuroradiology Unit, Circolo Hospital, ASST SetteLaghiDiagnostic and Interventional Neuroradiology Unit, Circolo Hospital, ASST SetteLaghiDepartment of Medicine and Technological Innovation, Insubria UniversityDepartment of Medicine and Technological Innovation, Insubria UniversityDepartment of Medicine and Technological Innovation, Insubria UniversityDiagnostic and Interventional Neuroradiology Unit, Circolo Hospital, ASST SetteLaghiDiagnostic and Interventional Neuroradiology Unit, Circolo Hospital, ASST SetteLaghiDiagnostic and Interventional Neuroradiology Unit, Circolo Hospital, ASST SetteLaghiDiagnostic and Interventional Radiology Unit, Circolo Hospital, ASST SetteLaghiDepartment of Medicine and Technological Innovation, Insubria UniversityDepartment of Medicine and Technological Innovation, Insubria UniversityAbstract Background Takayasu arteritis is a rare form of large-vessel vasculitis primarily affecting the aorta and its major branches, with a higher prevalence in young women. This inflammatory disease can lead to significant complications, including ischemic stroke and transient ischemic attacks, though large-vessel occlusion stroke is an uncommon initial manifestation. Diagnosis relies heavily on vascular imaging, and treatment typically involves high-dose glucocorticoids, revascularization procedures, and close monitoring for restenosis, which occurs frequently after interventions. Case presentation This case report describes a 38-year-old North African woman who presented with acute left-sided hemiparesis and visual disturbances due to large-vessel occlusion involving the common carotid artery and middle cerebral artery. Mechanical thrombectomy and stenting were performed successfully, resulting in complete recanalization without complications. The patient was later diagnosed with Takayasu arteritis, and this was managed with high-dose corticosteroids. During a 2-year follow-up, no complications such as restenosis or re-occlusion were observed, and the patient remained in good health. Conclusion This case is notable for the successful use of dual mechanical thrombectomy and stenting in the acute management of stroke in Takayasu arteritis without short- or long-term complications, a rare outcome not commonly reported in the literature. It highlights the potential efficacy of this approach in carefully selected patients, suggesting that postoperative immunosuppressive therapy may reduce the incidence of restenosis.https://doi.org/10.1186/s13256-024-04989-zTakayasu arteritisVasculitisCTANIHSSTIAStroke
spellingShingle Claudio Chirico
Andrea Giorgianni
Veronica Clivio
Silvia Malnati
Tonia Gatta
Francesco Alberto Vizzari
Carlo Pellegrino
Massimo Fusco
Filippo Piacentino
Massimo Venturini
Federico Fontana
Long-term successfully endovascular treatment of a complicated Takayasu’s arteritis with thrombectomy and stenting: a case report
Journal of Medical Case Reports
Takayasu arteritis
Vasculitis
CTA
NIHSS
TIA
Stroke
title Long-term successfully endovascular treatment of a complicated Takayasu’s arteritis with thrombectomy and stenting: a case report
title_full Long-term successfully endovascular treatment of a complicated Takayasu’s arteritis with thrombectomy and stenting: a case report
title_fullStr Long-term successfully endovascular treatment of a complicated Takayasu’s arteritis with thrombectomy and stenting: a case report
title_full_unstemmed Long-term successfully endovascular treatment of a complicated Takayasu’s arteritis with thrombectomy and stenting: a case report
title_short Long-term successfully endovascular treatment of a complicated Takayasu’s arteritis with thrombectomy and stenting: a case report
title_sort long term successfully endovascular treatment of a complicated takayasu s arteritis with thrombectomy and stenting a case report
topic Takayasu arteritis
Vasculitis
CTA
NIHSS
TIA
Stroke
url https://doi.org/10.1186/s13256-024-04989-z
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