Endovascular Versus Open Surgical Intervention in Patients with Takayasu's Arteritis: A Meta-analysis

Saqi

et al. 2020

Cureus

Section: Discussionmentioning

confidence: 99%

Catastrophic Cardiac Complications of Takayasu’s Arteritis

Saqi

et al. 2020

Cureus

“…A recent meta-analysis included 770 patients and 1363 lesions. Of these, 389 patients were treated endovascularly and 420 underwent surgical revascularisation [44]. Overall, the incidence of restenosis was lower following open surgery.…”

Section: Endovascular Versus Open Surgerymentioning

confidence: 99%

“…Outside the aorta, angioplasty is commonly employed for the treatment of stenoses in branch arteries. Although opinion remains divided on the use of stents, most studies have reported higher restenosis and recurrence rates when stents are deployed when compared to angioplasty alone [43,44,[49][50][51][52]. Increasingly, stents are reserved for the treatment of procedural complications such as dissection or for recurrent lesions.…”

Section: Endovascular Versus Open Surgerymentioning

confidence: 99%

Intervention in Takayasu Aortitis: When, Where and How?

Porter

Mason

2020

Hearts

Takayasu arteritis is a large vessel vasculitis which commonly affects the aorta and its major branches. Active arterial inflammation is characterised by the presence of T and B lymphocytes, natural killer cells, macrophages and occasional multinucleate giant cells. Uncontrolled vascular inflammation can progress to cause arterial stenosis, occlusion or aneurysmal dilatation. Medical treatment involves combination immunosuppression and more recently biologic therapies targeting TNF-α and IL-6. Due to the typical delays in diagnosis and accumulation of arterial injury, open and endovascular surgical intervention are important and potentially life-saving treatment options for Takayasu arteritis. Common indications for surgery include aortic coarctation and ascending aortic dilatation ± aortic valve regurgitation, renal artery stenosis, ischaemic heart disease, supra-aortic disease, mesenteric ischaemia, severe limb-threatening claudication and aneurysm repair. Surgical outcomes are markedly improved in patients with clinically inactive disease and those who receive adequate periprocedural immunosuppression. Decisions regarding surgical approaches are best made as part of a multi-disciplinary team.

“…Surgical intervention for TA includes two interventional options: 1) endovascular intervention, including percutaneous transluminal angioplasty and stent-graft placement and 2) open surgical intervention, including surgical bypass grafting, endarterectomy, and graft patch for short segment lesions [24]. intervention was higher when the supra-aortic branches were involved rather than the renal arteries [6].…”

Section: Takayasu's Arteritismentioning

confidence: 99%

“…Stroke can happen as a complication of vasculitis treatment. Some forms of surgical interventions for vasculitis treatment have been reported to result in stroke as a complication [6].…”

Section: Introductionmentioning

confidence: 99%

Association Between Cerebrovascular Accident and Vasculitis: Myth or Reality?

Aljanabi

Mamtani

Acharya

et al. 2019

Cureus

This article aims to determine an association between vasculitis and cerebrovascular accidents (CVA) and the ideal management plan to decrease the chances of CVA in vasculitis patients. We also attempt to find a preferred treatment regimen that decreases the complications of CVAs in vasculitis patients, thereby resulting in reduced mortality and morbidity. We reviewed both free-access full-text articles and the abstracts of articles behind a paywall. We used the PubMed database and reviewed 89 articles that matched our inclusion and exclusion criteria. In all, 42 out of the 89 articles had the most relevant data for our article. We used the following keywords to search the database: vasculitis, stroke, cerebrovascular accident, ischemic, arteritis, and steroid. We found an association between subtypes of vasculitis, mostly large vessel vasculitis and CVA. We could not identify a specific cutoff value for specific inflammatory markers that can increase the risk of developing CVA. Besides, there are no formal guidelines for the dosage or the route of administration for corticosteroids, which are the cornerstone of treatment for most vasculitis. We found that male giant cell arteritis (GCA) patients have a higher chance of developing CVA than females, Also interestingly, anemia was found to be protective against CVA development in GCA patients. Sometimes, CVA can happen due to the effects of treatments of some types of vasculitis. We recommend establishing further studies about other subtypes of vasculitis and their associations with stroke.