Percutaneous Transluminal Angioplasty for Symptomatic Pulmonary Stenosis in Takayasu Arteritis

Dong, Hua; Jiang, Xiongjing; Peng, Meng; Zou, Yubao; Guan, Ting; Zhang, Huimin; Song, Lingyun; Wu, Haiying; Yang, Yuejin; Gao, Runlin

doi:10.3899/jrheum.131007

Cited by 25 publications

(42 citation statements)

References 17 publications

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“…After an average of 29 months of follow-up, the New York Heart Association functional class and 6 min walking distances improved, while mean PAP measured by echocardiography decreased significantly (compared with baseline, all p<0.01). Two patients died, one had reperfusion pulmonary injury, dying of respiratory insufficiency 3 days after the procedure, and the other 28 months after the procedure, following a pulmonary infection and cardiac shock 75…”

Section: Resultsmentioning

confidence: 99%

Management of Takayasu arteritis: a systematic literature review informing the 2018 update of the EULAR recommendation for the management of large vessel vasculitis

et al. 2019

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ObjectiveTo collect available evidence on management of large vessel vasculitis to inform the 2018 update of the EULAR management recommendations.MethodsTwo independent systematic literature reviews were performed, one on diagnosis and monitoring and the other on drugs and surgical treatments. Using a predefined PICO (population, intervention, comparator and outcome) strategy, Medline, Embase and Cochrane databases were accessed. Eligible papers were reviewed and results condensed into a summary of findings table. This paper reports the main results for Takayasu arteritis (TAK).ResultsA total of 287 articles were selected. Relevant heterogeneity precluded meta-analysis. Males appear to have more complications than females. The presence of major complications, older age, a progressive disease course and a weaker inflammatory response are associated with a more unfavourable prognosis. Evidence for details on the best disease monitoring scheme was not found. High-quality evidence to guide the treatment of TAK was not found. Glucocorticoids are widely accepted as first-line treatment. Conventional immunosuppressive drugs and tumour necrosis factor inhibitors were beneficial in case series and uncontrolled studies. Tocilizumab failed the primary endpoint (time to relapse) in a randomised controlled clinical trial; however, results still favoured tocilizumab over placebo. Vascular procedures may be required, and outcome is better when performed during inactive disease.ConclusionsEvidence to guide monitoring and treatment of patients with TAK is predominantly derived from observational studies with low level of evidence. Therefore, higher-quality studies are needed in the future.

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Section: Resultsmentioning

confidence: 99%

Management of Takayasu arteritis: a systematic literature review informing the 2018 update of the EULAR recommendation for the management of large vessel vasculitis

et al. 2019

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“…With recent tremendous advances in endovascular therapy, PTA and stenting for stenotic TA lesions of the aorta and its branches have been reported to show excellent immediate and long‐term results when compared with surgical procedures . However, this form of therapy has been reported in only a few cases and small retrospective studies with aorta involvement.…”

Section: Discussionmentioning

confidence: 99%

Stenting for middle aortic syndrome caused by Takayasu arteritis‐immediate and long‐term outcomes

Che

Xiong

Jiang

et al. 2018

Cathet Cardio Intervent

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“…Once arterial symptoms occur, medical therapy alone is not effective, and revascularization is essential to restore blood flow and relieve organ ischemia. [7][8][9][10] Bypass surgery has high survival rates and little restenosis. 1,4,11 However, the surgical approach is technically challenging because of its complexity, with multiple vessel involvement and periprocedural complications, including anastomotic site aneurysms, graft occlusion, and death.…”

Section: Introductionmentioning

confidence: 99%

“…1,4,11 However, the surgical approach is technically challenging because of its complexity, with multiple vessel involvement and periprocedural complications, including anastomotic site aneurysms, graft occlusion, and death. [9][10][11] Percutaneous transluminal angioplasty (PTA) with provisional stenting for stenotic lesions of the aorta and its branches in TA has shown good periprocedural and long-term results in previous studies. [8][9][10] The involvement of the iliac arteries, with intermittent claudication as a late clinical manifestation, is not unusual in TA, with a prevalence of 7.8% to 13.0%.…”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11] Percutaneous transluminal angioplasty (PTA) with provisional stenting for stenotic lesions of the aorta and its branches in TA has shown good periprocedural and long-term results in previous studies. [8][9][10] The involvement of the iliac arteries, with intermittent claudication as a late clinical manifestation, is not unusual in TA, with a prevalence of 7.8% to 13.0%. 6,8,12 However, revascularization of iliac artery lesions has been reported in only a few cases.…”

Section: Introductionmentioning

confidence: 99%

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Endovascular Treatment of Iliac Artery Stenosis Caused by Takayasu Arteritis: A 10-Year Experience

et al. 2019

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Purpose: To evaluate the safety and efficacy of endovascular treatment for iliac artery stenosis caused by Takayasu arteritis (TA). Methods: Twenty-three consecutive TA patients (mean age 28.6±9.5 years; 17 women) with 30 iliac artery stenoses underwent percutaneous transluminal angioplasty (PTA) and selective stent implantation between January 2007 and December 2016. All had claudication (Rutherford category 2 or 3). The changes in the Rutherford category, ankle-brachial index (ABI), 6-minute walking capacity, and adverse events were assessed. Results: The success rate of endovascular therapy for iliac artery lesions was 93.3% (28/30). Guidewires could not cross either lesion in a patient with bilateral stenoses. Twenty-four lesions were treated by PTA alone and the other 4 lesions with provisional stents. One patient had a puncture site hematoma. Over an average of 4.8±3.3 years, 18 patients remained asymptomatic or had mild intermittent claudication. The other 4 patients developed moderate to severe intermittent claudication due to progression of a previously existing iliac lesion (n=1) or restenosis (n=3); all 4 underwent PTA. At the last follow-up, improvements were seen in the ABI (0.95±0.12 vs 0.51±0.22, p<0.001), 6-minute walking capacity (409.5±46.1 vs 272.6±32.3 m, p<0.001), and the Rutherford category of 22 patients. One patient died of a hemorrhagic stroke at 27 months due to uncontrolled hypertension. Conclusion: Endovascular therapy was safe and effective in treating TA patients with iliac artery stenosis, with good clinical outcomes in the long term.

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Percutaneous Transluminal Angioplasty for Symptomatic Pulmonary Stenosis in Takayasu Arteritis

Abstract: The study showed that PTA improved subjective symptoms and objective variables of the patients with symptomatic pulmonary stenosis in TA, with an acceptable mortality. PTA may be a promising therapeutic strategy for symptomatic pulmonary stenosis in TA.

Cited by 25 publications

References 17 publications

Management of Takayasu arteritis: a systematic literature review informing the 2018 update of the EULAR recommendation for the management of large vessel vasculitis

Management of Takayasu arteritis: a systematic literature review informing the 2018 update of the EULAR recommendation for the management of large vessel vasculitis

Stenting for middle aortic syndrome caused by Takayasu arteritis‐immediate and long‐term outcomes

Endovascular Treatment of Iliac Artery Stenosis Caused by Takayasu Arteritis: A 10-Year Experience

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