Surgery and Endovascular Management in Patients With Takayasu's Arteritis: A Ten-Year Retrospective Study

Diao, Yong; Yan, Sheng; Premaratne, Shyamal; Chen, Yuexin; Tian, Xinping; Chen, Zuoguan; Wu, Zhi-Yuan; Miao, Yuqing; Zhang, Wayne W.; Li, Yongjun

doi:10.1016/j.avsg.2019.07.009

Cited by 22 publications

(15 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In recent years, biological agents such as tocilizumab ( Zhou et al, 2017 ) and infliximab ( Torp et al, 2021 ) have also been used as candidate drugs for TA. However, the active inflammation of some patients cannot be effectively controlled following medical treatment; thus, the stenosis of the culprit vessels continues to progress, and these patients with TA ultimately requiring surgical management, including endovascular treatment and open surgical repair ( Chen et al, 2018 ; Diao et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Single-Cell RNA Sequencing Revealed CD14+ Monocytes Increased in Patients With Takayasu’s Arteritis Requiring Surgical Management

Gao

Wu²,

Yu³

et al. 2021

Front. Cell Dev. Biol.

View full text Add to dashboard Cite

Objectives: Takayasu Arteritis (TA) is a highly specific vascular inflammation and poses threat to patients’ health. Although some patients have accepted medical treatment, their culprit lesions require surgical management (TARSM). This study aimed at dissecting the transcriptomes of peripheral blood mononuclear cells (PBMCs) in these patients and to explore potential clinical markers for TA development and progression.Methods: Peripheral blood were collected from four TA patients requiring surgical management and four age-sex matched healthy donors. Single cell RNA sequencing (scRNA-seq) was adopted to explore the transcriptomic diversity and function of their PBMCs. ELISA, qPCR, and FACS were conducted to validate the results of the analysis.Results: A total of 29918 qualified cells were included for downstream analysis. Nine major cell types were confirmed, including CD14+ monocytes, CD8+ T cells, NK cells, CD4+ T cells, B cells, CD16+ monocytes, megakaryocytes, dendritic cells and plasmacytoid dendritic cells. CD14+ monocytes (50.0 vs. 39.3%, p < 0.05) increased in TA patients, as validated by FACS results. TXNIP, AREG, THBS1, and CD163 increased in TA patients. ILs like IL-6, IL-6STP1, IL-6ST, IL-15, and IL-15RA increased in TA group.Conclusion: Transcriptome heterogeneities of PBMCs in TA patients requiring surgical management were revealed in the present study. In the patients with TA, CD14+ monocytes and gene expressions involved in oxidative stress were increased, indicating a new treatment and research direction in this field.

show abstract

Section: Introductionmentioning

confidence: 99%

Single-Cell RNA Sequencing Revealed CD14+ Monocytes Increased in Patients With Takayasu’s Arteritis Requiring Surgical Management

Gao

Wu²,

Yu³

et al. 2021

Front. Cell Dev. Biol.

View full text Add to dashboard Cite

show abstract

“…Other complications included cerebral hyperperfusion syndrome, stent graft thrombosis, pseudoaneurysm, puncture site bleeding, stroke, restenosis, and renal failure. A 10-year retrospective study reported a complication rate of 8.2% (7/85) in an endovascular intervention group (24). Our patient with TA had obvious indications for emergency bridging therapy because her severe neurological deficits were related to AIS.…”

Section: Discussionmentioning

confidence: 73%

“…Interventions should preferably be performed only after stable control of inflammation, except for emergency indications such as severe ischaemia and neurological complications such as aneurysm, dissection, or stroke (14). Endovascular intervention may still be a safe and effective method, although it involves technical problems and may cause complications (24). The majority of complications with endovascular treatment were technical failures followed by dissection of the vessels (25).…”

Section: Discussionmentioning

confidence: 99%

Bridging Therapy for Acute Stroke as the Initial Manifestation of Takayasu Arteritis: A Case Report and Review of Literature

et al. 2021

View full text Add to dashboard Cite

Takayasu arteritis (TA) is a chronic inflammatory disease involving the aorta and its principal branches. Acute ischaemic stroke (AIS) as the initial manifestation of TA is uncommon. There is little evidence on the efficacy of bridging therapy for AIS induced by TA. A 23-year-old Chinese woman with a suspected stroke presented to our hospital with sudden onset of right-sided weakness, right facial palsy, and aphasia that occurred 1 hour ago. After physical and ancillary examinations, recombinant tissue plasminogen activator was administered to the patient, which led to partial recovery. Her neurological function deteriorated with a large salvageable ischaemic penumbra on computed tomography perfusion. Cerebrovascular angiography showed multiple stenoses in the brachiocephalic trunk, the beginning of the right common carotid artery (CCA), and the bilateral subclavian arteries, as well as occlusion of the left CCA and its branches. Mechanical thrombectomy of the left middle cerebral artery was performed immediately. Percutaneous transluminal balloon angioplasty of the left CCA followed by stent implantation of the proximal left CCA was then performed. A diagnosis of TA was made based on the findings. The patient’s neurological deficit fully recovered with immunosuppressants at the 3 month-follow-up. We report a rare case of a patient with TA initially presenting with AIS treated with bridging therapy with full recovery of neurological function. Bridging therapy should be taken into consideration for AIS in patients with TA. Further study is needed in this regard.

show abstract

“…Recently it has been shown that both open surgical and endovascular methods are featured with long-term durability. Dao et al reported that the results of open surgical and endovascular procedures in follow-up period of up to 10 years are satisfactory, with primary patency rates as follows: in open repair and endovascular groups at 1, 3, 5, and 10 years of follow-up, respectively: 97.3%, 86.2%, 70.5, and 48.8% and 93.3%, 73.1%, 57.5%, and 31.8% [25]. In the literature sev-eral indications for surgical intervention with good risk-to-benefit ratio in patients with TA are listed: (1) severe renovascular stenosis causing hypertension; (2) severe coronary artery stenosis leading to myocardial ischemia; (3) extremity claudication induced by routine activity; (4) critical cerebral ischemia and/or critical stenosis of 3 or more cerebral vessels; (5) severe aortic regurgitation; (6) thoracic or abdominal progressive aneurysms > 5 cm in diameter with a tendency for dissection or rupture; (7) severe coarctation of the aorta [32].…”

Section: Discussion and Review Of Literaturementioning

confidence: 99%

“…The treatment of patients with multiple aortic arch branch involvement, including their occlusion, has been widely described [7,8,[15][16][17][18][19][20][21][22][23][24][25]. In most cases of patients with the active inflammatory phase of TA, the immunosuppressive treatment alone may be effective in reducing the cerebral ischaemic Photo 1.…”

Section: Is Minimally Invasive Treatment Still Possible In Multiple Ementioning

confidence: 99%

Multiple occlusions in extracranial arteries in patients with aortic arch syndrome: is minimally invasive treatment still possible? Technical aspects of the treatment based on our own experience and a review of the literature.

Kaszczewski¹,

Ostrowski²,

Maciąg³

et al. 2020

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

Takayasu arteritis is a large vessel vasculitis of granulomatous nature and unknown aetiology affecting predominantly the aorta and its major branches, which may lead to ischaemic symptoms of many organs including the central nervous system. To decrease the risk of neurological complications and improve the quality of life, an arterial revascularisation may be necessary. The treatment options include pharmacotherapy as well as both open surgical and endovascular procedures, which has to be carefully chosen to obtain clinical success. There is an ongoing debate on the advantages, possibilities, and indications for implementing endovascular and open surgical methods, especially in high-risk patients. In this article we present our own experience in the treatment of an unusually complex and high-risk patient with multiple occlusion of supra-aortic branches, focusing on the technical aspects of the procedures and the decision-making process, as well as to confront with contemporary medical knowledge.

show abstract

Surgery and Endovascular Management in Patients With Takayasu's Arteritis: A Ten-Year Retrospective Study

Cited by 22 publications

References 29 publications

Single-Cell RNA Sequencing Revealed CD14+ Monocytes Increased in Patients With Takayasu’s Arteritis Requiring Surgical Management

Single-Cell RNA Sequencing Revealed CD14+ Monocytes Increased in Patients With Takayasu’s Arteritis Requiring Surgical Management

Bridging Therapy for Acute Stroke as the Initial Manifestation of Takayasu Arteritis: A Case Report and Review of Literature

Multiple occlusions in extracranial arteries in patients with aortic arch syndrome: is minimally invasive treatment still possible? Technical aspects of the treatment based on our own experience and a review of the literature.

Contact Info

Product

Resources

About