Takayasu's Arteritis with Collateral Circulation from the Right Coronary Artery to Intracranial Vessels— A Case Report

Abstract

A forty-four-year-old woman with Takayasu's arteritis and involvement of the aortic arch and its main branches complained of precordial pain on effort. Exercise electrocardiograms revealed significant ST segment depression in leads II, III, aVF, and V. Coronary arteriograms demonstrated no stenosis. However, the right coronary arteriogram revealed collateral circulation arising from the sinus node artery to the bilateral vertebral arteries and the left internal carotid artery. The collateral circulation was considered to be an important route of blood flow supply to the brain and, at the same time, a cause of coronary steal syndrome and, consequently, of angina pectoris.

Takayasu Arteritis with Multiple Coronary Artery Fistulas to Bronchial Arteries

“…Multislice cardiac computed tomography (MSCT) confirmed the presence of CF from the RCA, LAD, and IM to the bronchial arteries (►Fig. 4). No severe stenosis was observed in the coronary arteries.…”

“…3 CFs in patients with TA have been reported between coronary arteries and pulmonary, bronchial or even intracranial arteries. [4][5][6] CF between pulmonary and coronary arteries have been found to be related to extensive pulmonary involvement. 7 The changes on the pulmonary vessels' wall have been found to be similar to those seen in systemic vessels and included inflammation with granulomatous lesions in the elastic, medial, and adventitial layers, often with thrombus formation with newly formed arterioles and small vessel dilatation.…”

Coronary-Vertebral Collaterals in Takayasu Arteritis: Case Report

“…Представленное наблюдение является крайне редким случаем формирования коллатералей при артериите Такаясу . В литературе имеются только три описания наблюдений подобных пациентов с коллатералями к сосудам головного мозга (два случая описания анастомозов между коронарными артериями и сонными артериями [8,9], один -к ПкА из системы ПКА [10]) . Считается, что наличие такого коллатерального кровотока является компенсаторным механизмом поддержания кровотока в головном мозге [8] .…”