Descending aortic aneurysm with Takayasu's disease.

A 69-year-old woman with Takayasu's disease was referred to our hospital for surgical treatment of a descending aortic aneurysm. Preoperative angiography and computed tomography revealed abdominal aortic stenosis and severe calcification in the descending aorta. The abdominal aorta was first replaced, since the aortic stenosis would have disturbed blood flow to the abdominal organs during extracorporeal circulation, which would be needed for subsequent thoracic surgery. The descending aortic aneurysm was then resected under femoro-femoral bypass. Since the descending aorta was severely calcified, two occlusion balloon catheters were used to clear the aorta. After aortic walls just proximal and distal to the aneurysm were decalcified, a short prosthetic tube graft was anastomosed. Only 2 pairs of intercostal arteries were sacrificed and paraplegia was prevented. Vascular lesions must thus be accurately evaluated and suitable procedures selected in surgically treating Takayasu's disease.