Surgical treatment for Takayasu's arteritis. A long-term follow-up study.

Thirty patients with Takayasu's arteritis treated surgically were followed for more than ten years postoperatively, 28 women and 2 men. The average age at the initial operation was 29 years. The clinicopathological finding was classified in four types; the distribution of cases was 6 in Type I, 17 in Type II, 4 in Type III, and 3 in Type IV. Surgical procedures performed were carotid artery reconstruction in 9 patients, thoraco-abdominal aortic bypass in 5, renal artery reconstruction in 10, combined procedures in 2, aneurysmectomy in 2, and other procedures in 2 patients. Twenty-six patients survived; four died during the study period. Twenty-three patients (77%) are well with good function of the reconstructed arteries. Six women had safe deliveries after successful operations. However, anastomotic false aneurysms occurred in 5 patients. The surgical management of Takayasu's arteritis must be distinguished from that of atherosclerotic vascular disease.