Yongpeng Diao1, Sheng Yan2, Shyamal Premaratne3, Yuexin Chen4, Xinping Tian5, Zuoguan Chen1, Zhiyuan Wu1, Yuqing Miao1, Wayne W Zhang6, Yongjun Li7. 1. Department of Vascular Surgery, Beijing Hospital, National Center for Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. 2. Department of Cardiovascular Thoracic Surgery, Tai Yuan City Center Hospital, Shanxi Province, China. 3. Hunter Holmes McGuire Veterans Administration Medical Center, Richmond, VA. 4. Department of Vascular Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. 5. Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. 6. Division of Vascular and Endovascular Surgery, Department of Surgery University of Washington, Seattle, WA. Electronic address: wwzhang@uw.edu. 7. Department of Vascular Surgery, Beijing Hospital, National Center for Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. Electronic address: yongj_93@hotmail.com.
Abstract
BACKGROUND: Takayasu's arteritis (TA) is an uncommon chronic vasculitis, and there is a lack of long-term large cohort studies regarding the optimal revascularization outcomes of patients with TA. METHODS: One hundred and sixteen patients with TA who underwent surgery or endovascular repair over a 10-year period were studied retrospectively. One hundred and fifty-four vascular procedures were performed consisting of 69 open and 85 endovascular repairs. RESULTS: After a mean follow-up period of 48.5 ± 38.5 months, three cases each of cerebrovascular accident (CVA) and death occurred in the open repair group while two cases of CVA and 4 deaths were observed in the endovascular repair group. At 1, 3, 5, and 10 years of follow-up, the primary patency rates were 97.3%, 86.2%, 70.5%, and 48.8% in the open repair group and 93.3%, 73.1%, 57.5%, and 31.8% in the endovascular repair group, respectively. The primary assisted patency rates were 98.2%, 90.3%, 73.2%, and 47.2% in the open repair group and 95%, 81%, 64.4%, and 35% in the endovascular repair group, respectively. The secondary patency rates were 98.2%, 96.1%, 83.5%, and 56.2% in the open repair group and 98.7%, 86%, 71.2%, and 44.9% in the endovascular repair group, respectively. The cumulative survival rates were 96.9%, 96.9%, 96.9%, and 90% in the open repair group and 97.4%, 97.4%, 88%, and 79.2% in the endovascular repair group, respectively. CONCLUSIONS: Both surgical repair and endovascular management are safe and efficient modes of treatment of TA. Surgical repair showed long-term durability, and it is suitable for complex lesions and failed cases of endovascular management.
BACKGROUND:Takayasu's arteritis (TA) is an uncommon chronic vasculitis, and there is a lack of long-term large cohort studies regarding the optimal revascularization outcomes of patients with TA. METHODS: One hundred and sixteen patients with TA who underwent surgery or endovascular repair over a 10-year period were studied retrospectively. One hundred and fifty-four vascular procedures were performed consisting of 69 open and 85 endovascular repairs. RESULTS: After a mean follow-up period of 48.5 ± 38.5 months, three cases each of cerebrovascular accident (CVA) and death occurred in the open repair group while two cases of CVA and 4 deaths were observed in the endovascular repair group. At 1, 3, 5, and 10 years of follow-up, the primary patency rates were 97.3%, 86.2%, 70.5%, and 48.8% in the open repair group and 93.3%, 73.1%, 57.5%, and 31.8% in the endovascular repair group, respectively. The primary assisted patency rates were 98.2%, 90.3%, 73.2%, and 47.2% in the open repair group and 95%, 81%, 64.4%, and 35% in the endovascular repair group, respectively. The secondary patency rates were 98.2%, 96.1%, 83.5%, and 56.2% in the open repair group and 98.7%, 86%, 71.2%, and 44.9% in the endovascular repair group, respectively. The cumulative survival rates were 96.9%, 96.9%, 96.9%, and 90% in the open repair group and 97.4%, 97.4%, 88%, and 79.2% in the endovascular repair group, respectively. CONCLUSIONS: Both surgical repair and endovascular management are safe and efficient modes of treatment of TA. Surgical repair showed long-term durability, and it is suitable for complex lesions and failed cases of endovascular management.
Authors: Piotr K Kaszczewski; Tomasz Ostrowski; Rafał Maciąg; Michał Elwertowski; Witold Chudziński; Zbigniew Gałązka Journal: Wideochir Inne Tech Maloinwazyjne Date: 2020-04-20 Impact factor: 1.195