Takayasu's arteritis surgery: Difference between revisions
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==Overview== | ==Overview== | ||
Surgical options may need to be explored for those who do not respond to steroids. Re-perfusion of tissue can be achieved by large vessel reconstructive surgery such as bypass grafting. | Surgical options may need to be explored for those who do not respond to [[Steroid|steroids]]. Re-perfusion of tissue can be achieved by large [[Blood vessel|vessel]] reconstructive [[surgery]] such as bypass grafting. | ||
==Surgery== | ==Surgery== | ||
Severe stenotic lesions should be treated by [[angioplasty]] or surgical [[revascularization]] during periods of remission.<ref name="pmid1975175">{{cite journal |vauthors=Arend WP, Michel BA, Bloch DA, Hunder GG, Calabrese LH, Edworthy SM, Fauci AS, Leavitt RY, Lie JT, Lightfoot RW |title=The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis |journal=Arthritis Rheum. |volume=33 |issue=8 |pages=1129–34 |date=August 1990 |pmid=1975175 |doi= |url=}}</ref> | Severe [[Stenosis|stenotic]] lesions should be treated by [[angioplasty]] or surgical [[revascularization]] during periods of remission.<ref name="pmid1975175">{{cite journal |vauthors=Arend WP, Michel BA, Bloch DA, Hunder GG, Calabrese LH, Edworthy SM, Fauci AS, Leavitt RY, Lie JT, Lightfoot RW |title=The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis |journal=Arthritis Rheum. |volume=33 |issue=8 |pages=1129–34 |date=August 1990 |pmid=1975175 |doi= |url=}}</ref> | ||
Indications for surgical repair or angioplasty are as follow: | Indications for surgical repair or [[angioplasty]] are as follow: | ||
* Renovascular stenosis causing [[hypertension]] | * Renovascular stenosis causing [[hypertension]] | ||
* [[Coronary artery]] stenosis leading to [[myocardial ischemia]] | * [[Coronary artery]] stenosis leading to [[myocardial ischemia]] | ||
* Extremity [[claudication]] induced by routine activity | * Extremity [[claudication]] induced by routine activity | ||
* [[Cerebral ischemia]] and/or critical stenosis of 3 or more cerebral vessels | * [[Cerebral ischemia]] and/or critical [[stenosis]] of 3 or more [[Brain|cerebral]] vessels | ||
* [[Aortic regurgitation]] | * [[Aortic regurgitation]] | ||
* Thoracic or abdominal [[aneurysm]]<nowiki/>s larger than 5 cm in diameter | * Thoracic or abdominal [[aneurysm]]<nowiki/>s larger than 5 cm in diameter | ||
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=== Bypass graft surgery === | === Bypass graft surgery === | ||
Bypass graft surgery is the procedure with the best long-term patency rate. | [[Bypass (surgical)|Bypass]] [[graft]] [[surgery]] is the procedure with the best long-term patency rate. | ||
* Usually, the [[graft]] is a [[saphenous vein]] graft. | * Usually, the [[graft]] is a [[saphenous vein]] [[graft]]. | ||
* Indication of bypass surgery are as following: | * Indication of [[Bypass (surgical)|bypass]] [[surgery]] are as following: | ||
** Critical thoracic [[aortic arch]] arterial stenosis | ** Critical thoracic [[aortic arch]] [[Artery|arterial]] [[stenosis]] | ||
** Upper and lower extremity [[ischemia]] | ** Upper and lower extremity [[ischemia]] | ||
** Cerebrovascular accidents | ** Cerebrovascular accidents | ||
** [[Renal artery]] stenosis | ** [[Renal artery]] [[stenosis]] | ||
==References== | ==References== |
Revision as of 18:19, 27 April 2018
Takayasu's arteritis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farnaz Khalighinejad, MD [2]
Overview
Surgical options may need to be explored for those who do not respond to steroids. Re-perfusion of tissue can be achieved by large vessel reconstructive surgery such as bypass grafting.
Surgery
Severe stenotic lesions should be treated by angioplasty or surgical revascularization during periods of remission.[1]
Indications for surgical repair or angioplasty are as follow:
- Renovascular stenosis causing hypertension
- Coronary artery stenosis leading to myocardial ischemia
- Extremity claudication induced by routine activity
- Cerebral ischemia and/or critical stenosis of 3 or more cerebral vessels
- Aortic regurgitation
- Thoracic or abdominal aneurysms larger than 5 cm in diameter
- Severe coarctation of the aorta
Bypass graft surgery
Bypass graft surgery is the procedure with the best long-term patency rate.
- Usually, the graft is a saphenous vein graft.
- Indication of bypass surgery are as following:
- Critical thoracic aortic arch arterial stenosis
- Upper and lower extremity ischemia
- Cerebrovascular accidents
- Renal artery stenosis