[Surgical management of Takayasu's arteritis with extensive vascular involvement and bilateral renal artery stenosis]

Abstract

Proximal renal artery stenosis, in association with stenoses and/or aneurysms of aorta and its branches, suggests a Takayasu's disease and is an important, treatable cause of hypertension in young people. A 29-year-old black woman presents with systodiastolic hypertension and suprasternal and abdominal bruits. An aortography disclosed multiple aneurysms and stenosis of the aorta and its main branches, and bilateral stenosis of renal arteries. The patient underwent an unusual and well-succeeded surgical procedure consisting in the creation of a "ventral aorta", a bypass from the ascending aorta down to the aortic bifurcation, and revascularization of both kidneys. Takayasu's disease frequently courses with extensive involvement of vasculature and bilateral renal stenosis. Renovascular hypertension is a major complication, contributing to the high mortality of this disease. Renal revascularization plays an important role in the modification of the natural history of Takayasu's disease and is essential for long-term survival and prevention of ischaemic renal failure.