Stenting for middle aortic syndrome caused by Takayasu arteritis-immediate and long-term outcomes

Abstract

Objective: To evaluate immediate and long-term clinical outcomes of stenting for middle aortic syndrome (MAS) caused by Takayasu arteritis (TA).

Background: Studies of endovascular stenting for the treatment of MAS caused by TA are scare.

Methods: Data from 48 consecutive TA patients (mean 33.3 ± 12.6 years) with MAS treated by stenting in our institution between January 2010 and July 2016 were collected and retrospectively analyzed. Thirty-day and long-term follow-up clinical outcomes after aorta stenting were assessed.

Results: Stenting was successful in all patients. The mean stenosis and peak systolic pressure gradient of aorta lesions were reduced from 81.3 ± 8.0% and 70.7 ± 18.4 mm Hg to 14.7 ± 8.3% and 14.0 ± 5.8 mm Hg immediately after the 54 stents were implanted. One patient developed retroperitoneal hemorrhage and one developed flow-limiting dissection that involved bilateral renal arteries perioperatively. Both patients recovered without sequela. Compared with baseline, the ankle brachial index (0.92 ± 0.19 vs. 0.75 ± 0.22), mean systolic blood pressure (149.5 ± 19.1 vs. 179.0 ± 28.4 mm Hg) and antihypertensive drugs (1.1 ± 0.7 vs. 3.1 ± 0.9) significantly improved after an average follow-up of 3.1 years (all P < .001). A total of 5 (10.9%) patients developed in-stent restenosis, which were resolved by reintervention (restenting in 3 patients and re-angioplasty alone in 2 patients). No major adverse events occurred during follow up.

Conclusions: Percutaneous aortic stenting is highly efficacious and safe in treating patients with MAS caused by TA with good immediate and long-term clinical outcomes.

Keywords: Takayasu arteritis; hypertension; intermittent claudication; middle aortic syndrome; stents.