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Review
. 2018 Sep 20;4(2):117-125.
doi: 10.4244/AIJ-D-16-00013. eCollection 2018 Sep.

Takayasu's arteritis: a review of the literature and the role of endovascular treatment

Rachel Wenrui Lim  1 , Yann Shan Keh  1 , Khung Keong Yeo  1   2 , Narendra Nath Khanna  3
Affiliations
Review

Takayasu's arteritis: a review of the literature and the role of endovascular treatment

Rachel Wenrui Lim et al. AsiaIntervention. .

Abstract

Takayasu's arteritis (TA) is a chronic non-specific vasculitis with variable presentation in different ethnicities and countries. Treatment options vary and are dependent on the stage and presentation of the disease. We aimed to review current literature related to TA, focusing on the role of endovascular treatment in revascularisation. The temporal course of the disease and stage at presentation influence the management of TA. Treatment options include medical therapy, endovascular intervention or surgical vascular reconstruction. The decision to intervene is individualised according to vascular anatomy and the presence of haemodynamically significant lesions. There are currently no clear guidelines regarding the choice between the endovascular and open surgical approaches, but studies have shown that endovascular procedures are associated with slightly higher rates of restenosis while surgical procedures have higher rates of thrombosis. Periprocedural immunosuppression is suggested if the disease is active at the point of intervention. This improves outcomes but at the cost of immunosuppression-related side effects. Careful long-term follow-up is essential due to the risk of disease activation or flare-up, requiring appropriate evaluation of the diseased vessels.

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Conflict of interest statement

K.K. Yeo has received research support from Medtronic, and honoraria from Abbott Vascular and St. Jude Medical. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1. A 7-year-old female with stenosis of the descending thoracic aorta demonstrated on a CT aortogram.
Figure 2
Figure 2. CT aortogram of a 12-year-old male showing stenosis of the left subclavian artery and left renal artery.
Figure 3
Figure 3. A 23-year-old female with stenosis of the descending abdominal aorta with collaterals from celiac to inferior mesenteric artery.
Figure 4
Figure 4. A CT aortogram showing bilateral common carotid artery aneurysms.
Figure 5
Figure 5. Angiographic types of Takayasu’s arteritis.
See this image and copyright information in PMC

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