Bilateral subklavian arter tıkanıklığına subklavian çalma sendromunun eşlik ettiği Takayasu arteritli hastanın başarılı tedavisi: Olgu sunumu

Abstract

Takayasu arteriti (TA), büyük boyutlu arterlerde granülomatöz inflamasyon ile karakterize etiyolojisi bilinmeyen kronik bir vaskülittir. Genellikle arkus aorta ve dallarını tutar. Tartışmalı olmasına rağmen hastalığın  aktif  olmayan evresinde  aort ve dallarının   tıkanıklığı için perkütan translüminal anjiyoplasti (PTA) tercih edilmektedir. Bizde bu yazımızda remisyon periyodundaki  bilateral endovasküler girişimle tedavi edilen subklavian çalma sendromlu bir olguyu sunduk.

Keywords

• Takayasu's arteriti,Subklavian steal sendromu,Perkütan transluminal anjioplasti

Successful treatment of a patient with Takayasu's arteritis presenting as subclavian steal syndrome secondary to bilateral occlusion of subclavian arteries: A case report

Abstract

Takayasu's arteritis (TA) is a chronic vasculitis of unknown etiology, characterized by granulomatous inflammation of large-sized arteries. It usually involves aortic arch and its branches. It is controversial but percutaneous transluminal angioplasty (PTA) is preferred for non-active stenosis and occlusion of artery and aorta. We presented a case who was in remission period with subclavian steal syndrome treated with bilateral endovascular intervention.    

Keywords

• Takayasu's arteritis,Subclavian steal syndrome,Percutaneous transluminal angioplasty

References

1. 1. Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, et al. Takayasu arteritis. Ann Intern Med. 1994;120:919-29.
2. 2. Numano F: Differences in clinical presentation and outcome in different countries for Takayasu’s arteritis. Curr Opin Rheumatol. 1997; 9: 12-15.
3. 3. Keser G, Direskeneli H, Aksu K. Management of Takayasu arteritis: a systematic review. Rheumatology (Oxford). 2014 ;53:793-801.
4. 4. Hata A, Noda M, Moriwaki R, Numano F. Angiographic findings of Takayasu arteritis: new classification. Int J Cardiol. 1996;54:155-63.
5. 5. Bıçakçıgil M, Aksu K, Kamal S, Ozbalkan Z, Atas A, Karadag O, et al. Takayasu’s arteritis in Turkey-clinical and angiographic features of 248 patients. Clin Exp Rheumatol. 2009;27:59-64.
6. 6. Aboyans V, Ricco JB, Bartelink MEL, Björck M, Brodmann M, Cohnert T, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries. Endorsed by: the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J. 2017;26:1-60.
7. 7. Ogino H, Matsuda H, Minatoya K, Sasaki H, Tanaka H, Matsumura Y, et al. Overview of late outcome of medical and surgical treatment for Takayasu arteritis. Circulation. 2008;118:2738–47.
8. 8. Perera AH, Youngstein T, Gibbs RG, Jackson JE, Wolfe JH, Mason JC. Optimizing the outcome of vascular intervention for Takayasu arteritis. Br J Surg. 2014;101:43–50.

9. 9. Min P-K, Park S, Jung J-H, Ko YG, Choi D, Jang Y, et al. Endovascular therapy combined with immunosuppressive treatment for occlusive arterial disease in patients with Takayasu’s arteritis. J Endovasc Ther. 2005;12:28-34.
10. 10. Maksimowicz-McKinnon K, Clark TM, Hoffman GS. Limitations of therapy and a guarded prognosis in an American cohort of Takayasu arteritis patients. Arthritis Rheum. 2007;56:1000–9