Clinical Analysis Of Surgical Therapies In Takaya’s Arteritis

Background: Takayasu’s Arteritis(TA) is a chronic inflammatory disease which involve the large arteries mainly, primarily affecting the aorta and its main branches,the pulmonary artery and coronary artery are also involed sometimes, it usually causes severe ischemic manifestations. Most of these patients are young and female,Although the pathogenesis of TA remains unclear, the interaction of many factors,such as autoimmunity, inflammation,genetic and environmental factors, is involved in the occurrence and development of TA.The treatment of TA includes conservative theray and surgical procedure. The surgical procedure includes surgery and endovascular intervention. Surgeons are perplexed at relapse and restenosis of the lesions.Objective : This study aimed to analyze the efficacy and safety of bypsss surgery and endovascular treatment for Takayasu’s arteritis( TA).Methods : This is a retrospective review of patients with TA referred to us between 2004 and 2014.Results:The number of patients who received surgery in our hospital was 66,including 54 female cases,accounting for 81.8%,the average age was( 30. 07 ± 15.10) years,the bypass surgery was performed for 22 cases,endovascular treatment was given to 48 cases,129 culprit vessels were treated.The average follow-up period was(52.50± 39.53) months( 3-131 months), no deaths occurred in the perioperative period.The primary patency rates for the surgery among the 3-month,6-month,1-year,3-year,5-year,7-year were 94.4%、94.4%、83.3%、76.9%、70.5 % and 54.1%,respectively;and the primary patency rates for the endovasculartreatment among the 3-month,6-month,1-year,3-year,5-year,7-year were 82.7%、64. 5%、55. 7%、51. 6%、47. 1%、47. 1%(P=0.0377),respectively;For the endovascular treatment,the primary patency of renal artery among 3-month,6-month,1-year,3-year were 85.7%、85.4%、56.4%、50.1%;The primary patency of subclavian artery among 3-month,6-month,1-year,3-year were 77.8%、66.7%、53.3%、40%;The primary patency of carotid artery among 3-month,6-month,1-year,3-year were 72.7%、63.6%、36.4%、36.4%.Conclusion:Endovascular treatment and bypass surgery are both effective for the stenosis or occlusion caused by Takayasu diseases,the patency of the bypass is superior to the endovascula treatment’s;and,Surgical repair shows excellent long term durability,it seems to be more suitable for complex lesions and failure cases of endovascular management.