Journal «Angiology and Vascular Surgery» • 

1998 • VOLUME 4 • №3-4

SURGICAL MANAGEMENT OF AORTOARTERITIS

Zhong Gao Wang, Yong Qian Gu, Xiu Jie Wang, Si Hua Wang, Xiao Ming Zhang, Xu Ming Chen, CeBian, Yi Fun Jin
Vascular Institute, General Post & Telecom Hospital, Beijing Medical University, Beijing, China;
Division of Vascular Surgery, Yale University Hospital, New Haven, USA

The aortoarteritis is an idiopathic panarteritis, also called as Takayasu's arteritis, which is rare and mostly seen in the oriental countries. Hereby is a review of 92 cases admitted from June 1992 to December 1996. Eighteen males and 74 females were included with a female preference of 80.4%. The age ranged from 8 to 51 with 57 cases (62.0%) being between 16 to 31 years. The illness course was from 9 days to 15 years with a mean of 37 months. In 72 cases (78.3%), surgery was carried out. The ascending aorta to axillary or subclavian bypass and graft to carotid bypass were carried out in 27 cases. The aortorenal bypass in 10 cases. PTA was performed in 8 cases. For surgical group, the excellent effect was 37.5%, fair 36.1% and improved 11.1% in short term; 28.3%, 33.3% and 21.6% respectively during a mean follow-up of 3 years. We concluded that the aortoarteritis is a non-specific immune-related panarteri-tis, thus a combined therapy is necessary. Surgery is not a means for cure and is only used when the perfusion of the distal organ or limb is jeopardised and disease is at least relatively stabilised; if it is feasible, PTA should be the first choice; cerebral ischemia and renal hypertension are the most frustrating complications; patients with even four cerebral arterial lesions still have chance for carotid reconstruction; post-operative reperfusion syndrome is its major threatening complication though and is not completely solved even by preventive craniotomy; for those with renal hypertension, aortorenal bypass, splenorena I bypass, renal autotransplan-tation in addition to PTA are always useful, nephrectomy is last consideration; limb ischemia relieves mostly by bypass or intervention.

P. 77-78

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