title: Management of cerebral ischemia due to Takayasu's arteritis.
abstract: OBJECTIVE
  To explore the management of cerebral ischemia caused by Takayasu's arteritis.
  
  
  METHODS
  Ninety-three cases treated from June 1984 to September 1999 at the General Post & Telecom Hospital, the Sir Run Run Shaw Hospital, the First Affiliated Hospital of Zhejiang University, the Second Medical College of Beijing University, Beijing An Zhen Hospital, and the Beijing Union Medical College Hospital, including 10 men and 83 women, were reviewed. Of the 93 cases, bypasses from the ascending aorta to the axillary or subclavian artery and from graft to the carotid artery were performed in 47 cases. Subclavian to carotid bypass was performed in six cases. Percutaneous transluminal angioplasty (PTA) was used in five cases and stenting in one.
  
  
  RESULTS
  Marked improvement was achieved in 30.3%, fair in 34.9%, improvement in 21.2%, unchanged in 4.6%, and death in 9.0% before discharge; 30.6%, 38.8%, 16.3%, 4.1%, and 2.0% respectively during a mean follow-up of 48 months, and recurrence requiring revision in 8.2%.
  
  
  CONCLUSIONS
  Patients with occlusive lesions of all four cervical arteries always have severe cerebral ischemia and their distal runoff is always unvisualised by angiography. However, we found by exploration that the internal carotid artery is patent in all but one patient. Therefore, an ascending aorta to carotid bypass is feasible in most instances, and this can and should be done when the cerebral perfusion is jeopardized at a time when the patient is in a stable or relatively stable condition. Unfortunately, the cerebral re-perfusion syndrome is still a serious and not completely solved problem.
authors.affiliation: Vascular Institute, General Post & Telecom Hospital, the Eighth Clinical College of Beijing University, Beijing 100032, China. zhonggaowang@yahoo.com
authors.forename: Zhonggao
authors.initials: Z
authors.lastname: Wang
authors.forename: Laigen
authors.initials: L
authors.lastname: Shen
authors.forename: Jun
authors.initials: J
authors.lastname: Yu
authors.forename: Yongquan
authors.initials: Y
authors.lastname: Gu
authors.forename: Shihua
authors.initials: S
authors.lastname: Wang
authors.forename: Heng
authors.initials: H
authors.lastname: Guan
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Wu
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Zhang
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.forename: Jidong
authors.initials: J
authors.lastname: Wu
authors.forename: Guoxing
authors.initials: G
authors.lastname: Li
authors.forename: Songlin
authors.initials: S
authors.lastname: Pan
authors.forename: Hongkun
authors.initials: H
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Jin
mesh_terms: D000293:Adolescent; D000328:Adult; D000800:Angioplasty, Balloon; D002545:Brain Ischemia / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy; D028321:Plant Preparations / Q000627:therapeutic use; D013625:Takayasu Arteritis / Q000150:complications*; D029757:Tripterygium
chemical_list: D028321:Plant Preparations