title: Preventing a central nervous system catastrophe in a case of Takayasu's arteritis presenting with critical stenosis of all three arch vessels.
abstract: Multifocal and bilateral involvement of the arch vessels is a common presentation of Takayasu's arteritis. Endovascular stenting of multiple supra aortic lesions in Takayasu's arteritis has been described scarcely in literature. We describe the management of a case of Takayasu's arteritis who presented with recurrent vertebro-basilar symptoms and a single surviving arch vessel. Whether routine revascularization of all three vessels is superior to symptom driven revascularization of individual lesions remains uncertain. The abundant collateral blood flow; the problems with stenting during the acute phase of the disease; the risk of restenosis that is considerably higher than atherosclerotic lesions; and the chances of progression of the disease have to be taken into account during endovascular revascularization of multiple supra aortic arch vessels.
authors.affiliation: Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.
authors.forename: Srinivas Budanur
authors.initials: SB
authors.lastname: Chikkaswamy
authors.forename: Maneesh K
authors.initials: MK
authors.lastname: Rai
authors.forename: Chamrajnagar M
authors.initials: CM
authors.lastname: Nagesh
authors.forename: Babu
authors.initials: B
authors.lastname: Reddy
authors.forename: B
authors.initials: B
authors.lastname: Dinesha
authors.forename: Cholenahally Nanjappa
authors.initials: CN
authors.lastname: Manjunath
mesh_terms: D000328:Adult; D017130:Angioplasty / Q000379:methods*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D002490:Central Nervous System; D006801:Humans; D008297:Male; D011859:Radiography; D015607:Stents; D013625:Takayasu Arteritis / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000601:surgery*