title: Comparison of outcomes between endovascular treatment and bypass surgery in Takayasu arteritis.
abstract: OBJECTIVE
  There is currently a lack of evidence regarding the optimal revascularization method for Takayasu arteritis (TA). This study compares outcomes between endovascular treatment and surgical therapy in TA patients requiring revascularization.
  
  
  METHODS
  From September 1994 to January 2011, 235 patients were diagnosed with TA according to the diagnostic criteria of the 1990 American College of Rheumatology, and of these, arterial revascularizations were performed in 65 (27.7%). Symptomatic or angiographic recurrence and peri-operative use of immunosuppressive drugs were investigated by retrospectively reviewing medical records.
  
  
  RESULTS
  A total of 111 arterial lesions in the 65 (27.7%) patients were revascularized during the follow-up period (median 3.2 years, range 0.01-12.7 years). At the 2-year follow-up, the symptomatic recurrence rate was significantly higher in the endovascular treatment group (32.3% vs. 11.5%, p = 0.016), as was the incidence of angiographic recurrence (32.1% vs. 11.1%, p = 0.026). The symptomatic recurrence rate was not influenced by the need for peri-operative immunosuppressive drugs (20% vs. 34.1%, p = 0.34).
  
  
  CONCLUSIONS
  In TA patients, surgical revascularization seems to be superior to endovascular treatment with regard to patency. Further investigation to identify novel and optimal arterial revascularization methods for TA patients should be undertaken.
authors.affiliation: Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine , Seoul , South Korea.
authors.forename: G Y
authors.initials: GY
authors.lastname: Lee
authors.forename: P
authors.initials: P
authors.lastname: Jeon
authors.forename: Y-S
authors.initials: YS
authors.lastname: Do
authors.forename: K
authors.initials: K
authors.lastname: Sung
authors.forename: D-I
authors.initials: DI
authors.lastname: Kim
authors.forename: Y-W
authors.initials: YW
authors.lastname: Kim
authors.forename: D-K
authors.initials: DK
authors.lastname: Kim
mesh_terms: D000328:Adult; D000792:Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D012008:Recurrence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D013625:Takayasu Arteritis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents