title: Retrospective Comparison of Open versus Endovascular Procedures for Takayasu Arteritis.
abstract: OBJECTIVE
  To compare the outcomes between vascular surgery and endovascular procedures in a cohort of patients with Takayasu arteritis (TA).
  
  
  METHODS
  A retrospective cohort study was conducted of patients with TA who underwent vascular interventions at a tertiary center between 1984 and 2009. The American College of Rheumatology criteria for TA were used to select patients. Disease activity was assessed according to the Kerr criteria. Data are reported using descriptive statistics and Kaplan-Meier methods for complication rates.
  
  
  RESULTS
  The cohort included 66 patients with TA who underwent 119 vascular procedures (surgery 93; endovascular repair 26). The most frequent indication for vascular surgery and endovascular procedure was arm claudication (surgical group 43%, endovascular repair group 31%). In 59% of the vascular surgical procedures and in 38% of endovascular procedures, the disease was active within 1 month of intervention. The most frequent arterial lesion requiring intervention was the aorta (28%) in the vascular surgery group and the subclavian (35%) in the endovascular repair group. Early complications occurred after 15 surgeries and 4 endovascular repair procedures (p = 0.93). Late complications occurred after 34 surgical procedures and 10 endovascular repair procedures (44% vs 66%, respectively; p = 0.33). The majority of complications in both groups were restenosis. Hypertension, dyslipidemia, and higher doses of corticosteroids were associated with an increased risk of postprocedural complications and restenosis.
  
  
  CONCLUSIONS
  In patients with TA, both open surgical and endovascular revascularization procedures are associated with high failure rates and frequent operative complications. Traditional cardiovascular risk factors, corticosteroid dose, and active disease are risk factors for restenosis after revascularization procedures.
authors.affiliation: From the Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Department of Medicine, Mayo Clinic, Rochester, Minnesota; and Division of Rheumatology, University of California at Los Angeles (UCLA), Los Angeles, California, USA.C. Labarca, MD, Unit of Rheumatology, Department of Internal Medicine, Clinica Alemana de Santiago, Santiago, Chile; Division of Rheumatology, Department of Medicine, Mayo Clinic; C.S. Crowson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research and Division of Rheumatology, Department of Medicine, Mayo Clinic; A. Makol, MBBS, Division of Rheumatology, Department of Medicine, Mayo Clinic; T.A. Kermani, MD, MS, Division of Rheumatology, UCLA; E.L. Matteson, MD, MPH, Division of Rheumatology, Department of Medicine, and Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic; K.J. Warrington, MD, Division of Rheumatology, Department of Medicine, Mayo Clinic. clabarcasolar@gmail.com.
authors.forename: Cristian
authors.initials: C
authors.lastname: Labarca
authors.affiliation: From the Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Department of Medicine, Mayo Clinic, Rochester, Minnesota; and Division of Rheumatology, University of California at Los Angeles (UCLA), Los Angeles, California, USA.C. Labarca, MD, Unit of Rheumatology, Department of Internal Medicine, Clinica Alemana de Santiago, Santiago, Chile; Division of Rheumatology, Department of Medicine, Mayo Clinic; C.S. Crowson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research and Division of Rheumatology, Department of Medicine, Mayo Clinic; A. Makol, MBBS, Division of Rheumatology, Department of Medicine, Mayo Clinic; T.A. Kermani, MD, MS, Division of Rheumatology, UCLA; E.L. Matteson, MD, MPH, Division of Rheumatology, Department of Medicine, and Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic; K.J. Warrington, MD, Division of Rheumatology, Department of Medicine, Mayo Clinic.
authors.forename: Ashima
authors.initials: A
authors.lastname: Makol
authors.affiliation: From the Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Department of Medicine, Mayo Clinic, Rochester, Minnesota; and Division of Rheumatology, University of California at Los Angeles (UCLA), Los Angeles, California, USA.C. Labarca, MD, Unit of Rheumatology, Department of Internal Medicine, Clinica Alemana de Santiago, Santiago, Chile; Division of Rheumatology, Department of Medicine, Mayo Clinic; C.S. Crowson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research and Division of Rheumatology, Department of Medicine, Mayo Clinic; A. Makol, MBBS, Division of Rheumatology, Department of Medicine, Mayo Clinic; T.A. Kermani, MD, MS, Division of Rheumatology, UCLA; E.L. Matteson, MD, MPH, Division of Rheumatology, Department of Medicine, and Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic; K.J. Warrington, MD, Division of Rheumatology, Department of Medicine, Mayo Clinic.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Crowson
authors.affiliation: From the Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Department of Medicine, Mayo Clinic, Rochester, Minnesota; and Division of Rheumatology, University of California at Los Angeles (UCLA), Los Angeles, California, USA.C. Labarca, MD, Unit of Rheumatology, Department of Internal Medicine, Clinica Alemana de Santiago, Santiago, Chile; Division of Rheumatology, Department of Medicine, Mayo Clinic; C.S. Crowson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research and Division of Rheumatology, Department of Medicine, Mayo Clinic; A. Makol, MBBS, Division of Rheumatology, Department of Medicine, Mayo Clinic; T.A. Kermani, MD, MS, Division of Rheumatology, UCLA; E.L. Matteson, MD, MPH, Division of Rheumatology, Department of Medicine, and Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic; K.J. Warrington, MD, Division of Rheumatology, Department of Medicine, Mayo Clinic.
authors.forename: Tanaz A
authors.initials: TA
authors.lastname: Kermani
authors.affiliation: From the Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Department of Medicine, Mayo Clinic, Rochester, Minnesota; and Division of Rheumatology, University of California at Los Angeles (UCLA), Los Angeles, California, USA.C. Labarca, MD, Unit of Rheumatology, Department of Internal Medicine, Clinica Alemana de Santiago, Santiago, Chile; Division of Rheumatology, Department of Medicine, Mayo Clinic; C.S. Crowson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research and Division of Rheumatology, Department of Medicine, Mayo Clinic; A. Makol, MBBS, Division of Rheumatology, Department of Medicine, Mayo Clinic; T.A. Kermani, MD, MS, Division of Rheumatology, UCLA; E.L. Matteson, MD, MPH, Division of Rheumatology, Department of Medicine, and Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic; K.J. Warrington, MD, Division of Rheumatology, Department of Medicine, Mayo Clinic.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Matteson
authors.affiliation: From the Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Department of Medicine, Mayo Clinic, Rochester, Minnesota; and Division of Rheumatology, University of California at Los Angeles (UCLA), Los Angeles, California, USA.C. Labarca, MD, Unit of Rheumatology, Department of Internal Medicine, Clinica Alemana de Santiago, Santiago, Chile; Division of Rheumatology, Department of Medicine, Mayo Clinic; C.S. Crowson, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research and Division of Rheumatology, Department of Medicine, Mayo Clinic; A. Makol, MBBS, Division of Rheumatology, Department of Medicine, Mayo Clinic; T.A. Kermani, MD, MS, Division of Rheumatology, UCLA; E.L. Matteson, MD, MPH, Division of Rheumatology, Department of Medicine, and Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic; K.J. Warrington, MD, Division of Rheumatology, Department of Medicine, Mayo Clinic.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Warrington
mesh_terms: D000328:Adult; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013625:Takayasu Arteritis / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*; D055815:Young Adult
keywords: OUTCOMES; REVASCULARIZATION; TAKAYASU ARTERITIS; VASCULITIS