Long-Term Follow-Up of Endovascular Repair in the Management of Arterial Stenosis Caused by Takayasu's Arteritis.
BACKGROUND
This retrospective study evaluated the long-term results of endovascular repair in the management of arterial stenosis caused by Takayasu's arteritis (TA).


METHODS
Sixty-seven endovascular procedures (percutaneous transluminal balloon angioplasty or stenting) were performed for 49 arterial lesions in 35 patients. Endovascular treatment was performed when the disease was inactive. The patients were pretreated with immunosuppressive drugs and were followed every 3-6 months to monitor disease activity and medical treatment. Doppler ultrasonography and magnetic resonance angiography were performed every 6 months. Kaplan-Meier method with the log-rank test was used to analyze the survival of renal artery procedures because the number of lesions in other territories was not sufficient for statistical analysis. The mean follow-up duration after the endovascular procedure was 83 months (range: 12-144 months).


RESULTS
Twenty-two (33%) endovascular interventions resulted in restenosis or occlusion. Reinterventions resulted in primary assisted patency in 45 (92%) lesions with restenosis. Only 4 (8%) of the 49 arterial lesions were occluded at the time of the final evaluation. The overall patency rate for the renal artery stents was 93.7% (15/16) after 8 years of follow-up. In the Kaplan-Meier survival analyses of the renal artery lesions, the 1- and 8-year restenosis-free survival rates of renal arterial interventions were 74% and 57%, respectively, (P = 0.281).


CONCLUSIONS
In this study, endovascular treatment with adequate immunosuppressive medication resulted in long-term patency with one- or multi-stage reinterventions in 92% of stenotic arterial lesions caused by TA.
Department of Radiology, Dokuz Eylül University School of Medicine, İzmir, Turkey.
Aytaç
A
Gülcü
Department of Radiology, Dokuz Eylül University School of Medicine, İzmir, Turkey. Electronic address: drsinemgezer@gmail.com.
Naciye Sinem
NS
Gezer
Department of Internal Medicine, Katip Çelebi University School of Medicine, İzmir, Turkey.
Servet
S
Akar
Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey.
Nurullah
N
Akkoç
Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey.
Fatoş
F
Önen
Department of Radiology, Dokuz Eylül University School of Medicine, İzmir, Turkey.
Ahmet Yiğit
AY
Göktay
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation; D001027:Aortography; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013625:Takayasu Arteritis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014654:Vascular Patency; D055815:Young Adult
D007166:Immunosuppressive Agents