Surgical procedures in the management of Takayasu's arteritis

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Presentation transcript:

Surgical procedures in the management of Takayasu's arteritis Fred A. Weaver, MD, Albert E. Yellin, MD, David H. Campen, MD *, John Oberg, MD, John Foran, MD, Rodanthi C. Kitridou, MD *, Stephen E. Lee, MD, Roy D. Kohl, MD Journal of Vascular Surgery Volume 12, Issue 4, Pages 429-439 (October 1990) DOI: 10.1016/0741-5214(90)90045-C Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Anatomic distribution of arterial involvement with Takayasu's arteritis according to Ueno's classification. Type I, aortic arch involvement only, seven patients. Type II, thoracic and abdominal aortic involvement only, three patients. Type III, diffuse aortic involvement, 10 patients. Journal of Vascular Surgery 1990 12, 429-439DOI: (10.1016/0741-5214(90)90045-C) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Aortogram demonstrates large thoracic aneurysm. This patient had a concomitant abdominal aortic aneurysm. Journal of Vascular Surgery 1990 12, 429-439DOI: (10.1016/0741-5214(90)90045-C) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Elastin stain of renal artery demonstrates intimal and medial fibrosis, disruption and thinning of the internal elastic lamina, and a mild inflammatory infiltrate. Journal of Vascular Surgery 1990 12, 429-439DOI: (10.1016/0741-5214(90)90045-C) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Aortogram 30 months after surgery demonstrates patent, intact proximal supraceliac aortic anastomosis in a patient with a distal aortic occlusion. Journal of Vascular Surgery 1990 12, 429-439DOI: (10.1016/0741-5214(90)90045-C) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 A, Twenty-four-year-old Hispanic woman with severe hypertension and congestive heart failure. Aortogram demonstrates proximal left renal artery occlusion. Reconstituted distal renal artery (arrow) is fed by numerous collaterals. B, Eighteen months after a left renal artery bypass (arrow) the patient is normotensive on no antihypertensive agents. Her cardiac function is normal. Journal of Vascular Surgery 1990 12, 429-439DOI: (10.1016/0741-5214(90)90045-C) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions