Retrospective Analysis of Surgery Versus Endovascular Intervention in Takayasu Arteritis: A Multicenter Experience
Background—With recent advances in endovascular treatment, percutaneous endoluminal angioplasty has become particularly attractive for arterial lesions of Takayasu arteritis (TA). However, data provided from cases reports or small series and the long term outcome has not been reported. The incidence of potential vascular complications after surgery or endovascular treatment is still to be determined.
Methods and Results—Retrospective multicenter study analysing the results and outcome of 79 consecutive patients with TA [median (IQR) age 39 (25-50) years, with 63 (79.7%) females)] who underwent 166 vascular procedures [104 (62.7%) surgery and 62 (37.3%) endovascular] for the management of arterial complications. After a time of follow-up of 6.5 (2.2-11.5) years, 70 complications were observed including restenosis (n=53), thrombosis (n=7), bleeding (n=6), and stroke (n=4). The overall 1-, 3-, 5- and 10-years arterial complication free survival rates were of 78% (69-88), 67% (57-78), 56% (46-70) and 45% (34-60), respectively. Among the 104 surgical procedures 39 (37.5%) presented a complication, versus 31 (50%) of the 62 with endovascular repair. In multivariate analysis, biological inflammation at the time of revascularization [Odds ratio 7.48 (95% confidence interval, 1.42-39.39; P=0.04] was independently associated with the occurrence of arterial complications after the vascular procedure. Patients who experienced complications had higher erythrocyte sedimentation rate (P<0.001), C-reactive protein (P<0.001) and fibrinogen (P<0.005) serum levels compared to those without complications.
Conclusions—The overall 5-years arterial complication rate was of 44%. Biological inflammation increased the likelihood of complications after revascularization in patients with TA.
- Received July 23, 2011.
- Accepted December 5, 2011.
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