Takayasu Arteritis: Criteria for Surgical Intervention Should Not Be Ignored

Figure 3

Indications for surgical intervention in Takayasu arteritis. Surgery should not be undertaken lightly in patients with TA. However, the outcome of intervention in those with serious complications is good and improved if disease activity can be controlled prior to surgery. The figure shows MRA studies. (a) A right renal artery stenosis subsequently successfully treated by percutaneous angioplasty with resolution of hypertension. (b) Severe disease of the great vessels including stenoses of the right subclavian and common carotid arteries (arrows) and occlusion of the left subclavian and left common carotid arteries (stars). The patient suffered severe cerebrovascular symptoms and underwent successful bypass surgery. (c) A dilated ascending aorta with associated severe aortic regurgitation in a young female patient who required aortic valve replacement. (d) Although patients commonly suffer claudication symptoms as a consequence of subclavian artery stenosis (arrow), these often improve following the development of collaterals (stars) as shown here, precluding the need for intervention.