Retrospective Comparison of Open versus Endovascular Procedures for Takayasu Arteritis

被引:44
作者
Labarca, Cristian [1 ,4 ]
Makol, Ashima [1 ]
Crowson, Cynthia S. [1 ,2 ]
Kermani, Tanaz A. [3 ]
Matteson, Eric L. [1 ,5 ]
Warrington, Kenneth J. [1 ]
机构
[1] Mayo Clin, Div Rheumatol, Dept Med, Rochester, MN USA
[2] Mayo Clin, Div Biomed Stat & Informat, Dept Hlth Sci Res, Dept Med, Rochester, MN USA
[3] Univ Calif Los Angeles, Div Rheumatol, Los Angeles, CA USA
[4] Clin Alemana Santiago, Dept Internal Med, Rheumatol Unit, Santiago, Chile
[5] Mayo Clin, Div Epidemiol, Dept Hlth Sci Res, Rochester, MN USA
关键词
TAKAYASU ARTERITIS; VASCULITIS; OUTCOMES; REVASCULARIZATION; DISEASE-ACTIVITY; ANGIOPLASTY; INTERVENTION; PROGRESSION; PET;
D O I
10.3899/jrheum.150447
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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. Conclusion. 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.
引用
收藏
页码:427 / 432
页数:6
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