Ando M, Sasako Y, Okita Y, Tagusari O, Kitamura S, Matsuo H
Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
Jpn J Thorac Cardiovasc Surg. 2000 Mar;48(3):173-9. doi: 10.1007/BF03218116.
Takayasu's arteritis is an inflammatory vascular disease of unknown etiology that affects the aorta and its main branches, requiring surgical intervention due to occlusive lesions. We studied early and late surgical results.
Between 1979 and December 1998, 46 patients--1 man and 45 women aged 15 to 72 years (mean: 46 +/- 13 years)--with occlusive lesions caused by Takayasu's arteritis underwent surgery. Preoperative steroids were administered to 22 patients having inflammation. Diagnosis indicating surgery included obstructive cervical vessel disease in 13 patients, obstructive coronary artery disease in 19, aortic coarctation in 15, and abdominal branch stenosis in 3. Surgical procedures involved bypass grafting in 31 (cervical vessel bypass in 13, ascending-abdominal aortic bypass in 4, axillary artery-abdominal aortic bypass in 10, descending-abdominal aortic bypass in 1, abdominal branch bypass in 3), coronary artery bypass grafting in 10, and coronary ostial endarterectomy in 9.
Four (8.7%) died during hospitalization. Follow-up ranged from 1 to 240 months (mean: 117 months). Eight suffered late deaths and 6 patients died of cardiovascular problems. The total actuarial survival rate was 76.2% at 5 years and 70.5% at 10 years.
Steroid therapy before and after surgery appears to affect the overall prognosis positively in patients with Takayasu's arteritis.
高安动脉炎是一种病因不明的炎症性血管疾病，累及主动脉及其主要分支，因闭塞性病变常需手术干预。我们研究了其早期和晚期手术结果。
1979年至1998年12月，46例因高安动脉炎导致闭塞性病变的患者接受了手术，其中男性1例，女性45例，年龄15至72岁（平均46±13岁）。22例有炎症的患者术前使用了类固醇。手术指征包括13例颈部血管阻塞性疾病、19例冠状动脉阻塞性疾病、15例主动脉缩窄和3例腹部分支狭窄。手术方式包括31例旁路移植术（13例颈部血管旁路、4例升主动脉-腹主动脉旁路、10例腋动脉-腹主动脉旁路、1例降主动脉-腹主动脉旁路、3例腹部分支旁路）、10例冠状动脉旁路移植术和9例冠状动脉开口内膜切除术。
4例（8.7%）在住院期间死亡。随访时间为1至240个月（平均117个月）。8例出现晚期死亡，6例死于心血管问题。5年总精算生存率为76.2%，10年为70.5%。
手术前后的类固醇治疗似乎对高安动脉炎患者的总体预后有积极影响。
