Surgical treatment of Takayasu arteritis.

The role of surgical therapy for Takayasu arteritis remains controversial. From 1973-1991, 23 patients with Takayasu arteritis have been treated at the University of Southern California. Twelve patients have required 17 arterial reconstructions for symptomatic complications of arterial disease refractory to medical therapy. Indications for operation have included renovascular hypertension (7), extremity ischemia (5), cerebrovascular insufficiency (2), dilated ascended aorta with aortic insufficiency (1), thoracic aortic aneurysm (1), and abdominal aortic aneurysm (1). Long-term clinical follow-up has demonstrated uniform symptomatic improvement. Fifteen of seventeen arterial reconstructions are still patent. Surgical treatment of symptomatic Takayasu arteritis is highly effective. Excellent long-term graft patency can be expected following arterial reconstruction.