Department of Cardiology, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
J Med Case Rep. 2023 Jan 21;17(1):20. doi: 10.1186/s13256-023-03752-0.
Takayasu arteritis is a noninfective chronic vasculitis mainly involving the aorta and its main branches. The presentation of the disease is heterogeneous, ranging from asymptomatic to catastrophic illness.
A 52-year-old Caucasian woman with known Takayasu arteritis was referred to our hospital as she suffered symptoms suspicious for cerebral hypoperfusion. Computed tomography thorax angiography revealed occlusion of all aortic arch arteries and previous surgical bypasses. Cerebral perfusion depended on a few collaterals (from the distal common carotid artery to the right internal carotid artery and from the left and right internal mammary artery and the dorsal thoracic branches to both vertebral arteries). In addition, preoperative coronary angiography revealed an unusual and large collateral arising from the sinoatrial nodal artery to the left carotid artery.
Takayasu arteritis is a relatively rare disease, with various and sometimes devastating neurological manifestations due to occlusion of the aortic arch branches. Our case highlights the importance of a thorough preoperative evaluation in search of collateral supply in symptomatic patients with Takayasu arteritis.
Takayasu 动脉炎是一种非传染性的慢性血管炎，主要累及主动脉及其主要分支。该病的表现具有异质性，从无症状到灾难性疾病不等。
一名 52 岁的白人女性，已知患有 Takayasu 动脉炎，因疑似脑灌注不足的症状被转至我院。胸部计算机断层血管摄影显示所有主动脉弓动脉闭塞和先前的手术旁路。脑灌注依赖于一些侧支循环（从远端颈总动脉到右侧颈内动脉，以及从左侧和右侧乳内动脉和背部胸支到两侧椎动脉）。此外，术前冠状动脉造影显示来自窦房结动脉到左侧颈动脉的一条异常且粗大的侧支循环。
Takayasu 动脉炎是一种相对罕见的疾病，由于主动脉弓分支闭塞，可导致各种且有时是破坏性的神经表现。我们的病例强调了在有症状的 Takayasu 动脉炎患者中，进行彻底的术前评估以寻找侧支循环供应的重要性。
