Arslan Caner, Junusbekov Yerik, Hamid Rauf
Cardiovascular Surgery, Kocaeli Sağlık ve Teknoloji University, Medikar Hospital, Basiskele, Kocaeli, Turkey.
Cardiovascular Surgery, Avrasya Hospital, Istanbul, Turkey.
SAGE Open Med Case Rep. 2023 Oct 10;11:2050313X231205138. doi: 10.1177/2050313X231205138. eCollection 2023.
Type I Takayasu's arteritis is a rare form of large vessel vasculitis with an unknown etiopathogenesis. It is characterized by progressive chronic inflammation and occlusive thromboaortopathy affecting the aorta and its main branches. Type I Takayasu's arteritis predominantly affects women and is most commonly observed in their third decade of life. In this report, we present the case of a 32-year-old female patient who exhibited severe long-segment stenosis in the left common carotid artery and total occlusion of the left subclavian artery. The patient experienced significant ischemic symptoms of the left upper extremity and had previously been diagnosed with Takayasu's arteritis, being followed up under maintenance corticosteroid therapy. To address these complications, we conducted a surgical bypass using a prosthetic graft. The graft was inserted intrathoracically, extending from the patient's ascending aorta to both the left common carotid artery and the left distal subclavian artery. This approach was designed to closely mimic anatomical routes, promoting optimal graft patency. In the context of this case, we highlight the importance of surgical intervention in alleviating ischemia and explore potential surgical alternatives for treating patients with Takayasu's arteritis involving the supraaortic region.
I型大动脉炎是一种病因不明的罕见的大血管血管炎。其特征为进行性慢性炎症和闭塞性血栓性主动脉病，累及主动脉及其主要分支。I型大动脉炎主要影响女性，最常见于她们30岁左右。在本报告中，我们介绍了一名32岁女性患者的病例，该患者左颈总动脉出现严重的长段狭窄，左锁骨下动脉完全闭塞。患者出现左上肢明显的缺血症状，此前已被诊断为大动脉炎，一直在接受维持性皮质类固醇治疗。为解决这些并发症，我们使用人工血管进行了外科搭桥手术。人工血管经胸腔内插入，从患者升主动脉延伸至左颈总动脉和左锁骨下动脉远端。这种方法旨在紧密模拟解剖路径，促进人工血管的最佳通畅。在这个病例中，我们强调了手术干预在缓解缺血方面的重要性，并探讨了治疗累及主动脉弓上区域的大动脉炎患者的潜在手术替代方案。
