Bali H K, Jain S, Jain A, Sharma B K
Department of Internal Medicine, and Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Int J Cardiol. 1998 Oct 1;66 Suppl 1:S213-7; discussion S219-20. doi: 10.1016/s0167-5273(98)00171-5.
Eleven patients with Takayasu Arteritis (TA) underwent angioplasty and stent placement in aorta, renal, carotid, subclavian and coronary arteries. Five wall stents were deployed in aorta in four patients. Indications for angioplasty and stent placement in aorta included hypertension in four patients and claudication and erectile impotence in one patient each. Post-procedure the peak systolic pressure gradient across the stenotic segment in the aorta disappeared. Six patients underwent angioplasty and stent placement in carotid arteries. Indications were syncope in 6 patients, loss of vision, stroke, transient ischaemic attack and seizures in one patients each. There was a marked improvement in symptoms in the patients following the procedure. For chronic total occlusion of subclavian arteries, two stents were deployed in two patients. Following the stent placement pulses in upper limb reappeared. Stents were also deployed to treat near total occlusion of right coronary artery and flow limited dissection of renal artery in one patient each. Complications of the procedure included pain in the back, mild hypertension, transient bradycardia and conduction block in one patient each. In conclusion, the stenotic and obliterative vascular lesions in TA can be managed successfully with angioplasty and stent placement. A long term follow up is required to determine the re-stenosis rate.
11例大动脉炎（TA）患者在主动脉、肾动脉、颈动脉、锁骨下动脉和冠状动脉接受了血管成形术和支架置入术。4例患者在主动脉置入了5个壁式支架。主动脉血管成形术和支架置入的指征包括4例患者的高血压以及1例患者的跛行和勃起功能障碍。术后，主动脉狭窄段的收缩压峰值梯度消失。6例患者在颈动脉接受了血管成形术和支架置入术。指征为6例患者的晕厥，以及1例患者的视力丧失、中风、短暂性脑缺血发作和癫痫。术后患者症状有明显改善。对于锁骨下动脉慢性完全闭塞，2例患者置入了2个支架。支架置入后上肢脉搏重新出现。还为1例患者置入支架治疗右冠状动脉近完全闭塞和肾动脉血流受限性夹层。该手术的并发症包括1例患者的背部疼痛、轻度高血压、短暂性心动过缓和传导阻滞。总之，TA中的狭窄和闭塞性血管病变可以通过血管成形术和支架置入术成功治疗。需要长期随访以确定再狭窄率。
