Stenting for middle aortic syndrome
Eleven patients with Takayasu Arteritis (TA) underwent angioplasty and stent placement in the aorta, renal, carotid, subclavian and coronary arteries. Five wall stents were deployed in the aorta in four patients. Indications for angioplasty and stent placement in the 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 patient 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. Were stents also deployed to treat near total occlusion of the right coronary artery and? ow, limited dissection of the 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. ? 1998 Elsevier Science Ireland Ltd. All rights reserved.
A.K. Jain, H.K. Bali: Stenting for the middle aortic syndrome. Heart 1999, 536.