De novo Carotid Artery Stenting in Takayasu's Arteritis
Percutaneous balloon angioplasty (PTBA) is a universally accepted mode of therapy for stenotic coronary and peripheral arterial lesions. To establish the role of PTBA and stent placement in patients with Takayasu's arteritis (TA), these procedures were performed in 20 patients with TA. All patients received steroids, aspirin, and ticlodipine (for stent placement) prior to the procedure. Angioplasty was carried in patients with an asymptomatic stenotic vessel of more than 70% of normal diameter or a peak systolic gradient of more than 50 mm across the stenotic aortic lesion. Stenting was performed for the ostial lesion, long segment lesion or incomplete relief of stenosis and dissection following angioplasty. Carotid angioplasty and stenting was performed in five patients, aortic angioplasty in nine patients, aortic angioplasty and stenting in four patients, renal angioplasty in three patients, renal angioplasty and stenting in two patients and subclavian angioplasty in two patients, subclavian, angioplasty and stenting in three patients and coronary angioplasty and stent placement in one patient. The procedure was successful in all but one patient. On following up, two patients with carotid stent placement had restenosis. A saccular aneurysm developed at the lower end of the stent in one patient with aortic stent placement. The PTBA with or without stent placement is a safe and effective method for relief of stenotic lesion in patients with TA.
HK Bali, Suresh Kumar, D. Kaura, AK Jain, S. Singh, L Kumar, S. Jain BK Sharma: De novo Carotid Artery Stenting in Takayasu’s Arteritis, Indian Heart J 1997; 49-623.