De novo Stenting of thoracic Aorta in Takayasu's Arteritis – Initial Experience
We report our intermediate-term follow-up results of de novo stenting of the descending thoracic aorta in Takayasu arteritis. Six patients (5 males and 1 female) underwent aortoplasty and stenting (8 Wallstents were deployed in 6 patients). Aortoplasty was performed with conventional balloons in 5 patients and with an Inoue balloon in 1 patient. The mean diameter of the aorta increased from 5.36 +/- 0.62 mm to 13.91 +/- 1.8 mm after stenting while the peak systolic gradient was totally abolished in all cases. These results were significantly better than aortoplasty alone (p < 0.0001). Lower limb claudication improved in all patients. Hypertension was cured in 3 patients and improved in 3 patients. All patients were asymptomatic over 6Eth 30 months (mean, 22.8 +/- 4.0 months) follow-up. All patients underwent angiographic follow-up after 6 months. They continued to have an absence of gradient with excellent flow across the stents. A minimal intimal reaction was observed at the stent margins. On follow-up angiogram at 6 months, one of the patients was noted to have developed a small asymptomatic pseudoaneurysm at the lower margin of the stent, which gradually increased in size over the next year and was treated by the percutaneous endovascular deployment of a Wallstent graft. Our series demonstrates the safety and efficacy of stent deployment in stenotic lesions of the aorta in Takayasu arteritis and proves that the results are superior to plain balloon aortoplasty alone. This is also the only study that demonstrates intermediate-term success by angiographic follow-up at 6 months.
HK Bali, M Aggarwal, AK Jain, N Kumar, V Jetley: De novo Stenting of Thoracic Aorta in Takayasu’s Arteritis – Initial Experience. Indian Heart J 1997; 49: 663.