• Title/Summary/Keyword: Arteritis

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Extra-Anatomic Ascending Aorta to Abdominal Aorta Bypass in Takayasu Arteritis Patients with Mid-Aortic Syndrome

  • Kim, Hak Ju;Choi, Jae-Woong;Hwang, Ho Young;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.270-274
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    • 2017
  • Background: We evaluated the operative outcomes of an extra-anatomic bypass from the ascending aorta to the abdominal aorta in patients with type II or III Takayasu arteritis (TA) with mid-aortic syndrome. Methods: From 1988 to 2014, 8 patients with type II (n=2) or III (n=6) TA underwent an ascending aorta to abdominal aorta bypass. The mean patient age was $43.5{\pm}12.2years$ and the mean peak pressure gradient between the upper and lower extremities was $54.8{\pm}39.0mm\;Hg$. The median follow-up duration was 54.4 months (range, 17.8 to 177.4 months). Results: There were no cases of operative mortality. The mean peak pressure gradient significantly decreased to $-2.4{\pm}32.3mm\;Hg$ (p=0.017 compared to the preoperative value). Late death occurred in 2 patients. The symptoms of upper extremity hypertension and claudication improved in all patients. The bypass grafts were patent at $47.1{\pm}58.9months$ in 7 patients who underwent follow-up imaging studies. Conclusion: An extra-anatomic ascending aorta to abdominal aorta bypass could be an effective treatment option for severe aortic steno-occlusive disease in patients with type II or III TA, with favorable early and long-term outcomes.

Role of Nitric Oxide and Molsidomine in the Management of Pulmonary Hypertension in Takayasu's Arteritis (타카야수동맥염에 의한 만성 폐고혈압에서 Nitric Oxide가스와 Molsidomine의 치험 3예)

  • Chin, Jae-Yong;Lee, Sung-Soon;Lee, Sang-Soo;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Lee, Sang-Do
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.964-972
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    • 2000
  • We report three patients with pulmonary hypertension in Takayasu's arteritis, who showed long-term favorable response, clinically and hemodynamically, to the nitric oxide donor, molsidomine. In these patients, the inhaled nitric oxide was effective in reducing pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) as was shown in the acute vasodilator response test using the invasive hemodynamic monitoring. Molsidomine (single oral dose of 4 mg) was also effective in reducing PAP and PVR in the acute test, but nifedipine was not. With 4 mg of molsidomine three times daily, their dyspnea, exercise capacity and hemodynamic parameters were improved. These favorable responses have lasted during the 1st and 3rd month follow-up in all patients.

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Endovascular treatment of Takayasu arteritis in a middle-aged woman with syncope and limb claudication: a case report

  • Ha-Young Choi;Sunggun Lee;Jino Park;Yeo-Jeong Song;Dong-Kie Kim;Ki-Hun Kim;Sang-Hoon Seol;Doo-Il Kim;Seunghwan Kim
    • Journal of Yeungnam Medical Science
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    • v.40 no.4
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    • pp.448-453
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    • 2023
  • Takayasu arteritis (TA) is a disease that causes inflammation and stenosis of medium to large blood vessels. We report a case of a 50-year-old female patient with newly developed hypertension, syncope, and claudication of the extremities. Total occlusion of the left subclavian artery at the origin was found and significant stenosis of the right common iliac artery was revealed by hemodynamic analysis. She was successfully treated with percutaneous angioplasty for multiple peripheral arterial diseases and was finally diagnosed with TA. In consultation with a rheumatologist, medical treatment for TA was initiated, the patient's hypertension disappeared, and her claudication symptoms improved.

Aortic Valve Replacement in a Patient with Aortic Arch Syndrome Secondary to Takayasu's Arteritis -One case - (Takayasu씨 동맥염에 의한 대동맥궁 증후군 환자에서 대동맥판막 치환술 - 1예 보고 -)

  • 최종범;양현웅;이삼윤
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.88-91
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    • 2004
  • Aortic regurgitation is not a rare complication of Takayasu's disease. Aortic regurgitation may aggravate cerebral ischemic syndrome like syncope in patients with stenotic or occlusive lesions in cerebral branches of aorta secondary to acute or progressive inflammation. In a 34-yrs-old male patient who complained of syncope and exertional dyspnea with occlusion of both carotid arteries and severe stenoses of both subclavian arteries, occlusion of right coronary artery, and aortic regurgitation, his symptom was improved with perioperative aggressive steroid therapy, stent insertion in both subclavian arteries, and aortic valve replacement.

Carotid Artery Disease in Duplex Sonography: 3 Cases (이중초음파에서 관찰된 목동맥 질환: 3례)

  • Han, Minho;Choi, Junghye;Seo, Gang Sik;Nam, Hyo Suk
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.1
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    • pp.114-118
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    • 2019
  • Duplex sonography has been used to non-invasively diagnose carotid artery disease and to follow up patients with this disease. In carotid artery disease, carotid mobile thrombus and dissection are rarely detected by duplex sonography in patients with cerebrovascular events. In particular, carotid dissection occurs when a small tear forms in the tunica intima and makes 2 lumens in the carotid artery, including true and false lumens. This study reports 3 rare cases of carotid mobile thrombus, spontaneous carotid dissection, and carotid dissection in Takayasu arteritis.

Dark-Blood Computed Tomography Angiography Combined With Deep Learning Reconstruction for Cervical Artery Wall Imaging in Takayasu Arteritis

  • Tong Su;Zhe Zhang;Yu Chen;Yun Wang;Yumei Li;Min Xu;Jian Wang;Jing Li;Xinping Tian;Zhengyu Jin
    • Korean Journal of Radiology
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    • v.25 no.4
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    • pp.384-394
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    • 2024
  • Objective: To evaluate the image quality of novel dark-blood computed tomography angiography (CTA) imaging combined with deep learning reconstruction (DLR) compared to delayed-phase CTA images with hybrid iterative reconstruction (HIR), to visualize the cervical artery wall in patients with Takayasu arteritis (TAK). Materials and Methods: This prospective study continuously recruited 53 patients with TAK (mean age: 33.8 ± 10.2 years; 49 females) between January and July 2022 who underwent head-neck CTA scans. The arterial- and delayed-phase images were reconstructed using HIR and DLR. Subtracted images of the arterial-phase from the delayed-phase were then added to the original delayed-phase using a denoising filter to generate the final-dark-blood images. Qualitative image quality scores and quantitative parameters were obtained and compared among the three groups of images: Delayed-HIR, Dark-blood-HIR, and Dark-blood-DLR. Results: Compared to Delayed-HIR, Dark-blood-HIR images demonstrated higher qualitative scores in terms of vascular wall visualization and diagnostic confidence index (all P < 0.001). These qualitative scores further improved after applying DLR (Dark-blood-DLR compared to Dark-blood-HIR, all P < 0.001). Dark-blood DLR also showed higher scores for overall image noise than Dark-blood-HIR (P < 0.001). In the quantitative analysis, the contrast-to-noise ratio (CNR) values between the vessel wall and lumen for the bilateral common carotid arteries and brachiocephalic trunk were significantly higher on Dark-blood-HIR images than on Delayed-HIR images (all P < 0.05). The CNR values were significantly higher for Dark-blood-DLR than for Dark-blood-HIR in all cervical arteries (all P < 0.001). Conclusion: Compared with Delayed-HIR CTA, the dark-blood method combined with DLR improved CTA image quality and enhanced visualization of the cervical artery wall in patients with TAK.

Review of rheumatic diseases in terms of insurance medicine (주요 류머티스 질환의 보험의학적 이해)

  • Lee, Sin-Hyung
    • The Journal of the Korean life insurance medical association
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    • v.31 no.1
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    • pp.19-28
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    • 2012
  • Nowadays, Rheumatic diseases are increasing more and more. So, it's important knowing the pathophysiology and extra-risk of each rheumatic disease so as to do sound underwriting. Here is brief review and long-term prognosis of some rheumatic diseases such as rheumatoid arthritis, systemic lupus erythematosus, Sj$\ddot{o}$gren syndrome, antiphospholipid syndrome, systemic sclerosis, ankylosing spondylitis, Takayasu's arteritis, and Behcet syndrome.

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Angioplasty of Isolated Left Ostial Coronary Artery Tenosis in a Patient with Takayaus's Aortitis (Takayasus씨 대동맥염에 의한 단순 좌관상동맥 개구부협착의 성형술)

  • 안병희
    • Journal of Chest Surgery
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    • v.27 no.2
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    • pp.170-173
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    • 1994
  • Isolated stenotic lesion located at the ostium of the left main coronary artery associated with Takayasu`s aortitis is quite rare. This report herein described a case of 25 year old woman with isolated ostial stenosis of the left main coronary artery underwent pericardial patch [fixed with 0.6 % glutaraldehyde] angioplasty. An anterior approach was used and postoperative coronary angiogram of the patient showed normal coronary ostial contour with normal runoff.

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Clinical experiences of arterial disease (동백질환의 임상적 고찰)

  • Lee, J.H.;Kim, J.E.;Yu, H.S.
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.385-393
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    • 1980
  • From 1959 to 1980, for about 21 yrs, the authors have experienced of 69 cases of arterial diseases, and analyzed the diseases. They are Aneurysm 16 Iatrogenic thrombosis after angio & cardiac Cath. 20 Coarctation 3 Primary arteritis 9 Traumatic injury 9 Occlusive disease 12 But PDA (107 cases) & Buerger's disease are excluded in this study.

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Surgical Observations of Diseases of the Aorta (대동맥질환에 대한 외과적 고찰)

  • Rho, Joon Ryang
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.251-264
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    • 1976
  • Forty three patients with disease of the aorta were admitted in this department during the period from beginning of 1956 to the end of 1976. They consisted of eighteen cases of aortic aneurysms, eight cases of Takayasu's arteritis, eight Leriche syndromes, six dissecting aneurysms, two aortic coarctations and one case of vascular ring. Of eighteen aortic aneurysms, twelve were operated resulting in eight survivors. Three of four mortalities were in shock preoperatively because of aneurysmal rupture. Among six dissecting aortic aneurysms, four were type III and two were type I according to DeBakey's classification. For the purpose of relief of acute arterial insufficiency in the lower extremities, a re-entry operation grafting a Y-shaped dacron vessel between abdominal aorta and common iliac arteries was performed. The patient regained consciousness soon after the operation and was well until postoperative second day, when severe convulsion developed abruptly and died. And in a chronic case of type III dissecting aneurysm, a dacron graft bypass shunt between ascending aorta and lower descending thoracic aorta with resection of the aneurysm was performed, but acute severe aortic insufficiency developed soon after the operation and fell into intractable heart failure resulting in death. The cause of the aortic insufficiency seems to be retrograde dissection from the proximal anastomosis site in the ascending aorta. Three cases were treated medically with Wheat's regimen. Two of them survived with relief of symptoms. Eight patients of Takayasu's arteritis were all females and aged between twenty and forty-four averaging twenty nine. Bypass graft operation between aortic arch and carotid arteries using Y-shaped nylon prostheses were performed in three patients resulting in death in two cases postoperatively due to severe cerebral arterial insufficiency during the procedure. All the patients with Leriche syndrome were males and over forty. In two cases, bypass graft with Y-shaped dacron vessel between terminal aorta and common iliac or femoral arteries were performed with good result. Thromboembolectomy or thromboendarterectomy was employed in three patients, of whom one was aggravated in sexual problem postoperatively. One out of two aortic coarctations and a vascular ring were treated surgically with excellent results.

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