Simultaneous Multi-Supra-Aortic Artery Bypass Successfully Implemented in 17 Patients with Type I Takayasu Arteritis

• Published in: European journal of vascular and endovascular surgery Vol. 56; no. 6; pp. 903 - 909
• Main Authors: Chen, Zuoguan G., Chen, Yuexin X., Diao, Yongpeng P., Wu, Zhiyuan Y., Yan, Sheng, Ma, Li, Liu, Changwei W., Li, Yongjun J.
• Format: Journal Article
• Language: English
• Published: England Elsevier B.V 01.12.2018
• Subjects: Adolescent; Adult; Aorta - surgery; Blood Loss, Surgical - statistics & numerical data; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - methods; Brachiocephalic Trunk - surgery; Bypass; Carotid Artery Diseases; Cerebral ischaemia; Computed Tomography Angiography; Female; Humans; Length of Stay; Male; Middle Aged; Open surgery; Operative Time; Quality of Life; Recurrence; Reperfusion - methods; Saphenous Vein - transplantation; Simultaneous; Takayasu arteritis; Takayasu Arteritis - physiopathology; Takayasu Arteritis - surgery; Type I; Ultrasonography, Doppler, Duplex; Vascular Patency - physiology; Vascular Surgical Procedures - methods; Young Adult; Cerebral ischaemia; Takayasu arteritis; Simultaneous; Bypass; Open surgery; Type I
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/j.ejvs.2018.08.044

Type I Takayasu arteritis is common in Chinese patients and usually leads to cerebral ischaemia. There are limited data regarding simultaneous multi-supra-aortic artery (SMSAA) bypass in patients with type I Takayasu arteritis. The present study shares experience of using this method. Seventeen patients with Takayasu arteritis who received SMSAA bypass from June 2012 to March 2016 were included in this analysis. Demographic features and basic information were recorded. Follow up results, including major complications, patency rates, and survival rates, were also obtained. The EQ-5D questionnaire was also administered to evaluate the quality of life of patients. Among these 17 patients, there were 77 supra-aortic arteries affected by TA and 37 arteries were reconstructed, 10 with great saphenous vein and 27 with artificial blood vessels. All the operations were technical successes and the mean operation time was 396.6 ± 93.4 min. The patients were followed for a mean of 25.2 ± 12.3 months. Two graft restenoses were found, and both were successfully recanalised by balloon dilatation. One patient suffered a minor stroke but was free from obvious sequelae. No major complications, recurrent symptoms, or deaths occurred during the follow up period. The EQ-5D questionnaire scores were significantly improved after the operation compared with the pre-operative scores (87.14 ± 8.25 vs. 58.93 ± 14.4, p < .01), and all the patients enjoyed a satisfactory quality of life. SMSAA bypass in type I Takayasu arteritis can be effectively and safely performed with rigorous peri-operative management. Maintaining the patency of the bypass graft relieves the symptoms of cerebral ischaemia and helps sustain patients’ quality of life.