Takayasu arteritis in Turkey

Takayasu arteritis in Turkey

International Journal of cardiology International Journal of Cardiology 54 Suppl. (1996) S135-S136 Takayasu arteritis in Turkey Ciineyt Tiirkoglu*, ...

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International Journal of

cardiology International Journal of Cardiology 54 Suppl. (1996) S135-S136

Takayasu arteritis in Turkey Ciineyt Tiirkoglu*, Ahmet Memi~, Serdar Payzin, Mustafa Akin, Hakan Kiiltiisay, Azem Akilli, Levent Can, Ahmet Altintig Department of Cardiology and Radiology. Ege University School of Medicine. lzmir. Turkey

Abstract Takayasu arteritis is a non-spesific inflamatory process of unknown etiology affecting the aorta and its branches. A retrospective study was done in 14 patients diagnosed as Takayasu arteritis. Eleven patients were female and three were male. Ages ranged from 12 to 30 years. Seven patients had type I arteritis, three patients type II arteritis, and four patients type III Takayasu arteritis. Successful angioplasty was performed in five cases.

Keywords: Takayasu arteritis; Balloon angioplasty

1. Introduction

3. Results

Takayasu arteritis was first described in 1908 by Takayasu [I]. The disease affects women more frequently than men. A specific etiology for Takayasu arteritis has not been found [2]. The majority of cases have been reported from Asia [3]. In this paper a clinical study of 14 cases of Takayasu arteritis is described.

Seven patients had type I arteritis, three patients type II arteritis, and in four patients type III Takayasu arteritis was diagnosed. The angiography revealed irregular internal surface of the vessel wall, stenosis, occlusion of the proximal

2. Materials and methods A retrospective study was done in 14 patients diagnosed as Takayasu arteritis from 9200 angiographic studies in the last 3 years. Takayasu arteritis was diagnosed by clinical and angiographic findings in all cases. Eleven patients were female and three were male. The patients ages ranged from 12-30 years. • Corresponding author, Tel.: +90 232 3746278; fax: +90 232 3746618.

Table 1 Angiographic findings of patients Arterial lesions Thoracic aorta Subclavian Axillary Carotid Vertebral Abdominal aorta Mesenteric Renal Iliac Total

0167-5273/96/$15.00 © 1996 Elsevier Science Ireland Ltd. All rights reserved Pll SOI67-5273(96)02645-9

Stenosis 2 6 4 2

Occlusion Totallesion 2

2 2

2 2 4 I 5

I 4 1

5 2 27

8 6

5

2 32

SI36

C. Turkoglu et al./lnternational Journal of Cardiology 54 Suppl. (1996) S135-S136

Fig. I. Magnetic resonance image of patient with aortic coarctation.

portions of the branches of the aorta (Table I). Severe aortic coarctation was present in one patient (Fig. I). The arterial hypertension and low ejection fraction due to hypertention was present in this case. Successful angioplasty was performed in five cases. In these cases the stenosis was present in the renal artery in two, and in the axillary artery in three. 4. Discussion

Takayasu arteritis is a non-specific inflammattory process of unknown etiology affecting segmentally the aorta and its main branches. The end result of the marked fibrosis and thickening of the arterial wall is stenosis or occlusion [4,5]. In this paper 14 cases diagnosed as Takayasu arteritis are investigated, 78% of which are female, main symptoms of patients were anorexia, malaise, weight loss and arthralgias. Type I Takayasu arteritis was demonstrated in 50% of patients. Severe hypertension was present due to aortic coarctation in one patient and renal artery stenosis in two patients. Vasodilator agents and angiotensin converting enzyme inhibitors were used in these patients. Successful use of percutaneous transluminal angioplasty for dilatation of stenotic lesions has

also been reported [6,7]. In our five cases angioplasty was performed. Stenotic artery was axillary artery in three cases and renal artery in two cases. There is no complication such as dissection or acute occlusion. In a follow-up study after 6 months the patent arteries were found without restenosis. Heart failure was diagnosed in two patients. Medical treatment was successfull in these patients.

References [II Takayasu M. Case with unusual changes of the central vessels in the retina. Acta Soc Ophthalmol Jpn 1908;12:554. [2J Lupi-Herrera E, Sanches-Torres G. Marcushamen Jet a!. Takayasu's arteritis. Clinical study of 107 cases. Am Heart J. 1977;93:94. [3J Kakao K, Ikeda M, Kimata S et a!. Takayasu arteritis Clinical report of 84 cases and immunological studies of 7 cases. Circulation 1967;35: 1141. [4J Marooka S, Saito Y, Nonaka Y et a!. Clinical features of aortitis syndrome in Japanese women older than 40 years. Am J Cardiol 1984;53:859. [5J Swinton NW, Cook GA. Systolic hypertention cardiac mortality of Takayasu's aortoarteritis. Angiology 1976;27:568. [6J Hodgins GW, Dutton JW. Transluminal dilatation of Takayasu's arteritis. Can J Surg 1984;27:355. [7] Hall S, Barr W, Lie JT el a!. Takayasu arteritis. Medicine 1985;64:89.