Percutaneous transluminal angioplasty
Renal artery, stenosis
Subclavian artery, stenosis
Springer Online Journal Archives 1860-2000
Summary Percutaneous transluminal balloon angioplasty (PTBA) was performed in 87 patients for 111 stenotic lesions due to Takayasu arteritis. Of the lesions attempted for dilatation, 35 were in the aorta, 64 in renal arteries, 9 in subclavian, and 3 in common iliac arteries. The stenosis of aorta could be successfully dilated in 33 of 35 (94.3%) patients with fall in peak systolic pressure gradient (PSG) from 77.7 ± 28.4 mmHg to 26.4 ± 20.6 mmHg (P 〈 0.001) and increase in luminal diameter from 4.7 ± 2.4 mm to 10.1 ± 4.1 mm (P 〈 0.001). On hemodynamic and angiographic restudy in 20 patients at 3–24 months (mean 7.7 ± 4.1 months) further fall in PSG (⩾15 mmHg) was observed in 7 patients, no significant change in 12 patients and restenosis with increase in PSG in one patient which could be successfully redilated. Late restudy at 36–60 months (mean 43 ± 9.4) in six patients showed continued relief of stenosis (mean PSG 8.8 ± 7.8 mmHg). Of the 64 stenotic lesions of the renal arteries, 58 (90.6%) could be successfully dilated with decrease in stenosis from 89.1 ± 10.1% to 29.9 ± 14.9% (P 〈 0.001). Follow-up intra-arterial digital subtraction angiography in 25 patients at a mean follow-up period of 13.1 months (range 3–29 months) showed restenosis in 5/36 (13.9%) lesions which could be successfully redilated. Angioplasty was also successful in dilating 8/9 (88.9%) subclavian and all 3 common iliac artery stenosis. There was marked improvement in symptoms after successful angioplasty. Blood pressure was reduced to normal or improved in all successfully dilated aortic stenosis and in 84.6% of renal artery stenosis. In conclusion, PTBA is safe, highly effective, and therefore should be considered as the treatment of choice particularly for discrete stenotic lesions due to Takayasu arteritis.
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