| A Case of Takayasu's Arteritis
That Developed Impending Ruptured Subclavian Artery Aneurysm
Associated with Sepsis during Steroid Therapy |
(Department of Cardiovascular Surgery, Hokkaido
University, Sapporo, Japan)
| Takashi Kunihara |
Kazuhiro Eya |
Tsukasa Miyatake |
| Norihiko Shiiya |
Keishu Yasuda |
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A 20-year-old woman had intermittent
fever frequently since dental therapy one year previously. Two
months previously Takayasu's arteritis had been diagnosed and
she had been given 30mg/day prednisolone. She then developed
subarachnoid hemorrhage, left arm pain/cataplexy, purpura, sight
disturbance, and sepsis caused by Serratia.
Finally she felt chest pain and a left subclavian artery pseudoaneurysm
was detected out. Therefore she was transferred to our service
for emergency surgery. Preoperative angiography demonstrated
post-stenosis aneurysm in the right common carotid artery, left
common carotid artery aneurysm, and saccular pseudoaneurysm in
the left subclavian artery that suggested impending rupture.
The operation was performed through a left upper partial sternotomy
extended to the left supraclavicular space. The left subclavian
artery was ligated proximal to the aneurysm and distal portion
was also ligated through a subclavicular approach. The postoperative
course was uneventful. No ischemic sign has been seen in her
left arm one year after operation and left/right brachial artery
pressure index has improved to 0.80. The patient currently takes
steroids and remains healthy without signs of expansion of bilateral
carotid artery aneurysms.
Jpn. J. Cardiovasc. Surg. 33: 433-436 (2004) |
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