A Case of Thoracic Endovascular Aortic Repair for Descending Thoracic Aortic Aneurysm due to Takayasu Arteritis

(Division of Vascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan)

Kimihiro Igari Toshifumi Kudo Takahiro Toyofuku
Masatoshi Jibiki Yoshinori Inoue
A girl was given a diagnosis of Takayasu arteritis(TA)with thoracic aortic aneurysm(TAA)at 11 years old, and began receiving medical treatment using steroids. At age 19, her biological inflammation markers were within normal limit;however, contrast-enhanced CT showed the enlargement of the TAA to 60mm in diameter. The risks and benefits of traditional revascularization vs endovascular procedures were carefully considered. The presence of suitable anatomical conditions, including adequate 20-mm-long landing zones, led us to select an endovascular approach. We exposed the right common iliac artery via a retroperitoneal approach, then, original stent grafts, using Z stents covered with thin-wall polytetrafluoroethylene, were positioned in the descending aorta from the level of the left subclavian artery to the level of the celiac artery. Intraoperative arteriography showed a patent stent graft without endoleaks or enlargement of the TAA. The postoperative course was uneventful, and follow-up CT scan performed 4 years after the repair showed shrinkage of the aneurysm diameter, and no evidence of any endoleaks. We concluded that endovascular treatment for TA-related aneurysm can be useful and safe, but further follow-up is needed in this case.
  Jpn. J. Cardiovasc. Surg. 42:485-488(2013)

Keywords:Takayasu arteritis, descending thoracic aortic aneurysm, thoracic endovascular aortic repair