Coronary artery involvements in Takayasu arteritis: systematic review of reports
- PDF / 1,000,158 Bytes
- 22 Pages / 595.276 x 790.866 pts Page_size
- 32 Downloads / 226 Views
REVIEW ARTICLE
Coronary artery involvements in Takayasu arteritis: systematic review of reports Shi‑Min Yuan1 · Hui‑Zhen Lin2 Received: 20 January 2020 / Accepted: 28 April 2020 © The Japanese Association for Thoracic Surgery 2020
Abstract Coronary artery involvements in patients with Takayasu arteritis (TA) have not been sufficiently described. By comprehensive retrieval of the pertinent literature published in the past two decades, 59 reports including 141 patients were recruited into this study. In TA patients with coronary artery involvements, the right coronary artery was the most commonly affected. Stenosis was the most common coronary artery lesion, and the coronary ostium was the most commonly affected coronary segment. Acute myocardial infarction was diagnosed in 17 (12.1%) patients of this cohort. Patients receiving surgical treatment showed a higher recovery rate than interventionally treated patients. Interventional therapy was associated with a higher reintervention rate than surgical treatment. The inflammation condition in TA patients can lead to in-stent restenosis and warrant reinterventions. Surgical treatment is a preferable treatment of choice over interventional therapy for the coronary artery lesions of TA patients. Keywords Coronary vessels · Percutaneous coronary intervention · Takayasu arteritis
Introduction Takayasu arteritis (TA) is an idiopathic vasculitis mainly affecting the aorta and its major branches, leading to vascular wall thickening, fibrosis, stenosis and thrombus formation [1, 2]. Kerr et al. [3] reported that 32% of the TA lesions involved the aortic arch and its branches, 68% of which were above and below the diaphragm. The inflammatory process of TA leads to arterial wall thickening and results in vascular stenosis, occlusion and dilation or aneurysmal formation [4]. Overwhelming majority of TA patients develop stenotic lesions, while a few patients had vascular wall irregularity and poststenotic dilation [3]. Vascular calcification was * Hui‑Zhen Lin [email protected] Shi‑Min Yuan [email protected] 1
Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, Fujian, People’s Republic of China
Department of Clinical Laboratory, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, 389 Longdejing Street, Chengxiang District, Putian 351100, Fujian, People’s Republic of China
2
rarely seen and was usually confined to the abdominal aorta [3]. The coronary arteries, as branches of the aorta, are also affected by TA with a documented incidence of 6–30% [5]. The first diagnostic criteria for TA were developed by Ishikawa in 1988 and then modified by Sharma et al. in 1995 [4]. In the modified diagnostic criteria, the inclusion of coronary artery lesions in patients younger than 30 years in the absence of risk factors as a minor criterion [4]. Nevertheless, the clinical features, management and outcomes of TA patients with coronary artery involvements remain to be clarified. This art
Data Loading...
