Takayasu's Arteritis
| UCSF Vascular Surgeons have the expertise and skill to treat all forms of aortic arch diesase, including Takayasu’s arteritis, a rare form of vasculitis rarely seen in a community practice. |
Takayasu’s arteritis, a rare form of vasculitis, involves the inflammation of the aorta, the largest blood vessel in the body, and its branches. This inflammation can weaken the blood vessels, leading to aneurysms, or a ballooning of portions of the vessels that may eventually lead to a fatal rupture. The inflammation can also cause a narrowing and blockage of the arteries leading to:
- Poor circulation.
- Muscle pain upon exertion.
- Organ damage.
- Stroke.
Takayasu’s arteritis is most commonly diagnosed in young Asian women near or under the age of 30. The condition also goes by several other names including:
- Aortic arch syndrome.
- Takayasu’s aortitis.
- Pulseless disease (because of an inability to find a pulse in the extremities due to blood vessel narrowing).
The cause of Takayasu’s arteritis is unknown.
Symptoms
Early symptoms of Takayasu’s arteritits include:
- Fatigue
- Night sweats
- Fever
- Poor appetite
- Weight loss
- Joint pain
- Chest pain
However, Takayasu’s arteritits is usually not diagnosed until more severe symptoms occur. These later symptoms depend on which part of the arteries are affected and may include:
- High blood pressure.
- Kidney failure (due to reduced blood flow to the kidneys).
- A weak or absent pulse in the arms, neck or legs.
- A differential in blood pressure between the right and left limbs.
- Angina (chest pain), especially upon exertion.
- Shortness of breath and fatigue (as a result of congestive heart failure).
- Fainting or dizziness.
- Changes in vision.
- Mini-stroke or stroke resulting from poor blood flow to the brain.
- Abdominal pain, nausea and vomiting, that result from poor blood flow to the abdomen.
- Muscle weakness and pain in the arms or legs during movement.
Diagnosis
When a person under 40 years of age suffers from unexplained high blood pressure, this may be an early clue for a diagnosis of Takayasu’s arteritis. The following criteria are used to distinguish Takayasu’s arteritis from other forms of vasculitis:
- Symptom onset at age 40 or younger.
- Muscle weakness and pain during arm and leg movement.
- A weak pulse in the brachial artery, the major artery in the upper arm.
- A bruit, or a “whooshing” sound, which can be heard through a stethoscope, in the subclavian artery or the aorta.
- A differential of at least 10 mmHg in systolic blood pressure in the right versus the left arm.
Treatment
Treatment focuses on decreasing inflammation and controlling blood pressure through medication. Treatment with medication alone is effective in nearly 80 percent of Takayasu’s arteritis patients. If the patient has suffered significant damage or narrowing in a particular artery, an endovascular or surgical repair may be necessary to restore proper function to the affected limb or organ.
Endovascular Treatment
Narrowed or occluded arteries caused by Takayasu’s arteritis may be treated using angioplasty and stenting. This procedure involves placement of a catheter in an artery of the groin through a small opening in the skin. A balloon is then pushed through to the affected part of the artery where it is opened, pushing apart the artery wall. A tube-like stent is then placed to keep the artery open and blood flowing freely. Patients usually remain in the hospital overnight and can usually resume normal activities soon thereafter.
Surgical Repair
Open surgical repair of a severely damaged artery often involves taking a graft from a healthy vessel.