Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Surgery Versus Endovascular Repair in Takayasu Arteritis: A Multicenter Study of 166 Procedures.
Saadoun1, David, Lambert2, Marc, Mirault3, Tristan, Shoindre1, Yoland, Amoura4, Zahir, Rigon1, Mathieu Resche, Hatron5, Pierre yves
Department of Internal Medicine and Laboratory I3 "Immunology, Immunopathology, Immunotherapy", UMR CNRS 7211, INSERM U959, Groupe Hospitalier Pitié-Salpetrière, Université Pierre et Marie Curie, Paris 6, Paris,
Service de médecine interne, Hôpital Claude Huriez, Université Lille II, Lille, France, Lille, France
Service de Médecine Vasculaire HEGP, Paris, France
CHU Pitié-Salpêtrière, Paris, France
Service de médecine interne, Hôpital Claude Huriez, Université Lille II, Lille, France, Paris, France
Hopital La Pitie, Paris, France
With recent advances in endovascular treatment, percutaneous endoluminal angioplasty (PTA) has become particularly attractive for arterial lesions of Takayasu arteritis (TA). However, data provided from cases reports or small series and the long term outcome has not been reported. The incidence of potential vascular complications after surgery or endovascular treatment is still to be determined.
Retrospective multicenter study comparing the results and outcome of 79 consecutive patients with TA [median (IQR) age 39 (2550) years, with 63 (79.7%) females)] who underwent 166 vascular procedures [104 (62.7%) surgery and 62 (37.3%) PTA] for the management of arterial complications.
After a time of follow-up of 6.5 (2.211.5) years, 74 complications were observed including restenosis (n=42), thrombosis (n=7), renal insufficiency (n=7), bleeding (n=6), sepsis (n=4), stroke (n=4) and hypertension (n=4). The 5- and 10-years arterial complication free survival rates were 60% and 57% versus 49% and 29% (P<0.05) in the surgery group versus PTA group, respectively. In multivariate analysis, PTA [OR (95%CI) 3.61 (1.310.3); P=0.021] was independently associated with the occurence of arterial complications. Patients who experienced complications had higher erythrocyte sedimentation rate (P<0.001), C-reactive protein (P<0.001) and fibrinogen (P<0.005) serum levels compared to those without complications.
Our study is the first to show in TA that PTA increase by 4 times the likelihood of complications compared to surgery. Biological inflammation at the time of revascularisation is associated with an increase odds of arterial complications.
To cite this abstract, please use the following information:
Saadoun, David, Lambert, Marc, Mirault, Tristan, Shoindre, Yoland, Amoura, Zahir, Rigon, Mathieu Resche, et al; Surgery Versus Endovascular Repair in Takayasu Arteritis: A Multicenter Study of 166 Procedures. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :859