M. Staneva 1, V. Chervenkoff 1, B. Minkova 1, G. Kirova 2, D. Markov 1, Ts. Tsvetanov 1, P. Antova 1
1 Department of Vascular Surgery and Angiology,
2 Department of Radiology, Tokuda Hospital – Sofia, Bulgaria
Objective: Takayashu arteriitis (TA) is a necrotizing and obliterative segmental, large-vessel panarteriitis of unknown cause, involving elastic arteries including tha aortic arch and its branches.The disease has a strong female predilection with peak incidence in the third decade of life. Two specific forms are reported in the literature – Japanease,involving the thoracic aorta and its branches and Indian, affecting the abdominal aorta and renal arteries.
Case Reports: We present two clinical cases-patients are over 50 years of age after vascular reconstruction of supra-aortic arteries with risk factors for atherosclerosis - arterial hypertension, dyslipidemia, stress, family history. Due to recurrence of symptoms after a clinical exam and Color-coded Duplex Ultrasound (CDU) was performed and restenosis of the arterial reconstructions was found. On this occasion Multidetector Computed Tomography (MDCT) of supra-aortic cerebral arteries was performed.
The first patient (a 62 years old man) had involvement of major supra-aortic vessels and restenosis -1.5-2.5 years after the procedure. The other patient (a 52 years old woman) – the vascular lesions included supra-aortic arteries, small and medium-sized cerebral, coronary and tibial arteries. In her case it was observed early restenosis of supra-aortic and coronary reconstructions. With MDCT and immunological tests in these patients TA was diagnosed.
Discussion: In case of early or multiple restenosis of arterial reconstructions of supraaortic arteries TA is one of the major differential diagnosis to atherosclerotic lesions. Color-coded Duplex Ultrasound is a reliable modality to diagnose and follow-up of patients.
Key words: color-coded duplex ultrasound, restenosis, Takayashu arteriitis.