Takayasu arteritis

Giovanni Battista Mlorgani reported the first case with Takayasu arteritis (TA) in 1761. The disease affects the aortic arch and large blood vessels. It is found in every race and in every age-group, predominantly in female population aged 20-40 years. There are four types of TA: type I affects blood vessels of aortic arch: Type II is syndrome of middle aorta (thoracal and abdominal aorta); Type III affects aortic arch and abdominal aorta; Type IV affects pulmonary artery. TA has three phases: 1. weakness, fever, anemia, loss of appetite: 2. inflammation of blood vessels; 3. symptoms of stenosis and occlusive lesions. Pathoanatomical disorder includes inflammation of all three layers of blood vessels. This is a case report of a 41-year-old woman with TA. She suffered from chest pain, fatigue and pain in both legs, predominatly in the right. Clinical presentation of the disease varies whereas development of TA is unpredictable. Angiography is an important method in diagnosis of the disease and in planning surgical treatment. In our patient five arterial stenoses were established by angiography. ECHO Color Doppler angiography may be useful. Diagnostic criteria include: age under 40 years, occlusion of the right and left subclavian artery and nine minor criteria. Corticosteroid and antiinflammatory therapy is indicated. One third of patients needs surgery. In our opinion surgical treatment should be delayed until acute phase is over. Surgical treatment in our patient included: aortobifemoral bypass and left carotid-axillary bypass grafting. Some patients need multiple surgical treatments, like our patient. They also need post-surgical controls.