Chapter 17 - Takayasu’s Arteritis

Abstract

Takayasu's arteritis (TA) is a chronic nonspecific inflammatory disease that frequently occurs in young women. TA mainly involves the aorta and its major branches, the coronary and pulmonary arteries. About 10–30% of patients with TA have coronary artery involvement. Lesions of ostial or proximal segments of the main coronary artery are the most frequently observed sites. Accelerated atherosclerosis takes place particularly at sites of active inflammation. Revascularization procedures cannot be performed until inflammation is controlled. Coronary artery bypass grafting, especially saphenous vein graft, is preferred due to the nature of TA. Percutaneous transluminal coronary angioplasty with drug-eluting stents may work as a bridge until inflammation is effectively controlled and surgical grafting can be applied. Bioresorbable vascular scaffold may be an alternative method of treatment in young TA patients with ostial major vessel coronary disease. TA patients should be administered appropriate immunosuppressive pharmacotherapy given the systemic nature of TA.