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lüll Long-term survival after surgical treatment of patients with Takayasu s arteritis Miyata T; Sato O; Koyama H; Shigematsu H; Tada YCirculation 2003[Sep]; 108 (12): 1474-80BACKGROUND: Surgical interventions have been performed to ameliorate the complications of Takayasu's arteritis. However, the efficacy of surgery to increase long-term survival has not been established. METHODS AND RESULTS: A retrospective review was performed on the survival of 106 consecutive patients with Takayasu's arteritis who underwent surgical treatment during the past 40 years. Their ages ranged from 5 to 69 years (mean+/-SEM, 31.7+/-1.3 years). Survival was compared with the reported results of medically treated patients according to Ishikawa's prognostic classification. There were 12 hospital deaths, and the remaining 94 patients were followed up from 8 months to 41.8 years (mean, 19.8 years). A serious long-term complication was anastomotic aneurysm, with a cumulative incidence at 20 years of 13.8%. Thirty-one late deaths were observed, and the major cause was congestive heart failure. The overall cumulative survival rate at 20 years was 73.5%. The prognostic classification by Ishikawa had little influence on the survival of surgically treated patients. For stage 3 patients, surgery seemed to increase survival; however, surgery-related complications conversely decreased the survival of stage 1 patients. CONCLUSIONS: Surgery seems to increase the long-term survival of patients with stage 3 Takayasu's arteritis, whereas conservative treatment is recommended for those with stage 1 or 2 disease. An anastomotic aneurysm may occur at any time after surgery, and regular follow-up using imaging modalities such as multi-detector CT, MRI, or ultrasonography at least once every several years for the rest of the patient's life is mandatory for the early detection of anastomotic aneurysm.|Adolescent[MESH]|Adult[MESH]|Age Factors[MESH]|Aged[MESH]|Aneurysm/etiology[MESH]|Child[MESH]|Child, Preschool[MESH]|Chronic Disease[MESH]|Female[MESH]|Follow-Up Studies[MESH]|Hospital Mortality[MESH]|Humans[MESH]|Japan/epidemiology[MESH]|Male[MESH]|Middle Aged[MESH]|Prognosis[MESH]|Proportional Hazards Models[MESH]|Retrospective Studies[MESH]|Survival Rate[MESH]|Survivors/*statistics & numerical data[MESH]|Takayasu Arteritis/classification/diagnosis/*mortality/*surgery[MESH]|Vascular Surgical Procedures/adverse effects/*statistics & numerical data[MESH] |