Non specific aorto-arteritis - Clinical picture, diagnosis and therapy

This study is aimed at analyzing clinical features, angiographic findings a nd evolution of Takayasu's arteritis and the criteria adopted to establish the indication for non-surgical versus operative treatment. Eighteen patien ts affected by non specific aortarteritis were observed and treated at our Department between 1973 and 1996, All patients met the American College of Rheumatology 1990 criteria of classification of Takayasu's arteritis, Sixte en patients were young females. Two patients were males. Nine patients unde rwent surgical procedures. One young female underwent a PTA, All eight asym ptomatic patients were only medically treated. One patient died some days a fter an aorto-bicarotid bypass graft due to acute myocardial infarction. Tw o other patients died two and four years after intervention for renal and c ardiac failure respectively, One patient after an aorto bicarotid bypass un derwent a left hemiplegia due to thrombosis of the right graft branch. All the other 14 patients either surgically or medically treated are well and a re under strict surveillance through rigorous follow-up. The 10 patients wh o underwent surgical or interventional radiological treatment were certainl y the most seriously affected patients and were symptomatic (presented neur ological disturbances or a severe hypertensive state), This fact explains, to some extent, the mortality and morbidity rate observed in this group. Th e seven medically treated patients were completely asymptomatic in spite of a major involvement of various vascular districts.