ABS0067 BIOLOGICAL THERAPIES MAY IMPROVE LONG-TERM OUTCOMES OF VASCULAR INTERVENTIONS IN PATIENTS WITH TAKAYASU ARTERITIS: A MULTICENTER RETROSPECTIVE STUDY
Bildiriler > Özet Bildiri
Yazarlar: A. Avcu, S. Kaymaz-Tahra, R.C. Kardaş, F. Basibuyuk, O. Uludag, Duygu KERİM, S. San, H. Kocaayan, Z. Ademoğlu, G. Kenar, B. Ince, H. Emmungil, S. Akar, A. Cefle, A. Yazici, Gökhan KESER, Kenan AKSU, M. Inanc, F. Onen, H. Küçük, H. Direskeneli, F. Alibaz- Oner
Annals of the Rheumatic Diseases, , , Uluslararası, Özet Bildiri, Wos, cilt 84, ss 2327-2328
DOI: 10.1016/j.ard.2025.06.2015
Özet
Background: Takayasu arteritis (TAK) is a chronic, granulomatous large vessel vasculitis involving the aorta and its main branches [1]. Segmental stenosis, occlusion, dilatation and/or aneurysm may develop due to inflammation in the vessel wall [2]. Vascular intervention may be required in the presence of symptomatic signs of arterial stenosis (limb claudication, stroke, syncope, uncontrolled renovascular hypertension, etc.) and severe aneurysm [3]. Objectives: This study aimed to evaluate outcomes and complications of vascular interventions in patients with TAK. Methods: Patients who underwent vascular intervention before and after the diagnosis of TAK from eight tertiary hospitals were evaluated retrospectively. The indication for vascular intervention, the stage of the disease, the type of vascular intervention, complications, early and late results were recorded. Restenosis was evaluated when they were symptomatic or according to the results of imaging studies performed for any reason. Results: The study included 119 patients and a total of 201 lesions (184 stenosis/occlusions, 17 aneurysms or dissections). Among these patients, 61.2% (n=123) underwent procedures while receiving immunosuppressive therapy after diagnosing Takayasu arteritis (TAK). Control imaging was available for 168 procedures (88.4%). Re-stenosis occurred in 80 (47.9%) obstructive lesions during follow-up. The median time to re-stenosis was 14 (IQR: 5.2-52) months. Although restenosis was less frequent in procedures performed after diagnosis, there was no significant difference in the restenosis rate between procedures performed before and after diagnosis (54% versus 43%, p=0.16). 24% (n=25) of procedures performed during the active period. Restenosis rates were similar in procedures performed during the active and inactive periods (40% vs 39%, p=0.9). However, patients who received biological therapy during the procedure had a lower restenosis rate compared to those who did not receive this treatment (34% vs 50%, p=0.1). The major complication rate for percutaneous procedures was 3%, while surgical procedures had a higher complication rate of 10%. Unfortunately, one patient died following a TEVAR (thoracic endovascular aortic repair) operation, and another patient died due to intracranial bleeding after a stent procedure. Conclusion: In our study, 38.8% of vascular procedures had been performed before diagnosis. This shows that the importance of relevant departments's awareness about TAK and referral of patients for rheumatologic evaluation. We also found that vascular interventions can be safely performed in patients with TAK. Our results show that biological treatments in patients requiring vascular intervention may improve long-term outcomes in TAK. REFERENCES: [1] Gökhan Keser, Kenan Aksu, ve Haner Di̇Reskeneli̇, "Takayasu arteritis: an update", TURKISH JOURNAL OF MEDICAL SCIENCES 48, sy 4 (16 Ağustos 2018): 681-97, https://doi.org/10.3906/sag-1804-136. [2] Fatma Alibaz-Oner, Sibel Zehra Aydin, ve Haner Direskeneli, "Recent advances in Takayasu's arteritis", European Journal of Rheumatology 2, sy 1 (09 Mart 2015): 24-30, https://doi.org/10.5152/eurjrheumatol.2015.0060. [3] Ana F Águeda vd, "Management of Takayasu Arteritis: A Systematic Literature Review Informing the 2018 Update of the EULAR Recommendation for the Management of Large Vessel Vasculitis", RMD Open 5, sy 2 (Eylül 2019): e001020, https://doi.org/10.1136/rmdopen-2019-001020. Table 1The Characteristics of Takayasu Arteritis Patients (n=119) and Vascular Procedures (n=201)Female/Male (n/n)Age, years (IQR;median)101/1847 (36-58)Comorbidity, n(%)HT, n(%)75 (63.6%)HL, n(%)22 (18.6%)Stroke, n(%)10 (%8.5)DM, n(%)7 (5.9%)CAD, n(%)7 (5.9%)Treatment, n(%)Glucocorticoids86 (76.8%) Low dose (<7,5 mg/d)58 (51.8%) Moderate dose (7,5-30 mg/d)17 (15.2%) High dose (30-100 mg/d)12 (10.7%) csDMARD102 (85%) bDMARD43 (35.5%)Type of vascular involvement, n (%)Tip 121 (17.6%)Tip 212 (10%)Tip 38 (%6.7)Tip 412 (%10.1)Tip 566 (%55.5)Lesion location, n(%)Renal artery52 (25.9%)Subclavian artery30 (14.9%)Carotis artery28 (14%)Aorta28 (14%)Iliofemoral artery27 (13.5%)Mesenteric artery8 (4%)Type of procedure, n(%)Stent116 (57.7%)Balon angioplasty33 (%16.4)Bypass graft44 (21.9%)Endarterectomy4 (2%)TEVAR (thoracic endovascular aortic repair)/EVAR (abdominal endovascular aneurysm repair)4 (2%) Acknowledgements: NIL . Disclosure of Interests: None declared . © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.