Journal ArticleDOI
Longterm Outcomes of Renal Artery Involvement in Takayasu Arteritis.
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TLDR
Bilateral lesions and renal functional impairment at presentation, but not implementation of revascularization procedures, were significant factors for outcomes in TA patients with renal artery involvement.Abstract:
Objective. Takayasu arteritis (TA) involving the renal artery can result in hypertension (HTN), renal dysfunction, and premature death. The aim of this study was to investigate the longterm outcomes and factors that predict outcomes in patients with TA with renal artery stenosis. Methods. The medical records of patients diagnosed with TA between January 1997 and December 2014 were reviewed retrospectively. Renal artery involvement was based on computed tomography and/or angiography findings. Poor outcome was defined as refractory HTN, chronic renal insufficiency, or death. Results. Of the 62 TA patients with renal artery involvement, 11 (17.7%) underwent renal artery revascularization. Younger age, male sex, and more severe stenosis (> 70%) were associated with vascular intervention. After a median followup of 90.6 months, 11 (17.7%) of the 62 patients had refractory HTN and 6 (9.7%) had chronic renal insufficiency. Renal insufficiency [5/15 (33.3%) vs 3/47 (6.4%), p = 0.016] and bilateral involvement [12/15 (80.0%) vs 23/47 (48.9%), p = 0.041] were significantly more frequent in patients with poor than good outcomes. Multivariate Cox analysis revealed that renal insufficiency at presentation (HR 13.778, 95% CI 3.530–53.786, p Conclusion. Bilateral lesions and renal functional impairment at presentation, but not implementation of revascularization procedures, were significant factors for outcomes in TA patients with renal artery involvement.read more
Citations
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Journal ArticleDOI
2018 Update of the EULAR recommendations for the management of large vessel vasculitis.
Bernhard Hellmich,Ana Filipa Águeda,Sara Monti,Frank Buttgereit,Hubert de Boysson,Elisabeth Brouwer,Rebecca Cassie,Maria C. Cid,Bhaskar Dasgupta,Christian Dejaco,Gulen Hatemi,Nicole Hollinger,Alfred Mahr,Susan P Mollan,Chetan Mukhtyar,Cristina Ponte,Carlo Salvarani,Rajappa Sivakumar,Xinping Tian,Gunnar Tomasson,Carl Turesson,Wofgang Schmidt,Peter M. Villiger,Richard A. Watts,Chris Young,Raashid Luqmani +25 more
TL;DR: The recommendations for the management of LVV have been updated to facilitate the translation of current scientific evidence and expert opinion into better management and improved outcome of patients in clinical practice.
Journal ArticleDOI
Management of Takayasu arteritis: a systematic literature review informing the 2018 update of the EULAR recommendation for the management of large vessel vasculitis.
Ana Filipa Águeda,Sara Monti,Raashid Luqmani,Frank Buttgereit,Maria C. Cid,Bhaskar Dasgupta,Christian Dejaco,Alfred Mahr,Cristina Ponte,Carlo Salvarani,Wolfgang A. Schmidt,Bernhard Hellmich +11 more
TL;DR: Evidence to guide monitoring and treatment of patients with TAK is predominantly derived from observational studies with low level of evidence, therefore, higher-quality studies are needed in the future.
Journal ArticleDOI
Recent advances in the management of Takayasu arteritis.
TL;DR: Anti‐tumor necrosis factor alpha agents and tocilizumab may be useful in patients refractory to cDMARDs with retardation of angiographic progression, based on evidence derived from mostly retrospective case series, whereas the role of rituximab and ustekinumab needs further elucidation.
Journal ArticleDOI
Clinical course and prognostic factors of childhood Takayasu's arteritis: over 15-year comprehensive analysis of 101 patients.
Luyun Fan,Huimin Zhang,Jun Cai,Lirui Yang,Bin Liu,Dongmei Wei,Jiachen Yu,Jiali Fan,Lei Song,Wenjun Ma,Xianliang Zhou,Haiying Wu,Ying Lou +12 more
TL;DR: This large ambispective study of childhood Takayasu’s arteritis revealed an early 3% mortality at the first year and around 50% morbidity within 5 years after diagnosis.
References
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Andrew S. Levey,Lesley A. Stevens,Christopher H. Schmid,Yaping (Lucy) Zhang,Alejandro F. Castro,Harold I. Feldman,John W. Kusek,Paul W. Eggers,Frederick Van Lente,Tom Greene,Josef Coresh +10 more
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The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis.
William P. Arend,Beat A. Michel,Daniel A. Bloch,Gene G. Hunder,Leonard H. Calabrese,Steven M. Edworthy,Anthony S. Fauci,Randi Y. Leavitt,J. T. Lie,Robert W. Lightfoot,Alfonse T. Masi,Dennis J. McShane,John A. Mills,Mary Betty Stevens,Stanley L. Wallace,Nathan J. Zvaifler +15 more
TL;DR: Criteria for the classification of Takayasu arteritis were developed by comparing 63 patients who had this disease with 744 control patients with other forms of vasculitis, and the presence of 3 or more of these 6 criteria demonstrated a sensitivity of 90.5% and a specificity of 97.0%.
Journal ArticleDOI
Revascularization versus medical therapy for renal-artery stenosis.
Keith Wheatley,Natalie Ives,Richard Gray,Philip A. Kalra,Jonathan Moss,Colin Baigent,Sue Carr,Nicholas Chalmers,D Eadington,George Hamilton,G Lipkin,Anthony A. Nicholson,J Scoble +12 more
TL;DR: It is found that substantial risks are found but no evidence of a worthwhile clinical benefit from revascularization in patients with atherosclerotic renovascular disease.
Journal ArticleDOI
Stenting and medical therapy for atherosclerotic renal-artery stenosis
Christopher J. Cooper,Timothy P. Murphy,Donald E. Cutlip,Kenneth Jamerson,William L. Henrich,Diane M. Reid,David J. Cohen,Alan H. Matsumoto,Michael W. Steffes,Michael R. Jaff,Martin R. Prince,Eldrin F. Lewis,Katherine R. Tuttle,Joseph I. Shapiro,John H. Rundback,Joseph M. Massaro,Lance D. Dworkin +16 more
TL;DR: Renal-artery stenting did not confer a significant benefit with respect to the prevention of clinical events when added to comprehensive, multifactorial medical therapy in people with atherosclerotic renal-arterY stenosis and hypertension or chronic kidney disease.
Journal ArticleDOI
Takayasu arteritis: A study of 32 north American patients
TL;DR: Takayasu arteritis is more common than previously suspected in North America, is not restricted to any one racial group, and is readily treatable with corticosteroids and surgical vascular reconstruction.
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