Clinical features and surgical outcomes of childhood and adult Takayasu arteritis: A retrospective study

Abstract

OBJECTIVE: Takayasu arteries (TAK) is a rare and unexplained inflammatory arterial disease that can occur in both children and adults. Our goal was to clarify the clinical features and surgical outcomes of aortitis in children and adults. METHODS: A retrospective cohort study was conducted on patients with TAK treated at tertiary care centers between 2012 and 2020. The American College of Rheumatology’s TAK criteria were used to select patients. Study results were reported using descriptive statistics and Kaplan–Meier methods. RESULTS: The cohort included 106 TAK patients with a median follow-up of 69 (interquartile range 80) months. Childhood TAK (c-TAK) differed from adult TAK (a-TAK) in terms of baseline: the predominant Nomo staging for c-TAK was Type IV (70.4), while the predominant staging for a-TAK was Type I (68.4%). Sixty-eight of them underwent surgical intervention, with a total of 85 vascular procedures (77 endoluminal procedures and 8 open procedures). c-TAK group had more endoluminal interventions (100%), while the a-TAK group had a higher proportion of open procedures (17.8%) than the c-TAK group, and the main complication in both groups was restenosis. Kaplan–Meier curves showed that c-TAK had a significantly higher rate of restenosis than a-TAK and had a significantly higher reintervention rate (logrank, P < 0.001). CONCLUSION: In conclusion, the main difference between c-TAK and a-TAK is that Nomo typing c-TAK is mainly Type IV, while a-TAK is mainly Type I. Furthermore, c-TAK has a higher rate of reintervention after surgical treatment than a-TAK, more attention should be paid to the postoperative follow-up of c-TAK patients, and further large sample studies are needed to confirm this.

Keywords

• adults
• childhood
• clinical outcome
• endovascular intervention
• takayasu arteries