Application of drug coated balloon in treatment of Takayasu’s arteritis of renal artery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Yiren , GU Yongquan ,  GUO Lianrui

Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, P. R. China;

Corresponding?author：

GUO Lianrui, Email: 1044832160@qq.com

Keywords：

Takayasu’s arteritis; drug coated balloon; renal artery stenosis

DOI：

10.7507/1007-9424.202308062

Video：

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Objective To study the clinical safety and effectiveness of paclitaxel-drug coated balloon (DCB) in treatment of Takayasu’s arteritis (TA) of renal artery. Methods The retrospective analysis was made on the clinical data of the three patients with severe stenosis of renal artery, who were treated in our hospital from January 2019 to August 2023. The patients underwent paclitaxel-DCB dilation therapy. Results Successful treatment was accomplished in all the three patients. The patients were followed up for 17, 38, and 40 months respectively, follow-up examination of ultrasound showed that the blood flow in renal artery was unobstructed. The serum creatinine level was changed from preoperative 53, 64, 55 μmol/L to 43, 70, 59 μmol/L on postoperative day 1. The systolic blood pressure was decreased from preoperative 180, 220, 150 mmHg to 116, 120, 110 mmHg on postoperative day 1. The peak systolic velocity of renal artery was reduced from preoperative 350, 377, 293 cm/s to 120, 135, 94 cm/s on postoperative day 1. Conclusion Paclitaxel-DCB is safe and effective for patients with renal artery stenosis of TA, but further researches with large sample are still needed.

Citation： LIU Yiren, GU Yongquan, GUO Lianrui. Application of drug coated balloon in treatment of Takayasu’s arteritis of renal artery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(4): 439-443. doi: 10.7507/1007-9424.202308062 Copy

1.	Numano F, Okawara M, Inomata H, et al. Takayasu’s arteritis. Lancet, 2000, 356(9234): 1023-1025.
2.	Maksimowicz-McKinnon K. New insights into the pathogenesis and treatment of Takayasu arteritis. Expert Rev Clin Immunol, 2009, 5(4): 445-449.
3.	Watts R, Al-Taiar A, Mooney J, et al. The epidemiology of Takayasu arteritis in the UK. Rheumatology (Oxford), 2009, 48(8): 1008-1011.
4.	Maleszewski JJ. Inflammatory ascending aortic disease: perspectives from pathology. J Thorac Cardiovasc Surg, 2015, 149(2 Suppl): S176-S183.
5.	Chaudhry MA, Latif F. Takayasu’s arteritis and its role in causing renal artery stenosis. Am J Med Sci, 2013, 346(4): 314-318.
6.	Arend WP, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum, 1990, 33(8): 1129-1134.
7.	王健, 鄒英華, 宋莉, 等. 經肱動脈腎動脈支架置入術技術分析. 介入放射學雜志, 2007, 16(7): 452-454.
8.	Rundback JH, Sacks D, Kent KC, et al. Guidelines for the reporting of renal artery revascularization in clinical trials. American Heart Association. Circulation, 2002, 106(12): 1572-1585.
9.	Chung JW, Kim HC, Choi YH, et al. Patterns of aortic involvement in Takayasu arteritis and its clinical implications: evaluation with spiral computed tomography angiography. J Vasc Surg, 2007, 45(5): 906-914.
10.	徐建萍, 趙陽, 李俊芳, 等. 大動脈炎合并中樞系統病變研究進展. 山西醫藥雜志, 2017, 46(8): 900-902.
11.	鄒玉寶, 蔣雄京. 大動脈炎的研究現狀與進展. 中國循環雜志, 2016, 31(8): 822-824.
12.	Fanari Z, Weiss SA, Zhang W, et al. Comparison of percutaneous coronary intervention with drug eluting stents versus coronary artery bypass grafting in patients with multivessel coronary artery disease: meta-analysis of six randomized controlled trials. Cardiovasc Revasc Med, 2015, 16(2): 70-77.
13.	肖耀文, 陳忠, 楊耀國, 等. 大動脈炎手術與腔內治療的效果及其影響因素. 首都醫科大學學報, 2015, 36(1): 45-52.
14.	Lee GY, Jeon P, Do YS, et al. Comparison of outcomes between endovascular treatment and bypass surgery in Takayasu arteritis. Scand J Rheumatol, 2014, 43(2): 153-161.
15.	Xiao Y, Zhou J, Wei X, et al. Outcomes of different treatments on Takayasu’s arteritis. J Thorac Dis, 2016, 8(9): 2495-2503.
16.	章新根, 蔡海英. 多發性大動脈炎中醫治療方劑用藥規律挖掘分析及臨床應用舉隅. 中國中藥雜志, 2016, 41(9): 1754-1758.
17.	Luo XY, Wu QH, Zhang FX. Open and endovascular management of severe cerebral ischemia in Takayasu’s arteritis. Ann Vasc Surg, 2017, 42: 101-110.
18.	Ham SW, Kumar SR, Rowe VL, et al. Disease progression after initial surgical intervention for Takayasu arteritis. J Vasc Surg, 2011, 54(5): 1345-1351.
19.	Peng M, Ji W, Jiang X, et al. Selective stent placement versus balloon angioplasty for renovascular hypertension caused by Takayasu arteritis: two-year results. Int J Cardiol, 2016, 205: 117-123.
20.	Kinjo H, Kafa A. The results of treatment in renal artery stenosis due to Takayasu disease: comparison between surgery, angioplasty, and stenting. A monocentrique retrospective study. G Chir, 2015, 36(4): 161-167.
21.	史振宇, 符偉國, 郭大喬, 等. 炎性腎動脈狹窄的外科治療分析: 附31例報告. 中國臨床醫學, 2014, 21(4): 427-430.
22.	Akazawa H, Ikeda U, Yamamoto K, et al. Hypercoagulable state in patients with Takayasu’s arteritis. Thromb Haemost, 1996, 75(5): 712-716.
23.	de Souza AW, Machado NP, Pereira VM, et al. Antiplatelet therapy for the prevention of arterial ischemic events in Takayasu arteritis. Circ J, 2010, 74(6): 1236-1241.
24.	Li Cavoli G, Mulè G, Vallone MG, et al. Takayasu’s disease effects on the kidneys: current perspectives. Int J Nephrol Renovasc Dis, 2018, 11: 225-233.
25.	張斌, 王影, 王寶春. 頸動脈粥樣硬化斑塊的彩色多普勒超聲表現及其與腦梗死的關系研究. 現代中西醫結合雜志, 2017, 26(6): 663-665.
26.	李菁, 朱孟鑄, 楊云嬌, 等. 多發性大動脈炎合并活動性結核感染36例的病例對照研究. 中華風濕病學雜志, 2016, 20(3): 176-180.
27.	Terao C, Yoshifuji H, Ohmura K, et al. Association of Takayasu arteritis with HLA-B 67: 01 and two amino acids in HLA-B protein. Rheumatology (Oxford), 2013, 52(10): 1769-1774.
28.	Tepe G, Schnorr B, Albrecht T, et al. Angioplasty of femoral-popliteal arteries with drug-coated balloons: 5-year follow-up of the THUNDER trial. JACC Cardiovasc Interv, 2015, 8(1 Pt A): 102-108.
29.	Perera AH, Youngstein T, Gibbs RG, et al. Optimizing the outcome of vascular intervention for Takayasu arteritis. Br J Surg, 2014, 101(2): 43-50.

1. Numano F, Okawara M, Inomata H, et al. Takayasu’s arteritis. Lancet, 2000, 356(9234): 1023-1025.
2. Maksimowicz-McKinnon K. New insights into the pathogenesis and treatment of Takayasu arteritis. Expert Rev Clin Immunol, 2009, 5(4): 445-449.
3. Watts R, Al-Taiar A, Mooney J, et al. The epidemiology of Takayasu arteritis in the UK. Rheumatology (Oxford), 2009, 48(8): 1008-1011.
4. Maleszewski JJ. Inflammatory ascending aortic disease: perspectives from pathology. J Thorac Cardiovasc Surg, 2015, 149(2 Suppl): S176-S183.
5. Chaudhry MA, Latif F. Takayasu’s arteritis and its role in causing renal artery stenosis. Am J Med Sci, 2013, 346(4): 314-318.
6. Arend WP, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum, 1990, 33(8): 1129-1134.
7. 王健, 鄒英華, 宋莉, 等. 經肱動脈腎動脈支架置入術技術分析. 介入放射學雜志, 2007, 16(7): 452-454.
8. Rundback JH, Sacks D, Kent KC, et al. Guidelines for the reporting of renal artery revascularization in clinical trials. American Heart Association. Circulation, 2002, 106(12): 1572-1585.
9. Chung JW, Kim HC, Choi YH, et al. Patterns of aortic involvement in Takayasu arteritis and its clinical implications: evaluation with spiral computed tomography angiography. J Vasc Surg, 2007, 45(5): 906-914.
10. 徐建萍, 趙陽, 李俊芳, 等. 大動脈炎合并中樞系統病變研究進展. 山西醫藥雜志, 2017, 46(8): 900-902.
11. 鄒玉寶, 蔣雄京. 大動脈炎的研究現狀與進展. 中國循環雜志, 2016, 31(8): 822-824.
12. Fanari Z, Weiss SA, Zhang W, et al. Comparison of percutaneous coronary intervention with drug eluting stents versus coronary artery bypass grafting in patients with multivessel coronary artery disease: meta-analysis of six randomized controlled trials. Cardiovasc Revasc Med, 2015, 16(2): 70-77.
13. 肖耀文, 陳忠, 楊耀國, 等. 大動脈炎手術與腔內治療的效果及其影響因素. 首都醫科大學學報, 2015, 36(1): 45-52.
14. Lee GY, Jeon P, Do YS, et al. Comparison of outcomes between endovascular treatment and bypass surgery in Takayasu arteritis. Scand J Rheumatol, 2014, 43(2): 153-161.
15. Xiao Y, Zhou J, Wei X, et al. Outcomes of different treatments on Takayasu’s arteritis. J Thorac Dis, 2016, 8(9): 2495-2503.
16. 章新根, 蔡海英. 多發性大動脈炎中醫治療方劑用藥規律挖掘分析及臨床應用舉隅. 中國中藥雜志, 2016, 41(9): 1754-1758.
17. Luo XY, Wu QH, Zhang FX. Open and endovascular management of severe cerebral ischemia in Takayasu’s arteritis. Ann Vasc Surg, 2017, 42: 101-110.
18. Ham SW, Kumar SR, Rowe VL, et al. Disease progression after initial surgical intervention for Takayasu arteritis. J Vasc Surg, 2011, 54(5): 1345-1351.
19. Peng M, Ji W, Jiang X, et al. Selective stent placement versus balloon angioplasty for renovascular hypertension caused by Takayasu arteritis: two-year results. Int J Cardiol, 2016, 205: 117-123.
20. Kinjo H, Kafa A. The results of treatment in renal artery stenosis due to Takayasu disease: comparison between surgery, angioplasty, and stenting. A monocentrique retrospective study. G Chir, 2015, 36(4): 161-167.
21. 史振宇, 符偉國, 郭大喬, 等. 炎性腎動脈狹窄的外科治療分析: 附31例報告. 中國臨床醫學, 2014, 21(4): 427-430.
22. Akazawa H, Ikeda U, Yamamoto K, et al. Hypercoagulable state in patients with Takayasu’s arteritis. Thromb Haemost, 1996, 75(5): 712-716.
23. de Souza AW, Machado NP, Pereira VM, et al. Antiplatelet therapy for the prevention of arterial ischemic events in Takayasu arteritis. Circ J, 2010, 74(6): 1236-1241.
24. Li Cavoli G, Mulè G, Vallone MG, et al. Takayasu’s disease effects on the kidneys: current perspectives. Int J Nephrol Renovasc Dis, 2018, 11: 225-233.
25. 張斌, 王影, 王寶春. 頸動脈粥樣硬化斑塊的彩色多普勒超聲表現及其與腦梗死的關系研究. 現代中西醫結合雜志, 2017, 26(6): 663-665.
26. 李菁, 朱孟鑄, 楊云嬌, 等. 多發性大動脈炎合并活動性結核感染36例的病例對照研究. 中華風濕病學雜志, 2016, 20(3): 176-180.
27. Terao C, Yoshifuji H, Ohmura K, et al. Association of Takayasu arteritis with HLA-B 67: 01 and two amino acids in HLA-B protein. Rheumatology (Oxford), 2013, 52(10): 1769-1774.
28. Tepe G, Schnorr B, Albrecht T, et al. Angioplasty of femoral-popliteal arteries with drug-coated balloons: 5-year follow-up of the THUNDER trial. JACC Cardiovasc Interv, 2015, 8(1 Pt A): 102-108.
29. Perera AH, Youngstein T, Gibbs RG, et al. Optimizing the outcome of vascular intervention for Takayasu arteritis. Br J Surg, 2014, 101(2): 43-50.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of drug coated balloon in treatment of Takayasu’s arteritis of renal artery

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