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, 邹英华, 宋莉, 等. 经肱动脉肾动脉支架置入术技术分析. 介入放射学杂志, 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, 赵阳, 李俊芳, 等. 大动脉炎合并中枢系统病变研究进展. 山西医药杂志, 2017, 46(8): 900-902.
11.	邹玉宝, 蒋雄京. 大动脉炎的研究现状与进展. 中国循环杂志, 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, 陈忠, 杨耀国, 等. 大动脉炎手术与腔内治疗的效果及其影响因素. 首都医科大学学报, 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. 多发性大动脉炎中医治疗方剂用药规律挖掘分析及临床应用举隅. 中国中药杂志, 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, 符伟国, 郭大乔, 等. 炎性肾动脉狭窄的外科治疗分析: 附31例报告. 中国临床医学, 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.	张斌, 王影, 王宝春. 颈动脉粥样硬化斑块的彩色多普勒超声表现及其与脑梗死的关系研究. 现代中西医结合杂志, 2017, 26(6): 663-665.
26.	李菁, 朱孟铸, 杨云娇, 等. 多发性大动脉炎合并活动性结核感染36例的病例对照研究. 中华风湿病学杂志, 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, 邹英华, 宋莉, 等. 经肱动脉肾动脉支架置入术技术分析. 介入放射学杂志, 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, 赵阳, 李俊芳, 等. 大动脉炎合并中枢系统病变研究进展. 山西医药杂志, 2017, 46(8): 900-902.
11. 邹玉宝, 蒋雄京. 大动脉炎的研究现状与进展. 中国循环杂志, 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, 陈忠, 杨耀国, 等. 大动脉炎手术与腔内治疗的效果及其影响因素. 首都医科大学学报, 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. 多发性大动脉炎中医治疗方剂用药规律挖掘分析及临床应用举隅. 中国中药杂志, 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, 符伟国, 郭大乔, 等. 炎性肾动脉狭窄的外科治疗分析: 附31例报告. 中国临床医学, 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. 张斌, 王影, 王宝春. 颈动脉粥样硬化斑块的彩色多普勒超声表现及其与脑梗死的关系研究. 现代中西医结合杂志, 2017, 26(6): 663-665.
26. 李菁, 朱孟铸, 杨云娇, 等. 多发性大动脉炎合并活动性结核感染36例的病例对照研究. 中华风湿病学杂志, 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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