Abstract
BACKGROUND: Takayasu's arteritis (TA) is a rare inflammatory disease affecting large vessels, with pulmonary artery involvement being uncommon and challenging to manage. CASE SUMMARY: A 46-year-old woman with severe pulmonary hypertension, initially diagnosed with TA, presented with left pulmonary artery stenosis and right pulmonary artery total occlusion. After a series of percutaneous interventions over 20 years, the patient avoided lung transplantation and achieved stable long-term outcomes. DISCUSSION: This case is of particular interest due to the rare pulmonary involvement in TA and the successful management of chronic total pulmonary artery occlusion through sequential percutaneous interventions. The extended 20-year follow-up is exceptional, as long-term outcomes in similar cases are rarely documented. TAKE-HOME MESSAGE: Percutaneous treatments can provide significant long-term benefits in managing pulmonary artery involvement in TA, even in complex cases.