Abstract
INTRODUCTION: Takayasu arteritis is a rare, idiopathic large‐vessel vasculitis that primarily affects the aorta and its major branches, leading to stenosis, occlusion, and occasionally aneurysmal dilation. Endovascular approaches such as angioplasty and stenting have been reported in case series, but their efficacy remains uncertain, as outcomes are often variable due to the complex and progressive nature of the disease. MATERIALS/METHODS: The patient was evaluated in routine clinical practice. RESULTS: We present a case of a 24‐year‐old woman with medical history of D‐transposition of the great arteries (D‐TGA) status post arterial switch procedure at the age of 5 days, supravalvular pulmonary stenosis status post patch repair with bovine pericardium who presented to the emergency department for a ten day history of bilateral vision changes, lightheadedness and syncope. She was assessed by ophthalmology and her visual exam was normal. CTA at that time was notable for occlusion of the brachiocephalic trunk, occlusion of left common carotid artery and severe stenosis of the left subclavian artery, no evidence of severe stenosis of occlusion in brain vasculature. She was evaluated by interventional neurology and her symptoms were considered to be related to vascular insufficiency due to severe steno ‐ occlusive disease of great vessels. She underwent angiography via left radial access, which demonstrated a 75% stenosis of the left subclavian artery, with preserved patency of the entire intracranial anterior circulation maintained by collateral flow from the left vertebral artery. A Visi‐Pro 5mmx20mm stent was placed followed by balloon angioplasty with great radiographic outcome. At the two‐month follow‐up, the patient reported symptomatic improvement. She was eventually evaluated by rheumatology who diagnosed her with Takayasu's arteritis and was started on steroids. CONCLUSION: This case demonstrates a successful treatment of symptomatic severe stenosis of left subclavian artery in the setting of Takayasu arteritis with endovascular therapy via angioplasty and stenting. Given the high risk of progressive stenosis in Takayasu arteritis despite endovascular therapy, interdisciplinary management with rheumatology is essential to ensure timely initiation of appropriate immunosuppressive treatment. [Image: see text]