Top

Published in:

Open Access 01-12-2023 | CABG | Case Report

Restenosis after excimer laser coronary atherectomy and drug-coated balloon dilation in Takayasu’s arteritis: a case report and review of the literature

Authors: Shichu Liang, Jinming Yang, Min Ma, Minggang Zhou, Zhiyue Liu, He Huang, Yong He

Published in: Thrombosis Journal | Issue 1/2023

Abstract

Takayasu’s arteritis (TAK) is a rare chronic granulomatous arteritis that mainly affects the aorta and its major branches. Coronary artery (CA) involvement can be observed in 10–25% of TAK patients. We report a 21-year-old young female who was previously diagnosed with TAK and severe left main coronary artery (LMCA) stenosis and underwent numerous percutaneous coronary interventions (PCIs) in our hospital due to in-stent restenosis (ISR). This time, an excimer laser coronary atherectomy (ELCA) and drug-coated balloon (DCB) dilation was taken at the LMCA for the ISR. The blood flow was smooth after the operation, and she was symptom-free after discharge. Unfortunately, 5 months later, severe intimal hyperplasia was still seen in the stent of LMCA and left anterior descending (LAD) coronary artery. A coronary artery bypass graft surgery (CABG) was performed, and she has been symptom-free ever since. ELCA plus DCB is one of the novel ways we first reported. However, ensuring long-term inflammation control is equally important to restore blood flow. The combination of revascularization and anti-inflammation/immunosuppression is recommended to improve the outcomes of TAK patients with CA involvements.

Available only for authorised users

Bechman K, Gopalan D, Nihoyannopoulos P, et al. A cohort study reveals myocarditis to be a rare and life-threatening presentation of large vessel vasculitis. Semin Arthritis Rheum. 2017;47(2):241–6.PubMedCrossRef

Tombetti E, Mason JC. Takayasu arteritis: advanced understanding is leading to new horizons. Rheumatology (Oxford). 2019;58(2):206–19.PubMedCrossRef

Zeng Y, Duan J, Ge G, Zhang M. Therapeutic management of ocular ischemia in Takayasu’s arteritis: a case-based systematic review. Front Immunol. 2022;12:791278.PubMedPubMedCentralCrossRef

Mason JC. Takayasu arteritis–advances in diagnosis and management. Nat Rev Rheumatol. 2010;6(7):406–15.PubMedCrossRef

Huang Z, Zhang H, Wang M, Yang W, Qiao S, Hu F. Revascularization Versus Medical Therapy in Takayasu’s arteritis patients with coronary artery involvement. Rheumatol Ther. 2021;8(1):119–33.PubMedCrossRef

Joseph G, Thomson VS, Attumalil TV, et al. Outcomes of percutaneous intervention in patients with Takayasu Arteritis. J Am Coll Cardiol. 2023;81(1):49–64.PubMedCrossRef

Tonomura D, Shimada Y, Yamanaka Y, et al. Laser vaporization of atherothrombotic burden before drug-coated balloon application in ST-segment elevation myocardial infarction: two-year outcomes of the laser-DCB trial. Catheter Cardiovasc Interv. 2022;99(6):1758–65.PubMedCrossRef

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):1129–34.PubMedCrossRef

Kerr GS, Hallahan CW, Giordano J, et al. Takayasu arteritis. Ann Intern Med. 1994;120(11):919–29.PubMedCrossRef

10.

Misra R, Danda D, Rajappa SM, et al. Development and initial validation of the indian Takayasu Clinical Activity score (ITAS2010). Rheumatology (Oxford). 2013;52(10):1795–801.PubMedCrossRef

11.

Khanna S, Garikapati K, Goh DSL, et al. Coronary artery vasculitis: a review of current literature. BMC Cardiovasc Disord. 2021;21(1):7.PubMedPubMedCentralCrossRef

12.

Furukawa Y, Tamura T, Toma M, et al. Sirolimus-eluting stent for in-stent restenosis of left main coronary artery in takayasu arteritis. Circ J. 2005;69(6):752–5.PubMedCrossRef

13.

Lee K, Kang WC, Ahn T, et al. Long-term outcome of drug-eluting stent for coronary artery stenosis in Takayasu’s arteritis. Int J Cardiol. 2010;145(3):532–5.PubMedCrossRef

14.

Lee HK, Namgung J, Choi WH, et al. Stenting of the left main coronary artery in a patient with Takayasu’s arteritis. Korean Circ J. 2011;41(1):34–7.PubMedPubMedCentralCrossRef

15.

Soeiro Ade M, Pinto AL, Henares BB, Ribeiro HB, Lima FG, Serrano CV Jr. Takayasu arteritis: stenosis after bare-metal and drug-eluting stent implantation. Arq Bras Cardiol. 2013;100(1):e8–e11.PubMed

16.

Amir O, Kar B, Civitello AB, Palanichamy N, Shakir A, Delgado RM 3rd. Unprotected left main stent placement in a patient with Takayasu’s arteritis: an unusual solution for an unusual disease. Tex Heart Inst J. 2006;33(2):253–5.PubMedPubMedCentral

17.

Park JS, Lee HC, Lee SK, et al. Takayasu’s Arteritis Involving the Ostia of three large coronary arteries. Korean Circ J. 2009;39(12):551–5.PubMedPubMedCentralCrossRef

18.

Terasawa A, Kondo K, Ishikawa S, Morimoto R, Tajika T, Hayashi Y. Sirolimus-eluting stent implantation for ostial stenosis of left main coronary artery after Bentall operation in aortitis syndrome. J Cardiol. 2010;55(1):147–50.PubMedCrossRef

19.

Cheng Z, Yue C, Shen Z, Fang Q. Percutaneous coronary intervention in Takayasu’s arteritis. Int J Cardiol. 2011;151(2):231–2.PubMedCrossRef

20.

Isser HS, Chakraborty P, Bansal S. Coronary angioplasty of left main coronary artery in patient with Takayasu’s arteritis. Indian Heart J. 2013;65(5):650–2.PubMedPubMedCentralCrossRef

21.

Camuglia AC, Randhawa VK, Lavi S. Takayasu arteritis involving the left main coronary artery treated with a bioresorbable vascular scaffold. Int J Cardiol. 2015;190:1–3.PubMedCrossRef

22.

Rigatelli G, Zuin M, Picariello C, Cardaioli P, Roncon L. Aortitis-related isolated bilateral coronary artery ostial stenosis in a young woman with acute coronary syndrome. Int J Cardiol. 2016;223:111–2.PubMedCrossRef

23.

Zhou S, Gao C, Li F. Acute myocardial infarction with left main coronary artery ostial negative remodelling as the first manifestation of Takayasu arteritis: a case report. BMC Cardiovasc Disord. 2021;21(1):560.PubMedPubMedCentralCrossRef

24.

Chiew KLX, Lim PO. Three-year outcome with drug-coated balloon percutaneous coronary intervention in coronary Takayasu arteritis: a case review. Catheter Cardiovasc Interv. 2021;97(5):841–6.PubMedCrossRef

25.

Moses JW, Leon MB, Popma JJ, et al. Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med. 2003;349(14):1315–23.PubMedCrossRef

26.

Grube E, Silber S, Hauptmann KE, et al. TAXUS I: six- and twelve-month results from a randomized, double-blind trial on a slow-release paclitaxel-eluting stent for de novo coronary lesions. Circulation. 2003;107(1):38–42.PubMedCrossRef

27.

Shlofmitz E, Iantorno M, Waksman R. Restenosis of drug-eluting stents: a new classification system based on Disease mechanism to Guide Treatment and State-of-the-art review. Circ Cardiovasc Interv. 2019;12(8):e007023.PubMedCrossRef

28.

Sakai H, Oyama N, Kishimoto N, et al. Revascularization of malignant coronary instent restenosis resulting from Takayasu’s arteritis using sirolimus-eluting stents. Int Heart J. 2006;47(5):795–801.PubMedCrossRef

29.

Yokota K, Shimpo M, Iwata T, et al. A case of Takayasu arteritis with repeated coronary artery restenosis after drug-eluting stent implantation successfully treated with a combination of steroids. Intern Med. 2012;51(7):739–43.PubMedCrossRef

30.

Empen K, Hummel A, Beug D, Felix SB, Busch MC, Kaczmarek PM. Takayasu’s arteritis: a case with relapse after urgent coronary revascularization. BMC Res Notes. 2017;10(1):311.PubMedPubMedCentralCrossRef

31.

Macedo LM, Lima NA, de Castro Junior RL, Bannon SF. Takayasu arteritis with multiple coronary involvement and early graft relapse. BMJ Case Rep. 2019;12(4):e229383.PubMedPubMedCentralCrossRef

32.

Sammel AM, Wolfenden HD, Joshua F, Jepson N. Reduced efficacy of transcatheter and surgical revascularization in Takayasu arteritis. Int J Rheum Dis. 2019;22(1):152–7.PubMedCrossRef

33.

Shimizu T, Sato A, Sakamoto K, et al. Intravascular ultrasound imaging of isolated and non aorto-ostial coronary Takayasu arteritis: a case report. BMC Cardiovasc Disord. 2020;20(1):260.PubMedPubMedCentralCrossRef

34.

Madhavan MV, Coromilas EJ, Poterucha TJ, et al. Repeat revascularization for severe recurrent coronary artery disease in a Young Woman with Takayasu Arteritis. JACC Case Rep. 2020;2(1):77–81.PubMedPubMedCentralCrossRef

35.

Chen Q, Zhao QM. Five-year outcome with revascularisation therapy in Takayasu arteritis with multiple coronary involvement: a case review. Cardiol Young. 2022;32(11):1857–9.PubMedCrossRef

36.

Ali RM, Abdul Kader MASK, Wan Ahmad WA, et al. Treatment of Coronary Drug-Eluting Stent Restenosis by a Sirolimus- or paclitaxel-coated balloon. JACC Cardiovasc Interv. 2019;12(6):558–66.PubMedCrossRef

37.

Giacoppo D, Alfonso F, Xu B, et al. Paclitaxel-coated balloon angioplasty vs. drug-eluting stenting for the treatment of coronary in-stent restenosis: a comprehensive, collaborative, individual patient data meta-analysis of 10 randomized clinical trials (DAEDALUS study). Eur Heart J. 2020;41(38):3715–28.PubMedCrossRef

38.

Shibui T, Tsuchiyama T, Masuda S, Nagamine S. Excimer laser coronary atherectomy prior to paclitaxel-coated balloon angioplasty for de novo coronary artery lesions. Lasers Med Sci. 2021;36(1):111–7.PubMedCrossRef

39.

Rawlins J, Din JN, Talwar S, O’Kane P. Coronary intervention with the Excimer laser: review of the Technology and Outcome Data. Interv Cardiol. 2016;11(1):27–32.PubMedPubMedCentralCrossRef

40.

Yamanaka Y, Shimada Y, Tonomura D, et al. Laser vaporization of intracoronary Thrombus and identifying plaque morphology in ST-Segment Elevation myocardial infarction as assessed by Optical Coherence Tomography. J Interv Cardiol. 2021;2021:5590109.PubMedPubMedCentralCrossRef

41.

Joseph G, Goel R, Thomson VS, Joseph E, Danda D. Takayasu Arteritis: JACC Focus Seminar 3/4. J Am Coll Cardiol. 2023;81(2):172–86.CrossRef

42.

Wu C, Sun Y, Cui X, et al. Effectiveness and safety of methotrexate versus leflunomide in 12-month treatment for Takayasu arteritis. Ther Adv Chronic Dis. 2020;11:2040622320975233.PubMedPubMedCentralCrossRef

43.

Dai X, Cui X, Sun Y, Ma L, Jiang L. Effectiveness and safety of leflunomide compared with cyclophosphamide as induction therapy in Takayasu’s arteritis: an observational study. Ther Adv Chronic Dis. 2020;11:2040622320922019.PubMedPubMedCentralCrossRef

44.

Liao H, Du J, Li T, Pan L. Tocilizumab for faster and safer remission of Takayasu’s arteritis. Ther Adv Chronic Dis. 2022;13:20406223221131715.PubMedPubMedCentralCrossRef

45.

Borg FA, Dasgupta B. Treatment and outcomes of large vessel arteritis. Best Pract Res Clin Rheumatol. 2009;23(3):325–37.PubMedCrossRef

46.

Newman CB, Blaha MJ, Boord JB, et al. Lipid management in patients with endocrine Disorders: an endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2020;105(12):dgaa674.PubMedCrossRef

47.

Park MC, Lee SW, Park YB, Lee SK, Choi D, Shim WH. Post-interventional immunosuppressive treatment and vascular restenosis in Takayasu’s arteritis. Rheumatology (Oxford). 2006;45(5):600–5.PubMedCrossRef

48.

Wang X, Dang A. Prognostic Value of Brachial-Ankle Pulse Wave velocity in patients with Takayasu Arteritis with Drug-Eluting Stent Implantation. Arthritis Care Res (Hoboken). 2015;67(8):1150–7.PubMedCrossRef

49.

Yokokawa T, Kunii H, Kaneshiro T, et al. Regressed coronary ostial stenosis in a young female with Takayasu arteritis: a case report. BMC Cardiovasc Disord. 2019;19(1):79.PubMedPubMedCentralCrossRef

50.

Maz M, Chung SA, Abril A, et al. 2021 American College of Rheumatology/Vasculitis Foundation Guideline for the management of Giant Cell Arteritis and Takayasu Arteritis. Arthritis Rheumatol. 2021;73(8):1349–65.PubMedCrossRef

51.

Arita Y, Nakaoka Y, Eda Y, Kitabayashi K, Hasegawa S. Perioperative Management of Takayasu Arteritis for Cardiac surgery in a patient treated with Tocilizumab. JACC Case Rep. 2020;2(15):2363–7.PubMedPubMedCentralCrossRef

Title: Restenosis after excimer laser coronary atherectomy and drug-coated balloon dilation in Takayasu’s arteritis: a case report and review of the literature
Authors: Shichu Liang
Jinming Yang
Min Ma
Minggang Zhou
Zhiyue Liu
He Huang
Yong He
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: CABG
CABG
Arteritis
Published in: Thrombosis Journal / Issue 1/2023
Electronic ISSN: 1477-9560
DOI: https://doi.org/10.1186/s12959-023-00529-9

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2023

Antibiotic use in acute mesenteric ischemia: a review of the evidence and call to action

High-resolution magnetic resonance imaging-based radiomic features aid in selecting endovascular candidates among patients with cerebral venous sinus thrombosis

Robust preimplantation genetic testing of the common F8 Inv22 pathogenic variant of severe hemophilia A using a highly polymorphic multi-marker panel encompassing the paracentric inversion

Neutrophil extracellular traps in VTE

Clinical trial assessing the safety of edoxaban with concomitant chemotherapy in patients with gynecological cancer-associated thrombosis (EGCAT study)

Association between cancer history and second-generation drug-eluting stent thrombosis: insights from the REAL-ST registry

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials