Takayasu’s disease

1. Takayasu’s DiseaseTakayasu’s Disease
NewNew
Louay Altarazi, M.D Damascus, Syria

2. Case 1Case 1

3. Case 2Case 2

4. Case 3Case 3

5. Buerger’s DiseaseBuerger’s Disease
New endovascular approachNew endovascular approach
Louay Altarazi, M.D Damascus, Syria

6. "Oriental" countries are well known for certain life style and"Oriental" countries are well known for certain life style and
history, they also share certain characteristic vascularhistory, they also share certain characteristic vascular
pathologies and social reactions to disease and treatment.pathologies and social reactions to disease and treatment.
Buerger’s disease “TAO” may be the most typicalBuerger’s disease “TAO” may be the most typical
entity due to its high prevalence in our regionentity due to its high prevalence in our region
and rarity in occidental population, theand rarity in occidental population, the
difficulties to deal with the characteristicdifficulties to deal with the characteristic
psychic background of those young patients andpsychic background of those young patients and
the increase of young smokers in orientalthe increase of young smokers in oriental
societies.societies.
In Syria this pathology presents 6 -15% of allIn Syria this pathology presents 6 -15% of all
foots critical ischemia cases andfoots critical ischemia cases and
More than 70% of male young's foot necrosisMore than 70% of male young's foot necrosis

7. What Treatment ? (literature)What Treatment ? (literature)

8. Ultrasonic diagnosticUltrasonic diagnostic
corkscrew appearance, bidirectional flowcorkscrew appearance, bidirectional flow

9. Inclusion CriteriaInclusion Criteria
Olin’s Diagnostic criteriaOlin’s Diagnostic criteria

10. The procedureThe procedure (in brief)(in brief)
before during after

11. Before during afterBefore during after
The procedureThe procedure (in brief)(in brief)

12. Before during afterBefore during after
The procedureThe procedure (in brief)(in brief)

13. Before during afterBefore during after
The procedureThe procedure (in brief)(in brief)

14. Angiosomal conceptAngiosomal concept
A T PER P T

15. Anatomic ConsiderationAnatomic Consideration

16. BTK endovascular proceduresBTK endovascular procedures
characteristicscharacteristics
Atherosclerosis
Diabetic
arteriopathy
Buerger’s
disease
Pain during
procedure
slightly painful
specially during
inflating balloons
painless Can be very Painful
Recoil after PTA Possible leading to
Vascular reoclusion
Very rare Frequent but often
transitory
Wire & cath-
balloon passage
Relatively easy somehow difficult Difficult needs hard
pushability
Subintimal way Almost possible Sometimes feasible impossible
Incomplete
recanalization
Rarely useful ineffective Can be effective du
to intense
vasavasorium
development

17. Peri-procedure carePeri-procedure care

18. From January 2006 to July 2011From January 2006 to July 2011

19. Clinical ImprovementClinical Improvement
((21 patients followed for 6-30 months)21 patients followed for 6-30 months)
One major and three minor amputation

20. Before afterBefore after
Clinical caseClinical case

21. Before afterBefore after
Clinical caseClinical case

22. Before afterBefore after
Clinical caseClinical case

23. Before afterBefore after
Clinical caseClinical case

24. Before afterBefore after
Clinical caseClinical case

25. Before afterBefore after
Clinical caseClinical case

26. ConclusionConclusion