Università degli Studi di BariU.O. DI CHIRURGIA VASCOLARE

CATTEDRA E SCUOLA DI SPECIALIZZAZIONE IN CHIRURGIA

VASCOLARE ed ENDOVASCOLAREDirettore : Prof. Raffaele Pulli

Arteriti dei tronchi sovraaorticiD. Angiletta

• Medical• Open surgery• Endovascular surgery

• A small cohort of patients will require surgery

• Surgical intervention should be performedduring a period of quiescence an in absence ofelevated inflammatory markers

Aneurysms of the

supra-aortic trunks in

Takayasu’s disease.

Report of two cases

1998

Regarding extracranial carotid

artery aneurysms in

Takayasu disease 2000

Treatment of SAT aneurysm: Report of 16 cases Chir

Ital 1999

Aneurysmal aspects of

Takayasu Arteritis . Our

Experience 1998

Surgical andendovasculartreatment ofextracranial carotidartery aneurysms:early and long-termresults of a singlecenter. 2014

Endovascular treatmentof multiple aneurysmscomplicating cogansyndrome. 2014

Eight-year follow-up of endovascular repair of a brachiocephalic trunkaneurysm due to Takayasu's arteritis.2012

Surgical experience with carotid stenosis in young

HIV-1 positive patients under antiretroviral

therapy: an emerging problem? 2005

Endovascular treatment of two rare cases of aneurysms of the

supra-aortic trunks 2004

2011

HIV +HIV +

ARTERITEARTERITE

E2 Sα Pα L1 Cβ S3E 2 S α P α L 1 C β S 3

E3 Sα Pα L3 Cβ S2E 3 S α P α L 3 C β S 2

Surgical experience with carotid stenosis in young HIV-1 positive

patients under antiretroviral therapy: an emerging problem?

G. Regina, et al. , European Journal of Vascular and Endovascular Surgery 2005

•Intimal lesion with fragmentationof the internal elastic lamina

•Atrophy and fragmentation of the elastic fibers of the media with fibrotic substitution and scars

•Fibrosis of the adventitia

•Wide inflammatory infiltrationwith lymphomonocites and plasmacells along the wholethickness of the wall and around the vasa vasorum

• Anastomotic Pseudoaneurysm

• Graft occlusion

Stent Residual lumen

Vessel Wall

Stent

Non responder to medical therapy

Vessel Wall

Left ICA in stent restenosis

2014

Viabahn 9 mm x 5cm

• High intra stent restenosis rates

• Stent fractures

The diagnosis and management of Vasculitis is

not easy

Cardiovascular involvement in Vasculitis and, in

particular, in Behcet and Cogan Syndrome is not

common

High rates of postoperative complications are

reported

The endovascular treatment plays an increased

role, not only in high risk patients.