A Case of Takayasu's Arteritis That Developed Impending Ruptured Subclavian Artery Aneurysm Associated with Sepsis during Steroid Therapy / 日本心臓血管外科学会雑誌

ABSTRACT

A 20-year-old woman had intermittent fever frequently since dental therapy one year previously. Two months previously Takayasu's arteritis had been diagnosed and she had been given 30mg/day prednisolone. She then developed subarachnoid hemorrhage, left arm pain/cataplexy, purpura, sight disturbance, and sepsis caused by <i>Serratia</i>. Finally she felt chest pain and a left Subclavian artery pseudoaneurysm was detected out. Therefore she was transferred to our service for emergency surgery. Preoperative angiography demonstrated post-stenosis aneurysm in the right common carotid artery, left common carotid artery aneurysm, and saccular pseudoaneurysm in the left subclavian artery that suggested impending rupture. The operation was performed through a left upper partial sternotomy extended to the left supraclavicular space. The left subclavian artery was ligated proximal to the aneurysm and distal portion was also ligated through a subclavicular approach. The postoperative course was uneventful. No ischemic sign has been seen in her left arm one year after operation and left/right brachial artery pressure index has improved to 0.80. The patient currently takes steroids and remains healthy without signs of expansion of bilateral carotid artery aneurysms.