LAUSR

Background Although medical treatment has advanced, surgical treatment is needed to control the progression and symptoms of Takayau arteritis (TA). Endovascular intervention or surgical revascularization is performed; however, there are few comparative studies of these methods. Objectives There are many studies about surgery and endovascular intervention; however, it is still unclear which treatment has better a benefit/risk ratio. Because neither meta-analysis nor large-scale studies are available for surgical treatment of TA, we conducted a meta-analysis to examine the outcome of surgical treatment. Methods A meta-analysis comparing endovascular intervention and surgery outcomes was performed using the MEDLINE and Embase databases. Results A total of 14 studies of 598 patients and 1,049 lesions were included. Endovascular intervention was performed in 418 lesions and surgery in 631 lesions. Restenosis was more common in endovascular intervention than in surgery (odds ratio [OR] =2.74, 95% confidence interval [CI] =1.75–4.27, p <0.00001). Other complications, including stroke, did not differ between endovascular intervention and surgery (OR =0.75, 95% CI =0.49–1.15, p =0.19). There was no difference in mortality between the two groups (OR =1.11, 95% CI =0.50–2.46, p =0.81).Table 1. Outcomes of endovascular intervetion compared to sugery in patients with Takayasu artheritis Test of association Test of heterogeneity OR 95% CI P-value Model P-value I2(%) Restenosis 2.74 1.75–4.27 <0.00001 R 0.05 41 Other complications 0.75 0.49–1.15 0.19 F 0.27 18 Stroke 0.5 0.17–1.50 0.22 F 0.98 0 Death 1.11 0.50–2.46 0.81 F 0.67 0Figure 1. ORs and 95% CIs of individual studies and pooled data; comparison of endovascular intervention and surgical revascularization for restenosis. Conclusions This meta-analysis showed the superiority of surgical revascularization over endovascular intervention. References Saadoun D, Lambert M, Mirault T, et al. Retrospective analysis of surgery versus endovascular intervention in Takayasu arteritis a multicenter experience. Circulation 2012;125:813–9. Nakagomi D, Jayne D. Outcome assessment in Takayasu arteritis. Rheumatology 2016;55:1159–71. Labarca C, Makol A, Crowson CS, Kermani TA, Matteson EL, Warrington KJ. Retrospective comparison of open versus endovascular procedures for takayasu arteritis. J Rheumatol 2016;43:427–32. Lee GY, Jeon P, Do YS, et al. Comparison of outcomes between endovascular treatment and bypass surgery in Takayasu arteritis. Scand J Rheumatol 2014;43:153–61. Kalangos A, Christenson JT, Cikirikcioglu M, et al. Long-term outcome after surgical intervention and interventional procedures for the management of Takayasu's arteritis in children. J Thorac Cardiovasc Surg 2006;132:656–64. Acknowledgements No grants or other support were received for this study. Disclosure of Interest None declared