lCLINICAL INVESTIGATION l Endovascular Therapy Combined With Immunosuppressive Treatment for Occlusive Arterial Disease in Patients With Takayasu's

l l Purpose: To evaluate the feasibility and ef®cacy of endovascular therapy combined with immunosuppression for the treatment of arterial occlusive disease in patients with Tak-ayasu's arteritis (TA). Methods: From January 1998 to June 2003, 25 patients (22 women; age 37.8615.5 years) with TA were treated with angioplasty for symptomatic lesions or with a hemodynamically signi®cant aortic narrowing. The patients with active disease, de®ned as an increase in in¯ammatory markers (e.g., erythrocyte sedimentation rate [ESR]), were treated with im-munosuppressive agents before intervention. Angioplasty was performed after the ESR had been normalized. Results: In the 25 patients, 58 vascular territories (7 aortic, 9 carotid, 3 vertebral, 11 sub-clavian, 2 superior mesenteric, 18 renal, 4 iliac, and 4 coronary arteries) were treated with angioplasty only (19 lesions) or with stents (39 lesions). The mean ESR when the vascular lesions were initially diagnosed was 35.6626.2 mm/h, which fell to 18.567.8 mm/h after immunosuppressive therapy. The endovascular procedure was performed successfully i