THERAPY AND PREVENTION AORTITIS Percutaneous transluminal balloon angioplasty of the aorta in patients with aortitis

Four patients with aortitis and stenotic lesions of the aorta were successfully treated by percutaneous transluminal balloon angioplasty. The peak systolic gradient across the constrictions decreased from 82.5 ± 35.7 to 37.5 ± 18.5 mm Hg immediately after dilatation. Repeat angiography in the first three patients performed 2 months later showed a further decrease in the gradient to 13.8 + 9.5 mm Hg. There were no complications during or after the procedure, and all the patients have shown remarkable symptomatic relief during the follow-up. Circulation 76, No. 3, 597-600, 1987. AORTITIS is a form of vasculitis with the characteristic feature of "pulselessness."1 The inflammatory process commonly involves the aorta and its major branches. Its clinical manifestations are variable depending on the regional distribution of the disease, the type of vascular lesions, and whether the inflammation is persistent or has resolved. The etiology is still uncertain. Specific treatment of the disease is not available without knowledge of the exact etiology. Surgical treatment is used during the chronic phase to deal with late complications of aortitis, but the scope of surgical therapy is limited because of the multifocal and often progressive nature of the disease. After the introduction of percutaneous transluminal balloon angioplasty in 1964 by Dotter and Judkins2 and the development of the balloon dilatation catheter in 1974 by Griintzig and Hopff,3 percutaneous transluminal balloon angioplasty has become an accepted mode of treatment for stenotic lesions. Successful dilatation of coarctation of the aorta,4 5 restenosis of coarctation,6 atherosclerotic stenosis of the lower abdominal aorta,7 8 and peripheral arteries has been reported.19 Experience with balloon dilatation angioplasty in aortitis is very limited. To our knowledge, only four cases of balloon angioplasty in this setting have been reported. 12-14 Here we report for the first time four cases in which successful dilatation of aortic From the Department of Cardiology, G. B. Pant Hospital, New Delhi, India. Address for correspondence: Dr. M. Khalilullah, Department of Cardiology, G. B. Pant Hospital, New Delhi 110 002, India. Received Dec. 12, 1986; revision accepted April 23, 1987. Vol. 76, No. 3, September 1987 constrictions has been perfonned in patients with