sr. interventional cardiologist
TRANSCRIPT
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Dr AM ThirugnanamSr. Interventional Cardiologistwww.cardiologycourse.com, www.bestmedicalschoolonline.com, Hyderabad, Telangana, India.
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15 years old girl had undiagnosed Takayasu Arteritis accelerated hypertension.
She was treated outside for hypertension where they were unable to bring under control.
Both the legs were discolored.
Severe claudication, unable to walk for even 5 mts
Bilateral absence of femoral pulses
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Examination: ECG-NSR, Echocardiogram-N, Thyroid-N, Collagen profile-N, hsCRP-26, other basic biochemistry were normal
Physical examination: normal cardiac sounds, chest-clear, RAP-110/220mmhg, LAP-110/230mmhg, absence of bilateral femoral pulses and lower limb pulses
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Type I- Branches of Aortic Arch
Type IIa- Ascending Aorta, aortic arch and its branches
Type IIb- Type IIa region plus thoracic descending aorta
Type III- Thoracic descending aorta, abdominal aorta and renal arteries or a combination
Type IV- Abdominal aorta, renal arteries or both
Type V- Entire aorta and its branches
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1- treatment for thrombosis-Patient was given SC and oral anticoagulation for 4 weeks. Repeated imaging showed dissolved thrombus in SFA
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In Takayasu arteritis, thrombosis and descending aorta stenting make us tough
Proper skills in aorta procedure only can avoid unnecessary complications.
Not to go where the pulses are absent, CT guided approach is the safest and gold standard procedure to avoid procedure related complications