Quality of life of patients with Takayasu arteritis in the long-term after surgical treatment

Takayasu arteritis is a rare large vessel vasculitis affecting the aorta, its branches and the pulmonary artery. With a progressive course, the disease can lead to the development of stroke, ischemia of the upper extremities and a decrease in quality of life. There is a limited number of long-term results of treatment of Takayasu arteritis and there are no studies on assessing the quality of life in patients after surgery.

The aim of the study was to study the quality of life of patients with Takayasu arteritis who underwent surgery for damage to the branches of the aortic arch.

Materials and methods. The quality of life in the long-term period was assessed in 21 patients with Takayasu arteritis. They operated in the department of vascular surgery of A.V. Vishnevsky National Medical Research Center of Surgery from January 2001 to December 2021. Quality of life was assessed using the SF-36 (Short Form 36) questionnaire, Hospital Anxiety and Depression Scale (HADS), the Morisky – Green compliance scale and a specialized questionnaire developed as part of this study.

Results and discussion. When assessing the level of anxiety and depression on the HADS, it was revealed that 42,8% of operated patients with Takayasu arteritis have disorders in the psychoemotional sphere. The assessment of the quality of life by SF-36 scale demonstrates the absence of a statistically significant decrease in the quality of life of patients compared to the average indicators for the healthy population in the Russian population. Our data indicate that stroke before surgery has a statistically significant effect on the mental health of patients, a decrease in vital activity and leads to a significant decrease in social contacts of patients. At the same time, performing surgical intervention reduces the risk of developing stroke: the rate of freedom from neurological events in operated patients with damage to the branches of the aortic arch was 92.3±7.4%. Among the factors that statistically significantly reduce quality of life indicators are the development of restenosis and thrombosis of vascular grafts, multifocal type of damage to the aorta and its branches, and the presence of arterial hypertension.

Thus, patients with Takayasu arteritis require dynamic monitoring of the state of vascular reconstructions and correction of hypertension. When thrombosis and hemodynamically significant restenosis of grafts are detected, new vascular regions are involved, the issue of surgical treatment should be considered in order to restore blood flow in the affected area.

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