Introduction: Takayasu arteritis is a large vessel vasculitis that predominantly affects the aorta and its branches. It is a disease most commonly seen in women aged 10 - 40 years old. The Philippine Pediatric society has documented about 89 cases. Traditional methods of management are surgery and steroids, both of which are not without adverse effects. A novel, less invasive procedure for this condition, the first successful procedure of its kind in this country, is presented in this paper.
Case: This is a case of a 10 year old female who presented with a 7 month history of fever and abdominal pain. During her admission, she was noted to be pulseless on the right arm with diminished pulses. CT aortogram revealed discreet narrowing in the descending aorta. Impression was Takayasu arteritis. The patient underwent stenting using Optimus Stent XL expanded to 38mm and 40mm. Post-procedure echocardiography showed residual narrowing measuring 60mm from 34mm.
Discussion: Aortic involvement in Takayasu arteritis occurs in 85% of patients and involve the aorta. The most useful examination findings are diminished or delayed lower extremity pulses, and a differential blood pressure. The management is dictated by the age at presentation. In the older child stent placement is considered a reasonable approach from surgical intervention with good, long term outcomes.
Conclusion: This is the first reported case of successful stent implantation for coarcation of the aorta in a pediatric patient in the Philippines. This less invasive procedure, which was done instead of the traditional surgical intervention, may lead to a paradigm shift in the treatment of coarctation of the aorta in our country.