J.Jpn. Surg. Soc.. 80(4): 307-320, 1979

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Original article

EFFECT OF PREOPERATIVE ANTI-INFLAMMATORY STEROID ON THE ARTERIAL RECONSTRUCTIVE SURGERY OF NON-SPECIFIC ARTERITIS

Against the clinical reaction of active inflammation of non-specific arteritis only the steroid drug is recognized to be effective. However, it is not clarified whether steroid has some effect on the arterial reconstructive surgery of non-specific arteritis. This is to investigate the effect of preoperative steroid therapy on the intra-operative gross findings, microscopical features of the specimen and operative results among 102 cases of the arteritis, of which 17 cases were mainly studied. Most of the cases were aortitis syndrome (Takayasu arteritis).
Preoperative steroid therapy suppressed inflammatory reaction clinically, and brought about the gross findings of the lesion which were not so severe periarterial adhesion as the cases without steroid. However, undesirablly, in most of the cases with steroid appeared the severe inflammatory features in the specimen. On the clinical course of three ruptured cases of arterial aneurysm, steroid seemed to play a causative role of rupture. In the long-term follow-up period, weaning from the steroid therapy was difficult, and incidence of the aneurysms at the anastomotic site was high (33%).
The recommended operative chance of reconstructive surgery is at the stage of negative inflammatory reaction. However, by examining this clinical study, steroid is not considered to influence the healing process of inflammation in the non-specific arteritis. As to the arterial reconstructive surgery of the arteritis, steroid therapy should be limited at the acute phase of inflammation. And satisfactory late results of the surgical treatment additionally depend on the absence of inflammatory change at the anastomotic site.

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