Regional Cerebral Oxygen Saturation Monitoring in an Emergency Cesarean Section for Takayasu Arteritis: A Case Report on Utility and Limitations.

Takayasu arteritis is a chronic inflammatory vasculitis primarily affecting the aorta and its major branches, such as the subclavian and common carotid arteries (CCAs). Because Takayasu arteritis predominantly affects young women of reproductive age, clinicians may encounter pregnant patients requiring complex perinatal management. In these patients, anesthesia for cesarean section is particularly challenging because peripheral blood pressure often fails to accurately reflect cerebral perfusion pressure due to extensive arterial stenosis. We report the anesthetic management of a 39-year-old pregnant woman with Takayasu arteritis and a history of a left parietal infarction ten years prior, who required an emergency cesarean section. Computed tomography at that time had already revealed severe, long-standing bilateral stenosis of the subclavian and CCAs; notably, the systolic blood pressure in her upper extremities was 60 mmHg lower than in her lower extremities upon admission for delivery. Given her compromised cerebral vascular reserve and the unreliability of peripheral blood pressure, we utilized regional cerebral oxygen saturation (rSO