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Endovascular Arch and Thoracoabdominal Aortic Intervention in Patients With Connective Tissue Diseases: A Case Series

Griffin P Stinson1, Carlos A Valdes1, Ahmet Bilgili1

  • 1Division of Cardiovascular Surgery, University of Florida, Gainesville, FL, USA.

Innovations (Philadelphia, Pa.)
|June 20, 2025
PubMed

Insights

Endovascular repair offers a lifesaving option for connective tissue disease (CTD) patients unsuitable for open repair, demonstrating low aorta-related mortality and a manageable need for secondary interventions.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Interventions
  • Connective Tissue Diseases

Background:

  • Open aortic repair is standard for connective tissue disease (CTD) due to durability concerns with endovascular methods.
  • Complex CTD presentations can make open repair high-risk, necessitating alternative approaches.
  • Endovascular intervention is explored as a viable option for select CTD patients.

Purpose of the Study:

  • To review institutional experience with endovascular aortic repair in CTD patients.
  • To identify specific scenarios where endovascular intervention is a reasonable consideration for CTD patients.
  • To evaluate outcomes of endovascular repair in this high-risk population.

Main Methods:

  • Retrospective review of 45 CTD patients undergoing endovascular intervention (2006-2023).
  • Primary outcome: freedom from aorta-related mortality.
  • Secondary outcomes: all-cause mortality and freedom from secondary intervention.

Main Results:

  • 88.9% aneurysms and 80.0% dissections were common indications, with 68.9% presenting with both.
  • Freedom from aorta-related mortality was 88.7% at 1 year and 83.2% at 3 years.
  • 46.7% required secondary intervention, with a median time of 6.5 months.

Conclusions:

  • Endovascular intervention is a crucial, often lifesaving, treatment for CTD patients not candidates for open repair.
  • Low aorta-related mortality and less than half requiring secondary intervention support its use.
  • Endovascular repair serves as a valuable bridge to definitive open repair for CTD patients.
Abstract

Keywords:
aortic diseaseconnective tissue diseaseendovascular

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