231 - Managing Complications Encountered in Endovascular Revascularization of Single Patent Arch Vessel in Patients with Takayasu Arteritis: Long Term Outcomes

Tuesday, April 14, 2026

3:36 PM - 3:45 PM ET

Presenting Author(s)

Priya Jagia, MD (she/her/hers)

Professor and Head of Department
Dept of Cardiovascular radiology and Endovascular Interventions, AIIMS hospital, Delhi, India

Author/Co-author(s)

Sanjeev Kumar, MBBS, MD

Professor (additional)
All India Institute of Medical Sciences , New Delhi, India
DS

Damandeep Singh, MD

Senior resident
Dept of Cardiovascular radiology and Endovascular Interventions, AIIMS hospital, Delhi, India

Purpose: To describe management and long-term outcomes after endovascular intervention in symptomatic Takayasu's arteritis(TA) patients with single patent arch vessel.

Materials and Methods: 21 patients with TA (18 females, 3 males) and (age 21-49 years, mean, 30.0+11.2 years) with single patent arch vessel, underwent PTA for cerebrovascular symptoms caused by steno-occlusive lesions of arch vessels. 6/21 (28%) patients had active vasculitis at the time of presentation. Stents were placed in case of technical failure or in case of obstructive dissection after balloon angioplasty.

Results: PTA was attempted in 21 lesions; carotid (n=6), vertebral (n=8), brachiocephalic artery (n=5) and 1st part of subclavian artery (n=2). 17 lesions were discrete in morphology whereas 4 were diffuse long segment lesions. Plain balloon angioplasty was successfully performed in 17/21 lesions (80.9%). 3 lesions (14.2%) underwent bailout bare metal stent placement secondary to obstructive dissection flap after angioplasty
Angioplasty was unsuccessful in one patient. 4 (19%) patients developed early neurological complications, (posterior circulation stroke, n=2, anterior cerebral artery stroke, n=1 and middle cerebral artery stroke, n=1) with mean NIH stroke severe score 14 (moderate). These patients were immediately taken for endovascular management. 3 underwent thrombectomy and 1 underwent stenting for recoiled stenotic lesion. Positive inflammatory markers suggestive of active disease were seen in 3/4 patients (75%) who developed complications. On mean follow up of 15 months, reduction in mean NIH stroke severe score to 3.8 (minor stroke) was seen, with patent flowing vessel as seen on doppler.

Conclusion: Endovascular revascularization of single patent arch vessel in patients with TA is a safe and effective procedure. However, it carries an increased risk of neurological complications especially in cases with active disease, warranting pre-emptive readiness for tackling these complications in the lab.

Additionally, optimal medical treatment with immunomodulators or steroids to subvert inflammation whenever feasible, is essential in these patients, for good long term results.