Surgery improves survival rate in patients with Takayasu arteritis: a retrospective observational study.

OBJECTIVE: The long-term prognosis and optimal management for Takayasu arteritis (TA) patients with severe stenosis of the descending thoracic and abdominal aorta remain undefined. We compared the clinical outcomes of surgical intervention and medical management. METHODS: Between January 2011 and January 2022, 78 TA patients with severe descending thoracic and abdominal aortic stenosis were enrolled at Peking Union Medical College Hospital. The cohort included the surgical group (n = 62) and the conservative treatment group (n = 16). Baseline characteristics were assessed to reduce selection bias. The primary outcome was all-cause mortality. Secondary outcomes were defined as the event-free survival and quality of life. Long-term follow-up of the clinical outcomes was also performed. RESULTS: Surgical intervention significantly reduced all-cause mortality compared to conservative management (P < 0.001). Patients who underwent surgeries also exhibited improved quality of life regardless of their physical condition (P < 0.01) or psychological condition (P = 0.006). Postoperative reductions in systolic blood pressure (P = 0.033) and antihypertensive medication requirements (P = 0.015) were observed compared to medical management. In the surgical group, different surgical approaches presented with other complications, with the open surgical group having higher comorbidities within 30 days and a lower rate of long-term restenosis (P = 0.038). CONCLUSION: Surgical intervention significantly improves long-term outcomes in TA patients with severe stenosis of the descending thoracic and abdominal aorta.