Challenges and opportunities to improve outcomes for adults with iTTP. Atypical presentations often lead to delayed diagnosis in older adults. Clinician education and improved access to diagnostic assays may reduce time to diagnosis and treatment. Thromboembolic events are the leading cause of death during acute TTP and cause significant morbidity from end-organ injury such as myocardial infarction and stroke. Using caplacizumab during acute TTP may reduce ischemic events and shorten the duration of plasma exchange, which will also reduce the risk for catheter-related complications that were common in older adults. Finally, additional research is needed to identify risk factors for worse long-term outcomes after TTP. Because cardiovascular disease (rather than TTP relapse) is associated with worse long-term survival, a multidisciplinary approach is recommended to improve the care of older adults with TTP.