Endovascular treatment of veno-occlusive Behcet's disease

Cardiovasc Intervent Radiol. 2012 Aug;35(4):826-31. doi: 10.1007/s00270-011-0322-8. Epub 2011 Dec 14.

Abstract

Purpose: To retrospectively evaluate the outcome of endovascular treatments for patients with chronic veno-occlusive disease in different vascular beds secondary to Behcet's disease (BD). There are few case reports on the subject, and this is the largest study to date.

Materials and methods: From January 2001 through October 2009, chronic venous occlusions were treated in 10 patients (all male [age range 18-76 years]) with BD using percutaneous transluminal angioplasty and/or stent placement. All patients were symptomatic and had chronic iliofemoral deep venous thrombosis (DVT; n = 5), central venous occlusion (n = 3), or Budd-Chiari syndrome (BCS; n = 2). All patients met criteria of the International Study Group on Behcet's Disease.

Results: Two of five patients with DVT had unsuccessful recanalization attempts. Three patients had successful recanalization with stent placement. All three veins were occluded within 1 month with unsuccessful reinterventions. Three patients with chronic central venous occlusion had successful recanalization with percutaneous transluminal angioplasty (n = 1) and stent placement (n = 2). Two patients had reocclusion with successful reintervention. Two BCS patients had successful treatment with stent placements. Overall technical success was 69%, and no procedural complications were encountered. None of the patients with chronic DVT had patent veins; however, all patients with central venous occlusion or BCS had patent veins on color Doppler ultrasonography at follow-up ranging from 3 to 48 months after intervention.

Conclusion: Endovenous treatment for chronic iliofemoral DVT due to BD had a poor outcome. However, long-term outcome after endovenous treatment for upper-extremity central venous occlusion and BCS syndrome was good.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Angiography, Digital Subtraction
  • Angioplasty, Balloon
  • Behcet Syndrome / diagnostic imaging
  • Behcet Syndrome / surgery*
  • Budd-Chiari Syndrome / diagnostic imaging
  • Budd-Chiari Syndrome / surgery*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents
  • Treatment Outcome
  • Ultrasonography, Doppler, Color
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / surgery*