Durability of aneurysm treatments in patients with active Behcet's disease

Vascular. 2016 Oct;24(5):454-60. doi: 10.1177/1708538115611069. Epub 2015 Oct 29.

Abstract

Objective: Aneurysms in Behcet's disease are rare, serious, and recurrent. To achieve durable treatment, patients should receive immunosuppressive therapy before intervention to induce remission. We present early and long-term results of emergency cases of active Behcet's disease, which did not permit waiting for suppressive treatment.

Patients and methods: The study was undertaken on all cases admitted to the vascular unit, King Fahd Hospital of University for aneurysm treatment in patients with active Behcet's disease over about 10 years. All patients had exclusion of the aneurysm either by open surgery or endovascular intervention. Morbidities and mortality were recorded within the hospital admission and on the follow-up.

Results: During the study period, three cases were included. All interventions were successful and lifesaving. However, two cases, treated with surgical interposition grafts, were blocked in the intermediate term follow-up (2-12 months) and one case, treated with endovascular treatment, complicated with pseudoaneurysm at femoral puncture site after six months.

Conclusion: Although early results were good, intermediate ones were not satisfactory because of progressive graft thrombosis and formation of new aneurysms. Awareness of these rare cases help for early identification and proper immunosuppressive before emergency vascular intervention is warranted.

Keywords: Behcet’s disease; arterial aneurysm; endovascular treatment; polytetrafluroethylene (PTFE) graft.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm / diagnostic imaging
  • Aneurysm / etiology
  • Aneurysm / surgery*
  • Aneurysm, False / etiology
  • Angiography, Digital Subtraction
  • Behcet Syndrome / complications*
  • Behcet Syndrome / diagnosis
  • Behcet Syndrome / drug therapy
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Blood Vessel Prosthesis Implantation* / instrumentation
  • Computed Tomography Angiography
  • Endovascular Procedures* / adverse effects
  • Endovascular Procedures* / instrumentation
  • Graft Occlusion, Vascular / etiology
  • Hospitals, University
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Middle Aged
  • Polytetrafluoroethylene
  • Prosthesis Design
  • Recurrence
  • Risk Factors
  • Saudi Arabia
  • Time Factors
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Polytetrafluoroethylene