Endovascular Treatment of a Ruptured Superficial Femoral Artery Aneurysm in Behcet's Disease: Case Report and Literature Review

Ann Vasc Surg. 2020 May:65:287.e1-287.e6. doi: 10.1016/j.avsg.2019.11.023. Epub 2019 Nov 23.

Abstract

Purpose: The aim of the study was to report the endovascular repair of a ruptured superficial femoral artery (SFA) aneurysm in a young patient with Behcet's disease and review the literature.

Case report: A 43-year-old man with a known history of vasculo-Behcet's disease (v-BD) under daily immunosuppressive therapy presented with a ruptured aneurysm of the left SFA. The patient underwent urgent endovascular exclusion of the aneurysm using a self-expanding covered stent. Surgical cut-down followed by direct puncture of the SFA was preferred to percutaneous approach to reduce the risk of postoperative pseudoaneurysm formation. The procedure and postoperative recovery were successful. Doppler ultrasound performed at 3 months and computed tomography angiography performed at 6 months after the procedure confirmed aneurysm exclusion, the endograft patency, and the absence of aneurysm degeneration both at the level of surgical access and endograft landing zone.

Conclusions: The endovascular treatment of ruptured lower limb aneurysms has been scarcely reported in the literature despite representing the less invasive option. A rare case of ruptured aneurysm SFA in a patient with v-BD was successfully treated with endovascular therapy (ET) and led to satisfactory midterm outcomes. ET offers encouraging results in terms of reduced vessel trauma and reduced postoperative complication rates.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aneurysm, Ruptured / diagnostic imaging
  • Aneurysm, Ruptured / etiology
  • Aneurysm, Ruptured / physiopathology
  • Aneurysm, Ruptured / surgery*
  • Behcet Syndrome / complications*
  • Behcet Syndrome / diagnosis
  • Behcet Syndrome / drug therapy
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation* / instrumentation
  • Endovascular Procedures* / instrumentation
  • Femoral Artery / diagnostic imaging
  • Femoral Artery / physiopathology
  • Femoral Artery / surgery*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Stents
  • Treatment Outcome
  • Vascular Patency

Substances

  • Immunosuppressive Agents