Introduction
Behcet's disease is a systemic vasculitis with vascular tropism usually manifested by phlebitis. Arterial manifestations are rare, most often result in aneurysms than occlusions. The objective of this article, is to relate our experience and pretherapeutic reasoning for the indication of an endovascular treatment of an atypical sacciform iliac aneurysm, in an elderly patient followed for Behcet's disease.
Case report
This is a 73-year-old patient, followed for Behcet's disease under immunosuppressive treatment and corticosteroids treatment, admitted to our structure, for the surgical management of an aneurysm of the right common iliac artery diagnosed by computed tomographic angiography performed for chronic paroxysmal abdominal pain, treated by EVAR after a multidisciplinary discussion, complicated by a thrombosis of the left leg of the bifurcated aortic stent graft the, managed by performing an extra anatomical bypass, complicated late by the appearance of a Scarpa hematoma, who was evacuated.
Discussion
Behcet's disease is a systemic vasculitis with vascular tropism, usually affecting young. Our case is an elderly subject, whose diagnosis and follow-up of Behcet's disease is recent and whose discovery of this aneurysm was fortuitous, after performing a CT angiogram required for another reason.
The objective of this article, is to relate our experience and pre-therapeutic reasoning for theindication of an endovascular treatment, and our management of the complications.
Conclusion
Endovascular treatment of iliac sacciform aneurysm by placing a covered stent is a good alternative to conventional surgery with fewer complications; especially in front of a field of Behcet's disease.
Introduction
The false aneurysm of the aortic isthmus is, given its severity and case fatality rate, a subject of interest in vascular surgery. The interest of this article is the analysis of the different characteristics of this pathology based on the study of a case report and on a review of the literature.
Case report
This is a 21-year-old patient admitted for the management of a severe polytrauma following a fall from a cliff, causing him paraplegia following a fracture of the dorsal spine which is objectified on the CT bodyscan, which also shows the presence of a localized dissection with ruptured false aneurysm of the isthmus. After emergency conditioning and initial neurosurgical management by vertebral osteosynthesis, the postoperative effects are aggravated by the occurrence of a bilateral massive pulmonary embolism. Thus, given the high risk of complications or death following classic thoracotomy surgery, we decided to carry out endovascular treatment by placing a covered endoprosthesis.
Discussion
The aortic isthmus false aneurysm is a relatively rare condition that mainly interests the young subject in an often-post-traumatic context. The surgical treatment represented by thoracotomy, which, in addition to being invasive, exposes the patient to multiple complications as disabling as each other. All of these elements explain the advantage of endovascular treatment, which is much less invasive with a better prognosis.
Conclusion
The therapeutic management of a pseudoaneurysm of the isthmus is undergoing constant development; endoprostheses currently occupy the place of choice in the treatment of these lesions.
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