Endovascular Repair and Adjunctive Immunosuppressive Therapy of Aortic Involvement in Behçet's Disease

Abstract

Endovascular stent graft implantation and adjunctive immunosuppressive therapy seems to be safe and effective in the treatment of aortic involvement in Behçet's disease, but this approach needs further evaluation.

Tratamento endovascular de aneurisma de aorta abdominal com erosão de vértebra lombar associada à doença de Behçet: relato de caso

“…Involvement of the aorta in BD is different from atherosclerotic aneurysmal disease, because in the latter there is accentuated destruction and weakening of the artery wall. 3,5 Options for surgical treatment include open surgery and endovascular techniques. The classical method for surgical treatment of aneurysms associated with BD is open surgery.…”

“…3,4 In isolation, arterial involvement is rare, but is associated with potentially fatal complications, primarily due to development of aneurysms. [3][4][5] The vessel most often involved is the abdominal aorta, followed by the femoral artery and the pulmonary arteries, so the risk of surgical complications is high and morbidity and mortality rates are elevated.…”

“…It was subsequently recognized that clinical manifestations also include synovitis, cutaneous vasculitis, involvement of the gastrointestinal and urogenital systems, meningoencephalitis, and cardiovascular involvement. 2,3 Vascular manifestations include stenoses and occlusions, thrombosis, or formation of aneurysms and pseudoaneurysms, with incidence rates ranging from 25 to 30% of patients, the most common of which is deep venous thrombosis of the lower limbs. 3,4 In isolation, arterial involvement is rare, but is associated with potentially fatal complications, primarily due to development of aneurysms.…”

“…2,3 Vascular manifestations include stenoses and occlusions, thrombosis, or formation of aneurysms and pseudoaneurysms, with incidence rates ranging from 25 to 30% of patients, the most common of which is deep venous thrombosis of the lower limbs. 3,4 In isolation, arterial involvement is rare, but is associated with potentially fatal complications, primarily due to development of aneurysms. [3][4][5] The vessel most often involved is the abdominal aorta, followed by the femoral artery and the pulmonary arteries, so the risk of surgical complications is high and morbidity and mortality rates are elevated.…”

“…There were no occlusions of endoprostheses or pseudoaneurysms, although one patient developed a fistula between the duodenum and the endoprosthesis, which was corrected by resection of the duodenum and an omentum patch to the endoprosthesis. 3 Park et al treated seven patients with aortic aneurysms using endovascular surgery and observed one case of degeneration of the distal endoprosthesis anchor site. 10 Nitecki et al…”