Endovascular Stent-Grafting for Recurrent Aneurysm in Behcet's Disease

Abstract

SUMMARYArterial aneurysms represent a severe complication of Behcet's disease. A 42-year-old woman with Behcet's disease had a recurrence of an aneurysm after two surgical repair attempts using grafts. A covered stent-graft was implanted in her iliac external artery to occlude the neck of the aneurysm at the anastomosis of the bypass graft to her external iliac artery. The procedure reduced the size of the aneurysm by allowing the formation of a thrombus within its cavity. The implantation of an endovascular stent-graft may be a sound alternative to surgical repair for aneurysms associated with Behcet's disease. (Int Heart J 2005; 46: 745-749) Key words: Endovascular stent, Interventional radiology, Iliac artery, Long-term efficacy BEHCET'S disease is an inflammatory disorder characterized by recurrent oral and genital ulcers, uveitis, and skin lesions. 1) Cardiovascular complications develop in up to only one third of patients, but they are the main causes of death. 2-4) Arterial complications account for 10-15% of vascular complications and consist mainly of aneurysms. Though open surgical repair is the standard therapeutic approach for aneurysms, its results are unpredictable because of frequent postoperative recurrences. 5,6) Stent-graft placement has recently been attempted for the alternative treatment of aortic and arterial aneurysms in patients with Behcet's disease. 7) We describe a woman with this disease, in whom a covered-stent was successfully implanted in her right iliac external artery to occlude the neck of a recurrent aneurysm at the anastomosis of the bypass graft to her right external iliac artery.From the

Isolated brachial artery aneurysm successfully treated with a covered stent in a patient with Behçet's disease

“…However, arterial complications account for only 10 to 15% of all vascular complications. [4] Indeed, the prevalence of arterial involvement in BD has been estimated at 2.2 to 18% with a marked male predominance. [6] The most commonly affected artery is the abdominal aorta and pulmonary artery, while the involvement of other arteries is rare.…”

“…[2] However, arterial aneurysms are rarely seen in BD and account for 10 to 15% of all vascular complications. [3,4] The traditional treatment of aneurysms in BD patients is open surgery; however, stent-graft placement has become an alternative option in recent years. [5] Herein, we report a rare case of an isolated brachial artery aneurysm with a history of BD treated with endovascular covered stenting of the brachial artery.…”

Endovascular Stent-Graft Treatment of Abdominal Aortic Aneurysm in Behçet's Diseases: Case Report

“…11,12 Literatürde endovasküler stent-greft ile başarıyla tedavi edilen vaka bildirimleri mevcuttur. [19][20][21] Çalışmalarda yaklaşık olarak %20 oranında bildirilen komplikasyonlar içinde en şiddetlisi "endoleak"tir. Bu tablo bazı hastalarda ilerleyerek anevrizmanın genişlemesine ve sonrasında rüptüre neden olabilmektedir.…”

Single-Stage Endovascular Treatment Performed on Multiple Aortic Aneurysms in a Patient with Behçet’s Disease—Report of a Case

“…In recent years, there have been a number of reports regarding the use of stent-graft treatment in patients with Behçet's disease as a minimally invasive treatment as an alternative to the conventional surgical method consisting of the graft replacement. [5][6][7][8] However, many questions remain unsolved regarding its long-term outcome. Park, et al, 8) reported that the recurrence of an aneurysm at the distal part of the stent graft was found in 1 patient in whom stent grafts were placed in nine different locations for the treatment of aneurysms due to Behçet's disease.…”