Total endovascular treatment for thoraco-abdominal aortic aneurysm in a patient with Behçet’s disease: Case report and literature review

Abstract

Introduction To report total endovascular treatment for a rare case of Crawford extent IV thoraco-abdominal aortic aneurysm (TAAA) using custom-designed branched device in a patient with Behçet’s disease. Methods A 50 years’ old man with history of BD was accidentally diagnosed Crawford extent IV TAAA during computed tomography follow-up after left nephrectomy of renal carcinoma. The aneurysm extended from descending aorta to right common iliac artery with a maximum diameter of 6.2 cm. Results The endovascular procedure wassuccessfully performed using custom-designed branched component to cannulate visceral arteries, bifurcated endograft and iliac legs to exclude the aneurysm sac in abdominal aorta and an iliac branched device to preserve the right internal iliac artery. The patient was discharged without any complication. Computed tomography angiogram at one month after endovascular repair demonstrated total exclusion of the aneurysm, patent visceral branches and right internal iliac artery. No complication occurred to six-month follow-up. Conclusion Endovascular treatment of stable TAAA in patients with Behc?et's disease using custom-designed branched device is feasible, microinvasive and safe. The long-term efficacy needs to be observed.

Endovascular Treatment of Ruptured or Symptomatic Thoracoabdominal and Pararenal Aortic Aneurysms Using Octopus Endograft Technique: Mid-Term Clinical Outcomes

“…20 However, open surgery for inflammatory TAAA remains difficult, because of the perianeurysmal adhesions of the adjacent tissues, an up to 30% to 50% risk of recurrent pseudoaneurysm at the anastomosis site, and even a potential to exacerbate the process of inflammation. [21][22][23] Endovascular repair with adjunctive immunosuppresive therapy and corticosteroids for inflammatory aneurysm has been documented carrying less procedural trauma and higher survival rate than open repair, and a shift from open repair to endovascular repair has been recommended by some studies. [22][23][24] In the current study, 4 of the 10 cases were diagnosed inflammatory aneurysms, and 3 of them (except case 3, abdominal radiotherapy induced inflammatory aneurysm) accepted adjunctive immunosuppresive therapy and corticosteroids.…”

“…[21][22][23] Endovascular repair with adjunctive immunosuppresive therapy and corticosteroids for inflammatory aneurysm has been documented carrying less procedural trauma and higher survival rate than open repair, and a shift from open repair to endovascular repair has been recommended by some studies. [22][23][24] In the current study, 4 of the 10 cases were diagnosed inflammatory aneurysms, and 3 of them (except case 3, abdominal radiotherapy induced inflammatory aneurysm) accepted adjunctive immunosuppresive therapy and corticosteroids. Indeed, the mid-term clinical outcome is encouraging.…”