Transcatheter embolization of renal artery aneurysm in Behçet’s disease

Abstract

A 20-year-old man with Behçet's disease presented with a ruptured renal artery aneurysm. This patient had previously had aneurysms of the coronary arteries and coronary vein thrombosis that were treated with immunosuppression. A selective transcatheter embolization of the renal artery branch was done successfully and treatment with corticosteroids and methotrexate was added. Presented here is a rare complication of Behçet's disease, with discussion on the pathophysiology, differential diagnosis, and the advantages and disadvantages of the angiographic treatment. This paper is supplemented with a comprehensive review of the literature.

Vasculo-Behçet’s disease with non-traumatic subcapsular hematoma of the kidney and aneurysmal dilatations of the celiac and superior mesenteric arteries

“…Murakami et al [2] reported that they investigated 97 cases of vasculo-Behçet's disease and found no patient who developed abnormalities in the small renal, celiac or superior mesenteric arteries. To the best of our knowledge, at least six cases of vasculo-Behçet's disease, including our case, have been reported with the complication of renal artery abnormalities [3][4][5][6][7]. Moreover, including our case, only five cases of vasculo-Behçet's disease have been reported to be complicated with abnormalities in the celiac and superior mesenteric arteries [4,[8][9][10].…”

Bilateral renal artery aneurysm rupture in a man with leukemia: Report of a case

“…Etiologies for secondary renal artery aneurysms include pregnancy, trauma, iatrogenic causes, congenital malformations of the kidneys, malignancies, mycotic infections, neurofibromatosis, tuberous sclerosis, Ehlers-Danlos syndrome, and connective tissue diseases such as polyarteritis nodosa, Wegener's granulomatosis, and Behcet's disease. 4,6,11,12 The classic presentation for renal artery aneurysm prior to rupture consists of microscopic hematuria, hypertension, and flank and/or abdominal pain. Patients may also present with spontaneous rupture, or findings of an abdominal bruit or mass on examination.…”

Interventional Management of Renal Vascular Origin Hematuria

“…Coil embolization has been used to treat ruptures. 36,37 Limited experience with PTA to treat symptomatic stenoses resulting in hypertension or azotemia suggests it may be useful in carefully selected patients. 38 Renal vein thrombosis (RVT), which occurs in up to 10% of those with nephrotic syndrome, may also be seen in association with Behçet's disease and SLE, and present with hematuria.…”