Transcatheter embolotherapy of pulmonary artery aneurysms as emergency treatment of hemoptysis in Behcet patients: experience of a referral center and a review of the literature

Voiriot, Guillaume; Parrot, Antoine; Antoine, Martine; Gibelin, Aude; Haddad, Samuel; Carette, Marie-France; Fartoukh, Muriel; Khalil, Antoine

doi:10.1007/s11739-018-1817-y

Cited by 20 publications

(16 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In patients refractory to this first-line treatment, anti-TNF-α agents (mainly infliximab) can represent a life-saving treatment (86). Eventually, embolisation, lobectomy, cavitectomy, and decortication can be considered (87)(88)(89).…”

Section: Arterial Involvementmentioning

confidence: 99%

Treatment of Behçet's Disease: An Algorithmic Multidisciplinary Approach

et al. 2021

View full text Add to dashboard Cite

Behçet's disease (BD) is a chronic, relapsing inflammatory, multisystem disease of unknown etiology. The disease has a wide clinical spectrum of mucocutaneous lesions and ocular, vascular, articular, neurologic, gastrointestinal and cardiac involvement. Although the number of effective drugs used in the disease's treatment has increased in recent years, BD is still associated with severe morbidity because of mainly mucocutaneous, articular and ocular symptoms and an increased mortality because of large vessel, neurological, gastrointestinal and cardiac involvement. Many factors are associated with a more serious course, such as male gender and a younger age of onset. While the severity of the disease is more pronounced in the first years of the disease, it decreases in most patients after the age of forties. The primary goal of treatment should be the prevention of irreversible organ damage. Therefore, early diagnosis and appropriate treatment and close follow-up are mandatory to reduce the morbidity and mortality of the disease. Treatment varies depending on the organ involved and the severity of the involvement. For all these reasons, the treatment should be personalized and arranged with a multidisciplinary approach according to the organs involved. Treatment is mainly based on suppression of the inflammatory attacks of the disease using local and systemic immunomodulatory and immunosuppressive drugs. In this review, based on the mainly controlled studies and personal experience in clinical practice and basic research in this field, we propose a stepwise, symptom-based, algorithmic approach for the management of BD with a holistic perspective.

show abstract

Section: Arterial Involvementmentioning

confidence: 99%

Treatment of Behçet's Disease: An Algorithmic Multidisciplinary Approach

et al. 2021

View full text Add to dashboard Cite

show abstract

“…All patients with pulmonary artery involvement had hemoptysis. In a French study [13], hemoptysis was the inguinal symptom in 14 out of 17 patients with pulmonary artery aneurysm. As acute coronary syndrome and hemoptysis can both be severe and life-threatening, early diagnosis and appropriate treatment are required.…”

Section: Discussionmentioning

confidence: 98%

The Clinical Features, Risk Factors, and Outcome of Aneurysmal Lesions in Behcet’s Disease

Zhou

Shi

Liu

et al. 2019

Journal of Immunology Research

View full text Add to dashboard Cite

Objective. To investigate the clinical features and potential risk factors of aneurysmal lesions in Behcet’s disease (BD). Methods. We retrospectively reviewed the clinical data of BD patients with aneurysmal lesions in our institute from 1997 to 2017 and compared them with 207 BD patients without aneurysmal lesions. The treatment and outcome of these patients were also analyzed. Results. Sixty-nine patients were included with 117 aneurysmal lesions. The average period between BD onset and diagnosis of aneurysmal lesion was 5.4±5.5 years. Thirty-three patients (47.8%) had multiple aneurysmal lesions. Ten patients developed 20 pulmonary artery aneurysms alone. For the other 97 aortic and/or peripheral artery aneurysms in 59 patients, the most commonly affected vessels were abdominal aorta (27/97, 27.8%), coronary artery (10/97, 10.3%), and superficial femoral artery (8/97, 8.2%). Multivariate analysis revealed pathergy reaction (OR=3.78 (1.70-8.41)), arterial stenosis or occlusion (OR=44.12 (11.56-168.35)), and arterial thrombosis (OR=9.27 (2.33-36.93)) as independent predictors of aneurysmal lesions in BD. With a mean follow-up of 5.5±4.0 years, 40 patients (58.0%) achieved clinical improvements, 15 patients (21.7%) relapsed, and 10 patients (14.5%) died. The respective estimated cumulative 1- and 5-year relapse-free rates were 91.3% and 76.3%, and the respective estimated 1- and 5-year survival rates were 95.0% and 87.2%. Conclusion. Aneurysmal lesions are severe complications in BD. Pathergy reaction, arterial stenosis or occlusion, and arterial thrombosis are the risk factors of aneurysmal lesions in BD. Achieving BD remission and performing surgical or interventional procedures are both important in the treatment of these patients.

show abstract

“…A case series of 17 patients with Behçet's disease found that embolization of pulmonary artery aneurysms was successful in achieving immediate control of hemoptysis in all patients. 5 Hemoptysis recurred in 41% of patients within 12 months, and one major complication was reported (acute exacerbation of preexisting pulmonary hypertension). 5 Coil erosion and migration into the mainstem bronchus is a rare complication of coil embolization with an unknown incidence, described in a case report occurring 2 years after embolization for which a left lower lobectomy with resection of the PAA and coil was performed.…”

Section: Discussionmentioning

confidence: 99%