Aortic aneurysm in Behcet’s disease, endovascular management options: Single-center experience

Hossam Zaghloul; Mohamed Hosny El Dessouki; Alaa Eldin Mahmoud Amin; Marawan Yousry

doi:10.53730/ijhs.v6nS3.7275

Authors

Hossam Zaghloul Division of Vascular Surgery, Department of General Surgery, Kasr Alainy Hospital, Cairo University, Cairo, Egypt
Mohamed Hosny El Dessouki Division of Vascular Surgery, Department of General Surgery, Kasr Alainy Hospital, Cairo University, Cairo, Egypt
Alaa Eldin Mahmoud Amin
alaa301089@cu.edu.eg
Division of Vascular Surgery, Department of General Surgery, Kasr Alainy Hospital, Cairo University, Cairo, Egypt
Marawan Yousry Division of Vascular Surgery, Department of General Surgery, Kasr Alainy Hospital, Cairo University, Cairo, Egypt

Keywords:

Behçet’s syndrome, Behçet’s disease, immunosuppressive therapy, endovascular techniques, aortic aneurysm, pseudoaneurysm

Abstract

This study aims to review contemporary lines of endovasular management of Aortic aneurysm in bechet’s disease illustrating the pros and cons of each treatment modality. This is a retrospective cohort study of all consecutive Aortic aneurysms in patients diagnosed bechet’s disease treated between 2018-2021. The aim of this study is to evaluate efficacy &outcome of endovascular stent graft implantation for the treatment of Aortic aneurysm in Bechet’s disease. From feb 2018 to august 2021, 11 Aortic aneurysms were diagnosed in 10 patients with Bechet’s disease. All patients were male. The patients ranged in age from 33 to 66 years (median ,41 years). There were three infrarenal abdominal aortic aneurysm, two supra celiac aneurysm, three descending thoracic, one Aortic arch aneurysm, and one patient had both pararenal &descending thoracic aneurysm. All patients received immunosuppressive therapy before intervention to induce remission. After hospital discharge, all patients were followed up regularly at 3 months intervals. The mean duration of follow-up was 22.6 months (range ,1-39 months). A straight tube graft was implanted in nine patients and a bifurcated graft in one patient. Two stage procedures (debranching before endovascular therapy) were performed in three patients.

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References

Sarica‐Kucukoglu, Rifkiye, Afet Akdag‐Kose, Murat Kayabalı, Kurtulus Didem Yazganoglu, Rian Disci, Dilek Erzengin, and Gulsevim Azizlerli. "Vascular involvement in Behçet's disease: a retrospective analysis of 2319 cases." International journal of dermatology 45, no. 8 (2006): 919-921.

Koksoy, C., A. Gyedu, I. Alacayir, U. Bengisun, H. Uncu, and E. Anadol. "Surgical treatment of peripheral aneurysms in patients with Behcet’s disease." European Journal of Vascular and Endovascular Surgery 42, no. 4 (2011): 525-530.

Liu, Chang-Wei, Wei Ye, Bao Liu, Rong Zeng, Weiwei Wu, and Michael D. Dake. "Endovascular treatment of aortic pseudoaneurysm in Behçet disease." Journal of vascular surgery 50, no. 5 (2009): 1025-1030.

Ohira, Suguru, Shinsuke Masuda, and Tsutomu Matsushita. "Nine-year experience of recurrent anastomotic pseudoaneurysms after thoracoabdominal aneurysm graft replacement in a patient with Behçet disease." Heart, Lung and Circulation 23, no. 10 (2014): e210-e213.

Nitecki, Samy S., Amos Ofer, Tony Karram, Henry Schwartz, Ahuva Engel, and Aaron Hoffman. "Abdominal aortic aneurysm in Behçet’s disease: new treatment options for an old and challenging problem." Isr Med Assoc J 6, no. 3 (2004): 152-5.

Gouëffic Y, Pistorius MA, Heymann MF, Chaillou P, Patra P. Association of aneurysmal and occlusive lesions in Behçet’s disease. Ann Vasc Surg 2005; 19:276-9.

Malloy, Patrick C., Alankrita Raghavan, Theresa Elder, James Wright, Christina Huang Wright, Christopher Burant, Martha Sajatovic, and Alan Hoffer. "Cerebrospinal Fluid Drainage During Endovascular Aortic Aneurysm Repair: A Systematic Review of the Literature and Treatment Recommendations." Vascular and Endovascular Surgery 54, no. 3 (2020): 205-213.

Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, Flores-Suarez et al. "2012 revised international chapel hill consensus conference nomenclature of vasculitides." Arthritis & Rheumatism 65, no.1 (2013): 1-11.

Balcioglu, O., S. E. R. K. A. N. Ertugay, H. A. L. İ. L. Bozkaya, M. U. S. T. A. F. A. Parildar, and H. Posacioglu. "Endovascular repair and adjunctive immunosuppressive therapy of aortic involvement in Behçet's disease." European Journal of Vascular and Endovascular Surgery 50, no. 5 (2015): 593-598.

Kwon, T-W., S-J. Park, H-K. Kim, H-K. Yoon, G-E. Kim, and B. Yu. "Surgical treatment result of abdominal aortic aneurysm in Behçet's disease." European Journal of Vascular and Endovascular Surgery 35, no. 2 (2008): 173-180.

Kalko, Yusuf, Murat Basaran, Unal Aydin, Ulku Kafa, Gökcen Basaranoglu, and Tahsin Yasar. "The surgical treatment of arterial aneurysms in Behçet disease: a report of 16 patients." Journal of Vascular Surgery 42, no. 4 (2005): 673-677.

Vasseur MA, Haulon S, Beregi JP, Le Tourneau T, Prat A, Warembourgh H. Endovascular treatment of abdominal aneurysmal aortitis in Behcet’s disease. J Vasc Surg 1998; 27:974-6.

Kim, Sung Won, Do Yun Lee, Man Deuk Kim, Jong Yun Won, Sung Il Park, Young Nam Yoon, Donghoon Choi, and Young-Guk Ko. "Outcomes of endovascular treatment for aortic pseudoaneurysm in Behcet's disease." Journal of Vascular Surgery 59, no. 3 (2014): 608-614.

Shen, Chenyang, Weihao Li, Yongbao Zhang, Qingle Li, Yang Jiao, Tao Zhang, and Xiaoming Zhang. "Outcomes of surgery for patients with Behcet’s disease causing aortic pseudoaneurysm: a shift from open surgery to endovascular repair." Clinics 71, no. 6 (2016): 302-310.

Hatemi, Gulen, Robin Christensen, Dongsik Bang, Bahram Bodaghi, Aykut Ferhat Celik, Farida Fortune, Julien Gaudric et al. "2018 update of the EULAR recommendations for the management of Behçet’s syndrome." Annals of the Rheumatic Diseases 77, no. 6 (2018): 808-818.

International Study Group for Behçet’s Disease. Criteria for diagnosis of Behçet’s disease. Lancet 1990; 335:1078-80.