J Korean Soc Vasc Surg.  2003 May;19(1):44-48.

Surgical Option in Managing Recurring Pseudoaneurysms in Behcet's Vasculitis

Affiliations
  • 1Department of Surgery, Kangnam St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. sun60278@catholic.ac.kr

Abstract

PURPOSE
Behcet's disease is a systemic condition with multiple clinical manifestations, the basis of which is a vasculitis with unknown etiology. The most common cause of death in Behcet's disease is secondary to arterial complications. The pathogenesis of these arterial complications is related to the diseased arterial wall or vasa vasorum seen in the Behcet's disease process. Although vascular lesions are not listed among the criteria for diagnosis of Behcet's disease, up to 25~35% of patients develop vascular complications and probably even a greater proportion of patient may have small vessel vasculitis as the pathological basis for the systemic manifestation. Therefore, early diagnosis and aggressive management can result in the long-term salvaging of both limbs and may allow early intervention of arterial complications and prevent the usual fatal outcome. METHOD: We report 59 cases of Behcet's disease, involving the abdominal aorta and its main branches with variable operative procedure. The medical records of these 59 cases were retrospectively reviewed to examine the operation characteristics. RESULT: To manage recurrent aneurysms at previous anastomosis sites, we used PTFE (polytetrafluoroethylene), or autogenous vein and artery (internal iliac artery) as bypass or patch material. The results of the autogenous vessel grafts for arterial reconstructions in Behcet's vasculitis were superior to those of artificial grafts.
CONCLUSION
In one case of multiple recurrent anastomotic aneurysm, we attempted aortic blood flow diversion after closure of the false anastomotic aneurysm. This aortic blood flow diversion should be considered as an adopted surgical treatment of recurrent false AAA in Behcet's vasculitis.

Keyword

Behcet's disease; Pseudoaneurysm; Diversion

MeSH Terms

Aneurysm
Aneurysm, False*
Aorta, Abdominal
Arteries
Cause of Death
Diagnosis
Early Diagnosis
Early Intervention (Education)
Extremities
Fatal Outcome
Humans
Medical Records
Polytetrafluoroethylene
Retrospective Studies
Surgical Procedures, Operative
Transplants
Vasa Vasorum
Vasculitis*
Veins
Polytetrafluoroethylene
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