Abdominal Aortic Aneurysm in Behcet's Disease: Clinical Experience with 12 Patients

Kim, Hyang Kyoung; Kwon, Tae Won; Cho, Yong Pil

Abstract

PURPOSE: An aneurysm identified in a patient with Behcet's disease should be repaired because of the high risk of rupture. However, recurrent aneurysms are commonly seen following the treatment of an aneurysm in Behcet's disease. In addition, the success rate for surgical management has not been high. We report our experiences with abdominal aortic aneurysms (AAA) in patients with Behcet's disease. METHOD: Between September 1998 and June 2006, we performed 21 procedures for an AAA in 12 patients with Behcet's disease. The diagnosis of Behcet's disease was based on the criteria of the International Study Group for Behcet's Disease (1990). Retrospective analysis of the outcomes was carried out. RESULT: There were nine men and three women and the mean age was 34. Six patients had an infrarenal aneurysm, five had a suprarenal aneurysm and one had double lesions both infrarenal and suprarenal. A contained rupture was the most common clinical manifestation (75%). Recurrent aneurysms were noted in six (50%) patients during the median follow-up of 46 months. For the treatment of the original lesions, resection of the AAA and graft interposition was performed in six patients, patch closure in six and a stent-graft insertion in one. Recurrent aneurysms were treated by a stent-graft insertion in four patients, patch closure in two and graft interposition in one. The overall recurrence rate for each procedure was 38.1%. The recurrence rate was 14.3% for the resection and interposition graft, 62.5% for patch closure and 40% for the stent-graft insertion.
CONCLUSION
Resection of an AAA with an interposition graft showed the lowest recurrence rate in this study. Endovascular techniques for the treatment of these patients require further evaluation with prospective randomized trial and long-term follow up.