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[Arterial aneurysms and Behçet's disease: apropos of 3 cases]
T Sraieb1, N Ben Romdhane, S Longo
1Service de chirurgie vasculaire et de transplantation d'organes, hôpital militaire principal de Tunis, Mont Fleury Tunis, Tunisie.
Insights
Surgical intervention is recommended for arterial aneurysms in Behcet's disease, as medical treatments show limited efficacy. Long-term monitoring is essential due to potential complications and recurrence risks.
Area of Science:
- Vascular Surgery
- Rheumatology
- Internal Medicine
Background:
- Behcet's disease is a rare multisystem inflammatory disorder.
- Arterial aneurysms are a serious, though uncommon, complication of Behcet's disease.
- Optimal management strategies for arterial aneurysms in Behcet's disease require further definition.
Observation:
- This study reports on five cases of arterial aneurysms in three patients with Behcet's disease.
- Aortic aneurysms were the most common presentation.
- Diagnosis can be challenging due to atypical symptoms.
Findings:
- Surgical revascularization using prosthetic grafts was performed in all patients.
- Postoperative immunosuppressive therapy was administered to two patients.
- One patient experienced aneurysm recurrence, and another developed a new aneurysm during follow-up.
Implications:
- Arterial aneurysms in Behcet's disease appear to have a poor response to current medical regimens.
- Prosthetic grafts are preferred over venous autografts due to the risk of venous involvement.
- Careful, prolonged patient monitoring is crucial to manage potential complications and recurrences.
Purpose:
Results that were obtained from three patients and a literature review allow the authors to better define the place of medical and surgical treatments according to the different locations of arterial aneurysm occurring in the course of Behcet's disease.
Methods:
Retrospective report of five cases of arterial aneurysm that occurred during Behcet's disease in three patients.
Results:
Due to the unusual symptoms, diagnosis can be hampered. Though lesions may be observed in various areas, they were mostly aortic (two patients). Surgical revascularization was done in all three patients. It mainly involved prosthetic grafts. Two patients were subsequently treated by postoperative immunosuppressive drugs. The mean follow-up was 22 months. Relapsing aneurysm was observed in one patient, while in another patient aneurysm developed in a new location.
Conclusion:
These types of arterial lesions respond poorly to medical treatment when a combination of colchicine and intermittent intravenous bolus of cyclophosphamide is used. Surgical indications should be given great yet selected weight, using prosthetic rather than venous autologous grafts (due to the risk of spontaneous venous involvement). Since either complication or recurrence is possible, prolonged monitoring is required.