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Updated: Aug 9, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Reoperation results of arterial involvement in Behçet's disease
M Ozeren1, I Mavioglu, O V Dogan
1Department of Cardiovascular Surgery, SSK Ankara Training Hospital, Turkey.
Insights
Vascular interventions for arterial involvement in Behçet's disease yielded unsatisfactory results due to complications like graft thrombosis and new aneurysms. Aggressive medical management and minimized arterial punctures are recommended.
Area of Science:
- Vascular Surgery
- Rheumatology
- Internal Medicine
Background:
- Behçet's disease frequently involves vascular complications.
- Arterial involvement in Behçet's disease requires careful management.
- Limited data exists on surgical approaches for arterial manifestations.
Purpose of the Study:
- To evaluate the role and outcomes of vascular interventions in Behçet's disease patients with arterial involvement.
- To analyze the complications and long-term results of surgical treatment for arterial lesions.
Main Methods:
- Retrospective analysis of 178 Behçet's disease patients from 1989-1997.
- Identified 67 patients with vascular involvement (12 arterial).
- Detailed review of 12 primary arterial operations and 12 reoperations.
Main Results:
- Reoperations were necessary for anastomotic aneurysms, graft occlusion, infection, bleeding, and aortoenteric fistula.
- Mean time to first reoperation was 6.4 months.
- Three patients died during a mean follow-up of 36 months.
Conclusions:
- Surgical interventions showed unsatisfactory outcomes due to graft thrombosis and anastomotic aneurysms.
- Combined aggressive medical treatment is crucial for major vessel involvement.
- Minimize arterial punctures to reduce aneurysm formation risk; surgery reserved for specific indications.
Objectives:
to retrospectively evaluate the role of vascular interventions in Behçet's disease with arterial involvement. So far, little information is available on the surgical approach for arterial involvement in Behçet's disease.
Material And Methods:
between February 1989 and August 1997, among 178 patients with Behçet's disease referred to our clinic, vascular involvement was established in total of 67 patients (38%) which consisted of 59 venous (33%) and 12 (7%) arterial involvements requiring urgent surgical intervention. Primary arterial lesions were occlusive in one patient, aneurysm formation in nine or both in four.
Results:
twelve primary operations and 12 reoperations were performed. The reasons for reoperations were anastomotic aneurysms, graft occlusion, occlusion of native vessel, graft infection, bleeding from anastomosis and aortoenteric fistula. First reoperation was performed after a mean period of 6.4 months (1-15 months). Postoperative follow-up was 12-60 months (mean 36 months) and three patients died during follow-up.
Conclusions:
the surgical results were not satisfactory because of progressive graft thrombosis and formation of new aneurysms at the anastomosis. Aggressive medical treatment should be combined when major vessel involvement occurs. All types of arterial punctures for angiography or blood gases should be minimised because of the risk of new aneurysm formation. Surgical intervention is indicated only in patients with a growing aneurysm, acute rupture or severe ischaemia.
