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Aortic and arterial aneurysms in behçet disease: management with stent-grafts--initial experience
1Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea. parkjh@radcom.snu.ac.kr
Insights
Stent-graft placement is a safe and effective treatment for aortic and arterial aneurysms in Behçet disease patients. This minimally invasive approach offers a viable alternative to traditional surgery, with successful outcomes observed in initial studies.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Rheumatology
Background:
- Behçet disease is a rare inflammatory condition that can lead to arterial and aortic aneurysms.
- Traditional surgical repair of these aneurysms can be challenging due to the systemic nature of the disease.
Purpose of the Study:
- To evaluate the efficacy and safety of stent-graft application for managing aortic and arterial aneurysms in patients diagnosed with Behçet disease.
Main Methods:
- A retrospective analysis of nine aneurysms across seven patients with Behçet disease who underwent stent-graft repair.
- Utilized various stent-graft types, including Gianturco stents and balloon-expandable stents, for thoracic, suprarenal, infrarenal aortic, and peripheral arterial aneurysms.
Main Results:
- Successful stent-graft placement was achieved in all patients, with complete aneurysm exclusion confirmed by immediate angiography.
- Follow-up imaging demonstrated aneurysm thrombosis and stent-graft patency in most cases; one patient experienced stent occlusion due to complex lesions.
- Over a mean follow-up of 28 months, four patients showed aneurysm resolution, and recurrent aneurysms were successfully managed with additional stent-grafts.
Conclusions:
- Stent-graft insertion presents a promising, minimally invasive alternative to surgical intervention for aortic and arterial aneurysms in Behçet disease.
- This approach appears safe and effective, offering good long-term results and managing recurrent disease effectively.
Purpose:
To assess the application of stent-grafts in the management of aortic and arterial aneurysms in patients with Behçet disease.
Materials And Methods:
Nine aneurysms in seven patients were managed with various types of stent-grafts. Diagnoses were based on clinical findings. The aortic aneurysms (n = 3) were thoracic (n = 1), suprarenal (n = 1), or infrarenal (n = 1). The arterial aneurysms (n = 6) were in the right and left subclavian (n = 2), right common carotid (n = 2), right brachiocephalic (n = 1), or left common iliac arteries (n = 1). A tandem connection of Gianturco stent covered with polytetrafluorethylene was placed in three aneurysms, and a balloon-expandable stent was placed in six.
Results:
The stent-graft was successfully placed in all patients. Immediate follow-up angiography revealed complete exclusion of the aneurysm in all cases. Follow-up computed tomography performed 3 days to 2 weeks later revealed complete exclusion and thrombosis of the aneurysm and patency of the stent-graft in six patients. In one patient, total occlusion of the artery with a stent occurred due to flow disturbance caused by double lesions. During follow-up (range, 6-59 months; mean, 28 months), the aneurysm resolved and completely regressed in four patients. A recurrent aneurysm at the distal margin of previously inserted stent-graft was successfully managed with an additional stent-graft.
Conclusion:
The findings in this initial experience suggest that stent-graft insertion may be a safe and effective alternative to surgical treatment of aortic and arterial aneurysms in patients with Behçet disease.