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Dramatic vascular course of Behcet's disease
Mohamed A Elsharawy1, Khairi A Hassan, Majed Al-Awami
1Department of Surgery, College of Medicine, King Faisal University, PO Box 40081, Al-Khobar 31952, Kingdom of Saudi Arabia. elsharawya@yahoo.co.uk
Saudi Medical Journal
|February 16, 2005
Summary
Vascular Behcet's disease is rare but serious. This case highlights recurrent vascular events, including thrombosis and pseudoaneurysm, requiring multiple surgical interventions and anticoagulation therapy.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Vascular Surgery
Background:
- Behcet's disease is a rare multisystem inflammatory disorder.
- Vascular complications, though infrequent, are a significant cause of morbidity and mortality in Behcet's disease.
- Arterial and venous involvement necessitates tailored management strategies.
Observation:
- A patient with Behcet's disease presented with deep venous thrombosis and a right iliac pseudoaneurysm.
- The initial treatment involved a polytetrafluoroethylene (PTFE) graft repair, anticoagulation (warfarin, aspirin, clopidogrel), immunosuppressants, and corticosteroids.
- Recurrent vascular events occurred, including superior vena cava thrombosis and PTFE graft occlusion within months.
Findings:
- The initial PTFE graft for the iliac pseudoaneurysm thrombosed.
- Superior vena cava thrombosis developed despite anticoagulation and immunosuppressive therapy.
- Progressive ischemia of the right foot necessitated a complex femoro-femoral crossover PTFE graft.
Implications:
- This case underscores the aggressive and recurrent nature of vascular complications in Behcet's disease.
- Management requires a multidisciplinary approach and vigilant monitoring for treatment failure.
- Recurrent graft thrombosis highlights challenges in surgical repair and the need for optimized medical therapy.