Major arterial involvement and review of Behcet's disease

Ufuk Alpagut1, Murat Ugurlucan, Enver Dayioglu

  • 1Department of Cardiovascular Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey. ufukalpagut@yahoo.com

Insights

Vascular involvement in Behcet's disease, particularly arterial complications, presents significant surgical challenges and predicts mortality. Optimal management involves systemic therapy and careful consideration of surgical timing.

Area of Science:

  • Vascular Surgery
  • Rheumatology
  • Internal Medicine

Background:

  • Behcet's disease is a multisystemic disorder characterized by orogenital ulcers, vascular, ocular, and cutaneous lesions.
  • Vascular involvement, both venous and arterial, is a critical aspect of Behcet's disease, with arterial manifestations posing unique surgical challenges.
  • The disease predominantly affects individuals in their third and fourth decades and is prevalent in Mediterranean and East Asian populations.

Purpose of the Study:

  • To review the literature on Behcet's disease with a focus on vascular involvement.
  • To analyze the prognosis of surgical treatment for vascular complications in Behcet's disease.
  • To discuss the challenges and management strategies for arterial complications in Behcet's disease.

Main Methods:

  • Retrospective review of 31 consecutive patients with vasculo-Behcet's disease.
  • Analysis of clinical, pathological, and postoperative data from patients treated at the Medical Faculty of Istanbul.
  • Literature review on Behcet's disease and its vascular manifestations.

Main Results:

  • Vascular pathologies were observed in all 31 patients, with 15 involving the venous system and the remainder the arterial tree.
  • Ten patients underwent surgery for aneurysms/pseudoaneurysms, and six for occlusive lesions.
  • Recurrent pseudoaneurysms were noted in six patients, highlighting the complexity of arterial interventions.

Conclusions:

  • Vascular manifestations are significant predictors of mortality and morbidity in Behcet's disease.
  • Arterial complications in Behcet's disease present difficult surgical problems, with invasive procedures potentially leading to pseudoaneurysms.
  • Surgical intervention should be deferred during the acute phase, and systemic therapies (colchicine, aspirin, corticosteroids) are recommended.

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