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Prognosis of arterial aneurysm after surgery in patients with Behçet's disease
Insights
Surgical graft interposition offers a favorable prognosis for aortic or iliac aneurysms in Behçet
Area of Science:
- Vascular Surgery
- Rheumatology
- Behçet's Disease
Background:
- Arterial aneurysms are a serious complication of Behçet's disease (BD).
- Treatment of these aneurysms, particularly in BD, remains challenging despite advances in therapy.
Purpose of the Study:
- To evaluate the long-term outcomes and prognosis following surgical intervention for arterial aneurysms in patients with Behçet's disease.
Main Methods:
- A retrospective analysis of 9 patients (8 men, 1 woman) with BD who underwent surgery for arterial aneurysms between 1989 and 2008.
- Outcomes assessed included operative complications, survival rates, and long-term follow-up (mean 135 months).
Main Results:
- No operative mortality was observed.
- Aortic/iliac aneurysms treated with Dacron grafts had uneventful postoperative courses and no complications during follow-up.
- Lower-extremity aneurysms showed a higher rate of perioperative and postoperative complications, including graft degeneration. One patient died from a ruptured aortic aneurysm after treatment for a popliteal aneurysm.
Conclusions:
- Graft interposition surgery can yield favorable results for aortic and iliac aneurysms in BD patients.
- Surgical treatment for BD-related lower-extremity aneurysms is associated with significant short- and long-term complications.
- Immunosuppressive therapy may potentially enhance treatment outcomes for arterial aneurysms in Behçet's disease.
Aim:
Despite improvements in therapeutic modalities, the treatment of arterial aneurysms complicating Behçet's disease (BD) is still challenging. This study examined the long-term prognosis after surgery for arterial aneurysms in BD.
Methods:
This study included 9 patients with BD (8 men and 1 woman) who underwent surgery for arterial aneurysms between 1989 and 2008. The outcomes after the surgical intervention were assessed, including procedure-related complications and survival.
Results:
The initial surgical procedures were performed for aortic or iliac aneurysms in 5 patients and for lower-extremity aneurysms in 4 patients. There was no operative mortality. The mean follow-up period was 135±69 months, ranging from 53 to 259 months. Patients with aortic or iliac aneurysms underwent graft interposition with Dacron prostheses. Their postoperative courses were uneventful, and all patients were alive during the follow-up with no procedure-related complications. Those treated for lower-extremity aneurysms tended to show perioperative and postoperative complications, including aneurysmal degeneration of the autogenous vein graft in 2 patients. One patient who initially underwent surgery for a popliteal artery aneurysm died due to the rupture of a dissecting aortic aneurysm after serial surgical interventions for multiple aneurysms. Concomitant aortic or iliac aneurysms in 2 patients were followed up without any change in size under medical treatment using colchicine and corticosteroids.
Conclusion:
Although we cannot draw a firm conclusion because of the small number of cases in the present series, graft interposition can lead to a favorable prognosis in BD patients with aortic or iliac aneurysms, whereas surgical treatment of BD-related lower-extremity aneurysms is frequently associated with short- and long-term postoperative complications. Immunosuppressive therapy might possibly improve treatment outcomes.
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