Endovascular Treatment of Giant Celiac Artery Aneurysm in Behcet's Disease

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Rheumatology

Background:

• Behcet's disease (BD) is a rare multisystem inflammatory disorder.
• Aneurysms, particularly of the celiac artery, are a serious complication of BD.
• Giant aneurysms pose a significant risk of rupture and life-threatening hemorrhage.

Observation:

• A 17-year-old male with known Behcet's disease presented with severe abdominal and back pain, anorexia, and vomiting.
• Computed tomography angiography revealed a large (60 mm) wide-neck celiac artery aneurysm with signs of impending rupture.
• The patient's symptoms indicated acute distress due to the aneurysm.

Findings:

• Endovascular repair was technically successful, involving aortic stent grafting and transcatheter coil embolization of the aneurysm.
• The procedure achieved immediate interruption of aneurysm sac blood flow while preserving distal circulation.
• Follow-up imaging at 1 week, 3, 6, and 12 months confirmed complete aneurysm thrombosis and significant size reduction (to 24 mm).

Implications:

• Endovascular repair is a viable and effective treatment for giant celiac artery aneurysms in patients with Behcet's disease.
• This minimally invasive approach offers a life-saving alternative to open surgery for managing such critical vascular complications.
• Successful treatment led to complete symptom resolution and sustained aneurysm stability, highlighting the potential for excellent long-term outcomes.