Multiple concomitant arterial aneurysms in Behçet's disease.

Area of Science:

• Vascular Medicine
• Rheumatology
• Interventional Cardiology

Background:

• Behçet's disease (BD) is a rare systemic vasculitis affecting various vessels, with large vessel involvement in one-third of cases.
• Arterial aneurysms are the most frequent arterial complication in BD, with veins typically more affected than arteries.

Observation:

• A 41-year-old male with a history of popliteal aneurysm and BD presented with multiple arterial aneurysms, including a femoro-popliteal bypass graft aneurysm and aortoiliac aneurysms.
• Initial treatment involved intensified medical therapy with corticosteroids and infliximab, followed by endovascular repair of aortoiliac aneurysms and prosthetic repair of the bypass graft aneurysm.

Findings:

• Post-operative complications included acute limb ischemia due to stent graft occlusion, treated with thrombectomy.
• Vascular Behçet's disease can negatively impact surgical outcomes, necessitating careful pre-operative disease control.

Implications:

• This case underscores the importance of a combined medical and surgical approach for managing vascular complications in BD.
• Controlling BD activity with immunosuppressive therapy prior to surgical or endovascular procedures is crucial for better vascular outcomes, except in emergencies.