Stent-Assisted Coil Embolization of Multiple Intracranial Aneurysms Associated With Behçet Disease

Behçet disease (BD)-related aneurysms commonly occur in visceral vessels (eg, abdominal aorta, femoral artery, and pulmonary artery), whereas intracranial aneurysms are relatively rare. Although endovascular intervention is relatively mature in the treatment of congenital intracranial aneurysms, further research and clinical experience are needed in the treatment of intracranial aneurysms combined with BD, which is extremely challenging to treat with endovascular intervention because of the thin, fragile walls of the aneurysms under the inflammatory pathologic changes that result in a high tendency to rupture. This article reports the case of a 38-year-old female patient with BD who presented with headaches with episodic blindness for 1 month. Digital subtraction angiography (DSA) confirmed the presence of 5 intracranial aneurysms. After controlling systemic inflammation with glucocorticoids combined with immunosuppressants, an interventional stent-assisted coil embolization was performed for the responsible aneurysm (aneurysm of the left middle cerebral artery (MCA) M2 segment, 8.4×6.0 mm), and conservative observation was chosen for the remaining 4 small aneurysms. Postoperatively, the patient's symptoms were completely relieved without complications, and the results were satisfactory at the 2-month follow-up. This case demonstrates that adequate preoperative immunosuppression combined with targeted endovascular intervention is a safe and effective strategy for the treatment of BD combined with multiple intracranial aneurysms.