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Peripheral aneurysms in Behçet's disease
H Tüzün1, A Sayin, Y Karaözbek
1Cerrahpaşa Medical Faculty, Department of Thoracic and Cardiovascular Surgery, University of Istanbul, Turkey.
Insights
Behçet's disease patients with aneurysms face high risks. Arterial ligation, not reconstructive surgery, is recommended to prevent complications, alongside immunotherapy for relapse control.
Area of Science:
- Vascular Surgery
- Rheumatology
- Immunology
Background:
- Behçet's disease is associated with a high incidence of arterial aneurysms.
- Aneurysm formation in Behçet's disease leads to significant morbidity and mortality.
- Reconstructive surgery for these aneurysms often results in poor outcomes, including graft occlusion and anastomotic aneurysms.
Purpose of the Study:
- To evaluate the outcomes of arterial ligation versus reconstructive surgery in patients with Behçet's disease and aneurysms.
- To identify safer surgical strategies for managing arterial aneurysms in Behçet's disease.
- To emphasize the role of adjuvant immunotherapy in preventing aneurysm recurrence.
Main Methods:
- Retrospective review of 14 patients with Behçet's disease and 16 aneurysms.
- Analysis of surgical interventions, including arterial ligation and reconstructive procedures.
- Assessment of limb salvage rates and long-term complications.
Main Results:
- Arterial ligation of major vessels (common iliac, superficial femoral, popliteal) was successfully performed without limb loss in this cohort.
- Reconstructive surgery yielded discouraging results, with frequent anastomotic aneurysms and graft occlusions.
- Adjuvant immunotherapy was crucial for managing disease relapses and preventing new aneurysm formation.
Conclusions:
- Arterial ligation is a viable and safer alternative to reconstructive surgery for managing arterial aneurysms in Behçet's disease.
- Surgical management should prioritize ligation to avoid complications associated with reconstructive techniques.
- Long-term control of Behçet's disease through immunotherapy is essential to prevent recurrent aneurysm formation.
Abstract:
In this report, 14 patients with Behçet's disease with a total of 16 aneurysms are presented. The most common site of aneurysm formation was the femoral artery. Patients with Behçet's disease and aneurysm formation carry the highest morbidity and mortality rates among all those with the disease. The results of reconstructive surgery in the treatment of aneurysms are discouraging, with many anastomotic aneurysms and grafts occluding. In this study, it was possible to ligate major arteries such as the common iliac, superficial femoral and popliteal without limb loss. It is suggested that ligature either at initial surgery or reoperation should be performed to avoid complications of reconstructive surgery. Adjuvant immunotherapy is required to control relapses responsible for new aneurysm formation.