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Jalili J, Ebrahiminik H, Zafarani F, Akhavi Milani A. Endovascular Treatment of the Ruptured Pseudoaneurysm of Common Femoral Artery in Behcet's Disease: Report of a Case with Four Years of Follow-Up. Vasc Endovascular Surg 2022; 56:616-621. [PMID: 35475659 DOI: 10.1177/15385744221095652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Behcet's disease (BD) is a vasculitic condition that affects arteries and veins of all sizes. Arterial pseudoaneurysm is a rare but life-threatening complication of BD. We reported a 41-year-old man with 20 years history of BD and 5 years history of bilateral blindness. The patient presented with sudden onset of pain and swelling in his left groin and was diagnosed with the ruptured pseudoaneurysm of the left common femoral artery (CFA), which extended into the origins of superficial and deep femoral arteries. The patient was in the active phase of BD; therefore, he was initially treated with corticosteroids and cyclophosphamide pulse therapies and subsequently underwent stent graft placement. Post stenting angiography and postprocedural ultrasonography confirmed the successful exclusion of pseudoaneurysm without any evident complication. Four years of follow-up was uneventful.
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Affiliation(s)
- Javad Jalili
- Division of Interventional Radiology, Department of Radiology, Emam Reza Hospital, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hojat Ebrahiminik
- Assistant Professor of Interventional Radiology, Tirad Imaging Institute, Tehran, Iran
| | - Fatemeh Zafarani
- Student Research Committee, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Akhavi Milani
- Division of Interventional Radiology, Department of Radiology, Emam Reza Hospital, 48432Tabriz University of Medical Sciences, Tabriz, Iran
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2
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Bounssir A, Bakkali T, Mouhani S, Elkhaloufi S, Sefiani Y, El Mesnaoui A, Lekehal B. [Unusual complication of Behcet's disease]. Ann Cardiol Angeiol (Paris) 2021; 70:119-121. [PMID: 33032787 DOI: 10.1016/j.ancard.2020.07.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 07/21/2020] [Indexed: 06/11/2023]
Abstract
Arterial involvement in Behcet's disease is rare and the tibioperoneal trunk localisation is exceptional. We report the case of a young men with Behcet's disease and in whom the evolution to angiobehcet was unusual. The medical treatment and the therapeutic abstention were decided according to a bundle of argument.
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Affiliation(s)
- A Bounssir
- Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina de Rabat, 10104 Souissi Rabat, Maroc; Université Mohammed V de Rabat, avenue des Nations Unies, Agdal Rabat, Maroc.
| | - T Bakkali
- Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina de Rabat, 10104 Souissi Rabat, Maroc; Université Mohammed V de Rabat, avenue des Nations Unies, Agdal Rabat, Maroc
| | - S Mouhani
- Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina de Rabat, 10104 Souissi Rabat, Maroc; Université Mohammed V de Rabat, avenue des Nations Unies, Agdal Rabat, Maroc
| | - S Elkhaloufi
- Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina de Rabat, 10104 Souissi Rabat, Maroc; Université Mohammed V de Rabat, avenue des Nations Unies, Agdal Rabat, Maroc
| | - Y Sefiani
- Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina de Rabat, 10104 Souissi Rabat, Maroc; Université Mohammed V de Rabat, avenue des Nations Unies, Agdal Rabat, Maroc
| | - A El Mesnaoui
- Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina de Rabat, 10104 Souissi Rabat, Maroc; Université Mohammed V de Rabat, avenue des Nations Unies, Agdal Rabat, Maroc
| | - B Lekehal
- Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina de Rabat, 10104 Souissi Rabat, Maroc; Université Mohammed V de Rabat, avenue des Nations Unies, Agdal Rabat, Maroc
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Eleshra A, Abdelgawwad M, Regal S, Soliman M, Khafagy T. Short-term outcome of primary stent graft for peripheral artery aneurysm in patients with Behçet disease. J Vasc Surg 2020; 73:279-284. [PMID: 32325230 DOI: 10.1016/j.jvs.2020.03.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 03/05/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Endovascular treatment of peripheral artery aneurysms (PAAs) in patients with Behçet disease is controversial. We report a single-institution experience of primary stent graft repair of PAAs in Behçet patients. METHODS Behçet patients who had endovascular stent graft repair of PAAs at a single center between January 2012 and December 2018 were identified. Demographics, past medical history, cardiovascular risk profile, and perioperative details were analyzed. RESULTS Twenty-two patients (mean age, 38 ± 7 years; 100% male) were included. The distribution of PAAs was external iliac artery in 2 (9%) patients, common femoral artery in 4 (18%) patients, superficial femoral artery in 15 (68%) patients, and above-knee popliteal artery in 1 (5%) patient. Pseudoaneurysm was diagnosed in five (23%) patients. We used antegrade access in the majority of patients (16 [73%]). Technical success was achieved in 21 (95%) patients. The mean hospital stay was 3 ± 2 days. There were no deaths or serious complications, and five (23%) patients experienced access site complications. The mean follow-up was 23 ± 11 months. The early primary and assisted primary patency rate was 91%. However, follow-up computed tomography angiography detected stent graft occlusion in six patients (27%). CONCLUSIONS Stent graft for PAA in patients with Behçet disease had a high early patency rate and minimal morbidity. However, the complication and reintervention rates were high during follow-up, with low surgical conversion.
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Affiliation(s)
- Ahmed Eleshra
- Department of Vascular and Endovascular Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohammed Abdelgawwad
- Department of Vascular and Endovascular Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Samer Regal
- Department of Vascular and Endovascular Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mosaad Soliman
- Department of Vascular and Endovascular Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Tamer Khafagy
- Department of Vascular and Endovascular Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
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Jiang F, Xiang H, Peng ZY. Incomplete intestinal obstruction as the possible main complaint in Behcet's disease after surgery for recurrent abdominal aortic pseudoaneurysms: a case report and literature review. BMC Cardiovasc Disord 2018; 18:238. [PMID: 30558546 PMCID: PMC6296136 DOI: 10.1186/s12872-018-0977-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 12/06/2018] [Indexed: 11/17/2022] Open
Abstract
Background Behcet’s disease (BD) is a systemic vasculitis characterized by oral and genital aphthosis, and ocular and skin lesions. The disease is involved in vascular, gastrointestinal, and central nervous systems. Vasculitis may exacerbate fatal problems, such as anastomotic pseudoaneurysms. If the mesenteric vessels are involved, severe abdominal symptoms such as intestinal obstruction may occur. Case presentation This case report describes a young female patient who suffered from BD with recurrent abdominal aortic pseudoaneurysms, as well as deep venous thrombosis and subsequent complications of incomplete intestinal obstruction. This patient first underwent stent grafting, which was followed by rupture of two newly formed anastomotic pseudoaneurysms within six months. Emergency open surgical repair (OSR) was then performed on the ruptured pseudoaneurysms. Thrombosis and incomplete ileus occurred five months after surgery. This case was unique due to the presence of incomplete intestinal obstruction being the possible main complaint for a patient with Behcet’s disease, and it is the first ever case to be reported. Conclusion Intestinal obstruction may present as the possible main complaint in BD. Careful and attentive strategy should be carried out to prevent fatal outcomes.
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Affiliation(s)
- Fang Jiang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 169 Dong'hu Road, Wuhan, 430071, Hubei, People's Republic of China
| | - Hui Xiang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 169 Dong'hu Road, Wuhan, 430071, Hubei, People's Republic of China
| | - Zhi-Yong Peng
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 169 Dong'hu Road, Wuhan, 430071, Hubei, People's Republic of China.
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Successful Endovascular Treatment of a Ruptured Popliteal Artery Aneurysm in a Patient with Behcet Disease. Ann Vasc Surg 2018; 53:274.e1-274.e5. [DOI: 10.1016/j.avsg.2018.05.076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 05/25/2018] [Accepted: 05/26/2018] [Indexed: 11/21/2022]
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Hamouda M, Dakour Aridi H, Lee RE, Dhaliwal JS, Malas MB. Management of tibioperoneal trunk aneurysm in a patient with Behçet disease. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2017; 4:15-18. [PMID: 29725662 PMCID: PMC5928002 DOI: 10.1016/j.jvscit.2017.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 10/28/2017] [Indexed: 11/30/2022]
Abstract
Only a few cases of infrapopliteal aneurysms are reported in the literature. These are commonly associated with trauma, infection, and iatrogenic injuries and mostly present as pseudoaneurysms. We report the case of a 44-year-old man with Behçet disease and an 8-cm tibioperoneal trunk aneurysm and discuss the management options of these aneurysms.
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Affiliation(s)
- Mohammed Hamouda
- Johns Hopkins Bayview Vascular and Endovascular Research Laboratory, Department of Surgery, Baltimore, Md
| | - Hanaa Dakour Aridi
- Johns Hopkins Bayview Vascular and Endovascular Research Laboratory, Department of Surgery, Baltimore, Md
| | - Rachel Elizabeth Lee
- Johns Hopkins Bayview Vascular and Endovascular Research Laboratory, Department of Surgery, Baltimore, Md
| | - Jasninder Singh Dhaliwal
- Johns Hopkins Bayview Vascular and Endovascular Research Laboratory, Department of Surgery, Baltimore, Md
| | - Mahmoud B Malas
- Johns Hopkins Bayview Vascular and Endovascular Research Laboratory, Department of Surgery, Baltimore, Md
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7
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Hasanaghaei T, Ghoddusi Johari H, Shenavandeh S. Huge femoral artery pseudoaneurysm in a patient with Behçet’s disease. THE EGYPTIAN RHEUMATOLOGIST 2017. [DOI: 10.1016/j.ejr.2017.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Ventarola DJ, Labropoulos NN, Landau DS, Tassiopoulos AK, Loh SA. Tibioperoneal Trunk Aneurysm Resulting in Compartment Syndrome with Associated Aneurysms of the Popliteal and Dorsalis Pedis Arteries. Ann Vasc Surg 2016; 35:207.e11-6. [PMID: 27238986 DOI: 10.1016/j.avsg.2016.01.049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 01/08/2016] [Accepted: 01/31/2016] [Indexed: 11/26/2022]
Abstract
True aneurysms of the tibioperoneal trunk are rare. Given the scarcity of reports, the clinical presentation and treatment is not well defined. This is a case report of a 50-year-old male patient presenting with severe lower extremity swelling and compartment syndrome with neurological compromise secondary to a tibioperoneal trunk aneurysm. He was also noted to have discrete ipsilateral popliteal and dorsalis pedis artery aneurysms. Given the location and size of the aneurysm, the severe leg swelling, and venous hypertension, aneurysmorrhaphy or aneurysm sac excision with arterial reconstruction was prohibitively dangerous. Thus, following fasciotomies, a hybrid repair utilizing a saphenous vein superficial femoral to anterior tibial artery bypass along with coil embolization of the aneurysm sac was performed. The patient recovered full function of his leg and follow-up computed tomography angiogram demonstrated thrombosis and regression of the aneurysm sac with a patent bypass.
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Affiliation(s)
- Daniel J Ventarola
- Department of Surgery, Division of Vascular and Endovascular Surgery, Stony Brook University Medical Center, Stony Brook, NY
| | - Nicos N Labropoulos
- Department of Surgery, Division of Vascular and Endovascular Surgery, Stony Brook University Medical Center, Stony Brook, NY
| | - David S Landau
- Department of Surgery, Division of Vascular and Endovascular Surgery, Stony Brook University Medical Center, Stony Brook, NY
| | - Apostolos K Tassiopoulos
- Department of Surgery, Division of Vascular and Endovascular Surgery, Stony Brook University Medical Center, Stony Brook, NY
| | - Shang A Loh
- Department of Surgery, Division of Vascular and Endovascular Surgery, Stony Brook University Medical Center, Stony Brook, NY.
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[Coil embolization therapy in post-traumatic pseudoaneurysms and arteriovenous fistula of knee and leg arteries]. ACTA ACUST UNITED AC 2016; 41:74-9. [PMID: 26803565 DOI: 10.1016/j.jmv.2015.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 11/28/2015] [Indexed: 11/24/2022]
Abstract
Pseudoaneurysms remain a rare complication of knee and leg trauma. They may go unnoticed and manifest late after the initial trauma; they are often associated with arteriovenous fistula. No standard treatment is recognized. We report a case of post-traumatic pseudoaneurysm of the inferior articular artery of the knee, treated by coil embolization and a case of post-traumatic pseudoaneurysm of the anterior tibial artery associated with an arteriovenous fistula, treated with coil embolization and decompression surgery. Follow-up in both patients was satisfactory.
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Faridhosseini R, Jabbari F, Shirkani A, Zandkarimi MR, Yousefzaedh H, Sahebari M, Basiri R. Multiple Right and Left Pulmonary Arteries and Subdivisions of Inferior Mesenteric Artery Aneurysms in Behcet's Disease Case: A Rare Clinical Presentation. Oman Med J 2014; 29:e072. [PMID: 30992738 DOI: 10.5001/omj.2014.63] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Behcet's disease is a multi-systemic inflammatory disorder with cutaneous acneiform eruptions, orogenital aphthae, uveitis, arthritis and systemic vascular inflammation. One of the rare vascular manifestations is thoraco-abdominal aortic and pulmonary aneurysm that is associated with high risk of morbidity and mortality. We report a 36-year-old man with chronic cough, hemoptysis, significant weight loss, and orogenital ulcers from one year before referral. Initial assessments revealed multiple parahillar nodules in chest X-ray, chronic inflammatory anemia, erythrocyte sedimentation rate more than 100, and positive Human Leukocyte Antigen B5 and B51. Evaluation for infection and malignancies was unremarkable. Open exploratory lung study showed multiple pulsatile nodules in both lungs. AMIGO computed tomogram confirmed multiple right and left pulmonary artery aneurysms and impending to rupture aneurysm at subdivision of inferior mesenteric artery. After beginning of three methylprednisolone and cyclophosphamide pulse doses, the clinical aspect of the patient dramatically improved. Although pulmonary aneurysm is a rare manifestation of Behcet's disease and it is more infrequent in the distal branches, it can be seen in patients presenting with inflammatory disease and respiratory manifestations and with Behcet's disease diagnosis. Corticosteroid pulse-therapy could be considered as the first line of medical treatment in these patients.
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Affiliation(s)
- Reza Faridhosseini
- Allergy Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farah Jabbari
- Allergy Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Afshin Shirkani
- Allergy and Clinical Immunology Department, School of Medicine, Bushehr University of Medical Science, Bushehr, Iran
| | - Mohammad Reza Zandkarimi
- Allergist and Clinical Immunology Department, School of Medicine, Bushehr University of Medical Sciences, Mashhad, Iran
| | - Hadis Yousefzaedh
- PhD Student of Immunology, Immunology Research Center, Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Sahebari
- Rheumatologic Diseases Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Basiri
- Pulmonology Department, Qhaem Medical Center, Mashhad University of Medical Sciences, Mashhaad, Iran
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Owlia MB, Mehrpoor G. Behcet's Disease: New Concepts in Cardiovascular Involvements and Future Direction for Treatment. ISRN PHARMACOLOGY 2012; 2012:760484. [PMID: 22530146 PMCID: PMC3317002 DOI: 10.5402/2012/760484] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 12/15/2011] [Indexed: 01/02/2023]
Abstract
Behcet's disease (BD) is the only systemic vasculitis involving both arteries and vein in any sizes. It frequently encounters in rheumatology clinics. It has some major morbidities and even fatal outcomes in some cases. The aim of this paper is to analyze the main concepts on pathophysiology and treatment options in BD, focusing on cardiovascular aspects, thrombosis, and potential future treatment.
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Affiliation(s)
- M. B. Owlia
- Division of Rheumatology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - G. Mehrpoor
- Division of Rheumatology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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