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Outcomes of surgery for patients with Behcet's disease causing aortic pseudoaneurysm: a shift from open surgery to endovascular repair
Shen, Chenyang; Li, Weihao; Zhang, Yongbao; Li, Qingle; Jiao, Yang; Zhang, Tao; Zhang, Xiaoming.
  • Shen, Chenyang; Center of Vascular Surgery. Chinese Academy of Medical Sciences and Peking Union Medical College. Fuwai Hospital. National Center for Cardiovascular Diseases. Beijing. CN
  • Li, Weihao; Center of Vascular Surgery. Chinese Academy of Medical Sciences and Peking Union Medical College. Fuwai Hospital. National Center for Cardiovascular Diseases. Beijing. CN
  • Zhang, Yongbao; Center of Vascular Surgery. Chinese Academy of Medical Sciences and Peking Union Medical College. Fuwai Hospital. National Center for Cardiovascular Diseases. Beijing. CN
  • Li, Qingle; Center of Vascular Surgery. Chinese Academy of Medical Sciences and Peking Union Medical College. Fuwai Hospital. National Center for Cardiovascular Diseases. Beijing. CN
  • Jiao, Yang; Center of Vascular Surgery. Chinese Academy of Medical Sciences and Peking Union Medical College. Fuwai Hospital. National Center for Cardiovascular Diseases. Beijing. CN
  • Zhang, Tao; Center of Vascular Surgery. Chinese Academy of Medical Sciences and Peking Union Medical College. Fuwai Hospital. National Center for Cardiovascular Diseases. Beijing. CN
  • Zhang, Xiaoming; Center of Vascular Surgery. Chinese Academy of Medical Sciences and Peking Union Medical College. Fuwai Hospital. National Center for Cardiovascular Diseases. Beijing. CN
Clinics ; 71(6): 302-310, tab, graf
Article in English | LILACS | ID: lil-787419
ABSTRACT

OBJECTIVES:

Behcet’s disease is a form of systematic vasculitis that affects vessels of various sizes. Aortic pseudoaneurysm is one of the most important causes of death among patients with Behcet’s disease due to its high risk of rupture and associated mortality. Our study aimed to investigate the outcomes of Behcet’s disease patients with aortic pseudoaneurysms undergoing open surgery and endovascular aortic repair.

METHODS:

From January 2003 to September 2014, ten consecutive patients undergoing surgery for aortic pseudoaneurysm met the diagnostic criteria for Behcet’s disease. Endovascular repair was the preferred modality and open surgery was performed as an alternative. Systemic immunosuppressive medication was administered after Behcet’s disease was definitively diagnosed.

RESULTS:

Eight patients initially underwent endovascular repair and two patients initially underwent open surgery. The overall success rate was 90% and the only failed case involved the use of the chimney technique to reach a suprarenal location. The median follow-up duration was 23 months. There were 7 recurrences in 5 patients. The median interval between operation and recurrence was 13 months. No significant risk factors for recurrence were identified, but a difference in recurrence between treatment and non-treatment with preoperative immunosuppressive medication preoperatively was notable. Four aneurysm-related deaths occurred within the follow-up period. The overall 1-year, 3-year and 5-year survival rates were 80%, 64% and 48%, respectively.

CONCLUSIONS:

Both open surgery and endovascular repair are safe and effective for treating aortic pseudoaneurysm in Behcet’s disease patients. The results from our retrospective study indicated that immunosuppressive medication was essential to defer the occurrence and development of recurrent aneurysms.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Behcet Syndrome / Aortic Aneurysm, Abdominal / Aneurysm, False / Endovascular Procedures Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Adult / Humans / Male Language: English Journal: Clinics Journal subject: Medicine Year: 2016 Type: Article / Project document Affiliation country: China Institution/Affiliation country: Center of Vascular Surgery/CN

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Full text: Available Index: LILACS (Americas) Main subject: Behcet Syndrome / Aortic Aneurysm, Abdominal / Aneurysm, False / Endovascular Procedures Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Adult / Humans / Male Language: English Journal: Clinics Journal subject: Medicine Year: 2016 Type: Article / Project document Affiliation country: China Institution/Affiliation country: Center of Vascular Surgery/CN