Vascular Manifestations in Behcet's Disease

ABSTRACT

PURPOSE: Behcet's disease, distinguished by the triad of chronic oral aphthae, recurrent genital ulcers and uveitis, is a chronic, relapsing systemic disease. Vascular complications occur in 7~29% of Behcet's patients and are the most common causes of death. Consequently, vascular surgeons should be familiar with the vascular manifestations in Behcet's disease. METHOD: Between October 1994 and July 2002, we retrospectively reviewed 779 patients diagnosed with Behcet's disease in Samsung Medical Center. RESULT: Thirty cases of the 779 patients had vascular manifestations. Male to Female ratio was 25 (83.3%) to 5 (16.7%). In age distribution, males were most frequent in their 30s, while females were equally distributed. Arterial involvement occured in 10 cases (33.3%), venous involvement in 16 (53.3%) and combined arterial and venous involvement in 4 (13.3%). As for arterial manifestations, arterial occlusion occured in 7 cases, aneurysm in 5 and pseudoaneurysm in 4. Venous manifestations were all deep vein thrombosis (DVT). Iliofemoral vein DVT occured in 14 cases, IVC thrombosis in 5, and renal vein thrombosis in 1. Surgical treatment was performed in 5 cases; one primary repair and one arterial ligation were done in 2 cases of pseudoaneurysm, two combined aneurysmal resection and bypass in 2 cases of aneurysm, and one bypass in 1 case of arterial occlusion. Radiologic intervention was done in 5 cases. Stent graft insertion was performed in 2 cases, combined thrombolysis and percutaneous transluminal angioplasty in 1 case, occluder balloon in 1 case, and inf. vena cava filter insertion in 1 case. CONCLUSION: Behcet's disease is a chronic and systemic disease that may involve multiple organs. Because of vascular involvements, in particular the high fatality of arterial complications in Behcet's disease, we must always perform early diagnosis, proper clinical intervention and continuous follow up.