title: Endovascular therapy combined with immunosuppressive treatment for pseudoaneurysms in patients with Behçet's disease.
abstract: OBJECTIVE
  To evaluate the feasibility, efficacy, and outcome of endovascular therapy combined with immunosuppression for the treatment of arterial pseudoaneurysms due to Behçet's disease.
  
  
  METHODS
  Eleven pseudoaneurysms (3 in the abdominal aorta, 3 in the subclavian artery, and individual lesions in the brachiocephalic artery, renal artery, common iliac artery, common carotid artery, and the descending thoracic aorta) in 9 patients with Behçet's disease were treated with 10 stent-grafts and 1 self-expanding stent. All patients with elevated erythrocyte sedimentation rate (ESR) were treated with immunosuppressive agents (azathioprine, prednisolone) before and after the procedure.
  
  
  RESULTS
  Endovascular treatment was successful in all cases, without major adverse events. The ESR was reduced from 42.7+/-18.0 mm/h initially to 18.6+/-12.6 mm/h after immunosuppressive therapy prior to endovascular repair. During follow-up (mean 24.1+/-14.0 months, range 6-43), 8 of 11 lesions showed complete resolution. One stent-graft to treat a postsurgical recurrent carotid artery pseudoaneurysm was occluded, and an abdominal aortic pseudoaneurysm recurred; both patients stopped their medications. ESR during follow-up was 7.9+/-4.5 mm/h.
  
  
  CONCLUSIONS
  Endovascular treatment for pseudoaneurysms due to Behçet's disease is feasible and effective when disease activity is strictly controlled with immunosuppressive therapy.
authors.affiliation: Division of Cardiology, Yonsei Cardiovascular Center and Cardiovascular Research Institute, Seoul, Korea.
authors.forename: Bon
authors.initials: B
authors.lastname: Kwon Koo
authors.forename: Won-Heum
authors.initials: WH
authors.lastname: Shim
authors.forename: Young-Sup
authors.initials: YS
authors.lastname: Yoon
authors.forename: Byoung
authors.initials: B
authors.lastname: Kwon Lee
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Do-Yun
authors.initials: DY
authors.lastname: Lee
authors.forename: Byung-Chul
authors.initials: BC
authors.lastname: Chang
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D001528:Behcet Syndrome / Q000150:complications*; D019917:Blood Vessel Prosthesis Implantation; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents