Major vessel involvement in Behçet disease.
OBJECTIVE
Large vessel vasculitis occurs in a subgroup of patients with Behçet disease at high risk for disease-related morbidity and mortality. Recognition of patients at risk, early detection of vasculitis, and the need for aggressive treatment are essential for optimal care of these patients. The authors review the clinical spectrum and management of large vessel problems in Behçet disease, highlighting contributions over the past year.


RESULTS
Vasculo-Behçet patients are at risk for multiple vessel-related complications including thromboses, stenoses, occlusions, and aneurysms. A number of factors may contribute to thrombosis in individual cases, but the primary reason for clot seems to reside in the inflammatory process in the arterial wall, still incompletely understood. An appreciation for the challenges in the perioperative period requires the joint efforts of physicians and surgeons, and fuels the study of alternate, less invasive procedures for Behçet patients.


CONCLUSIONS
Because of earlier recognition, aggressive medical treatment, and novel surgical procedures, the morbidity and mortality of large vessel vasculitis in Behçet disease are beginning to change. In the absence of controlled treatment studies, reports of clinical experience remain an important source of information for clinicians. Identification of patients at risk for vascular complications remains a priority.
Calamia
Kenneth T
KT
Mayo Clinic College of Medicine, Jacksonville, Florida 32225, USA. calamia@mayo.edu
Schirmer
Michael
M
Melikoglu
Melike
M
D000783:Aneurysm / Q000209:etiology / Q000473:pathology; D001528:Behcet Syndrome / Q000150:complications / Q000473:pathology*; D006801:Humans; D013927:Thrombosis / Q000209:etiology / Q000473:pathology