Outcomes of endovascular treatment for aortic pseudoaneurysm in Behcet's disease.
OBJECTIVE
To evaluate the effectiveness of endovascular stent grafting for surgical management of aortic pseudoaneurysm in patients with Behcet's disease (BD).


METHODS
We present a single-institution retrospective cohort of patients with aortic pseudoaneurysm and BD treated with aortic stent grafting. Computed tomography imaging was obtained preoperatively in all patients and once within 2 weeks postoperatively, and then annually. Clinical follow-up and erythrocyte sedimentation rate were used to follow BD activity. Immunosuppressant therapy was instituted prior to endovascular treatment unless a contraindication existed.


RESULTS
From 1998 to 2012, 10 patients (eight male, two female; median age, 39) with BD and aortic pseudoaneurysm were treated with endovascular stent grafting at this institution. Ninety percent of these patients received immunosuppressive therapy before and after surgical treatment. The median follow-up period was 57 months (interquartile range, 43-72). The locations of the 12 pseudoaneurysms treated in this cohort were infrarenal abdominal aorta (seven), descending thoracic aorta (four), and aortic arch (one). Median pseudoaneurysm size was 4.5 cm (interquartile range, 3.4-5.9). At long-term follow-up, complete resolution of the aortic pseudoaneurysm was noted in all patients. No endoleaks occurred. Newly developed pseudoaneurysm at the distal margin of the stent graft was noted in one patient 17 months after the stent graft procedure. One patient required a subsequent stent graft placement for an expanding pseudoaneurysm of the subclavian artery. No patient deaths occurred during the follow-up period.


CONCLUSIONS
Endovascular treatment of aortic pseudoaneurysm with stent-grafting in patients with BD is safe and effective with long-term durability.
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Sung Won
SW
Kim
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: dyl@yuhs.ac.
Do Yun
DY
Lee
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: mdkim@yuhs.ac.
Man Deuk
MD
Kim
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Jong Yun
JY
Won
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Sung Il
SI
Park
Department of Cardiothoracic Surgery, Cardiovascular Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Young Nam
YN
Yoon
Division of Cardiology, Departments of Internal Medicine, Cardiovascular Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Donghoon
D
Choi
Division of Cardiology, Departments of Internal Medicine, Cardiovascular Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Young-Guk
YG
Ko
D000328:Adult; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001528:Behcet Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D001799:Blood Sedimentation; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D056910:Republic of Korea; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D007166:Immunosuppressive Agents