title: Outcomes of surgery for patients with Behcet's disease causing aortic pseudoaneurysm: a shift from open surgery to endovascular repair.
abstract: OBJECTIVE
  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.
authors.affiliation: Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, National Center for Cardiovascular Diseases, Center of Vascular Surgery, Beijing, China.
authors.forename: Chenyang
authors.initials: C
authors.lastname: Shen
authors.affiliation: Peking University People's Hospital, Department of Vascular Surgery, Beijing, China.
authors.forename: Weihao
authors.initials: W
authors.lastname: Li
authors.affiliation: Peking University People's Hospital, Department of Vascular Surgery, Beijing, China.
authors.forename: Yongbao
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Peking University People's Hospital, Department of Vascular Surgery, Beijing, China.
authors.forename: Qingle
authors.initials: Q
authors.lastname: Li
authors.affiliation: Peking University People's Hospital, Department of Vascular Surgery, Beijing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Jiao
authors.affiliation: Peking University People's Hospital, Department of Vascular Surgery, Beijing, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Peking University People's Hospital, Department of Vascular Surgery, Beijing, China.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000188:drug therapy / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000188:drug therapy / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D001528:Behcet Syndrome / Q000150:complications / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents