title: The value of endografts in the surgical management of arterial lesions secondary to Behçet disease.
abstract: BACKGROUND
  This study summarizes our experience in the surgical management of arterial lesions secondary to Behçet disease (BD) and assesses the value of endografts.
  
  
  METHODS
  Data from BD patients with arterial lesions managed surgically in our center from January 1998 to December 2015 were studied retrospectively. Surgical procedures, graft selection, graft-related complications, and retreatments were analyzed.
  
  
  RESULTS
  We recruited 33 patients (29 men and 4 women; male-to-female ratio, 7.25:1) with an average age of 36.7 years (range, 25-51 years). The arterial lesions included 27 aneurysms in 24 patients and nine stenotic or occlusive lesions in nine patients. Immunosuppressive therapy was administered routinely preoperatively and postoperatively as recommended. Altogether, 15 great saphenous veins (GSVs), 8 synthetic grafts, and 13 endografts were used in 36 primary procedures. The mean follow-up duration was 3.8 ± 2.9 years. Graft-related pseudoaneurysm was seen in three GSVs (20%) and in three synthetic grafts (38%) at the anastomosis, but not in endograft implantations (log-rank, P = .171). Graft occlusions were observed in 1 GSV (7%), 2 synthetic (25%), and 2 endografts (15%; log-rank, P = .881). Graft infection occurred in one synthetic graft (13%) and in one endograft (8%) but not in the GSVs (log-rank, P = .689). Graft-related artery rupture occurred in only one endograft (8%). Two patients died, giving a mortality rate of 6.1%.
  
  
  CONCLUSIONS
  In the surgical management of arterial lesions secondary to BD, endografts were superior to GSV and synthetic grafts in decreasing anastomotic pseudoaneurysm. However, improvements are needed to enhance the long-term patency and reduce infections.
authors.affiliation: Division of Vascular Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Electronic address: yinhh168@126.com.
authors.forename: Henghui
authors.initials: H
authors.lastname: Yin
authors.affiliation: Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Songqi
authors.initials: S
authors.lastname: Li
authors.affiliation: Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Mian
authors.initials: M
authors.lastname: Wang
authors.affiliation: Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Zuojun
authors.initials: Z
authors.lastname: Hu
authors.affiliation: Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Jinsong
authors.initials: J
authors.lastname: Wang
authors.affiliation: Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Yao
authors.affiliation: Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Guangqi
authors.initials: G
authors.lastname: Chang
authors.affiliation: Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Shenming
authors.initials: S
authors.lastname: Wang
mesh_terms: D000328:Adult; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D017541:Aneurysm, False / Q000209:etiology; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D001528:Behcet Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002681:China; D018572:Disease-Free Survival; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D007166:Immunosuppressive Agents