Amahzoune B, Boulahya A, Selkane C, Houssa M Ait, Bekkali Y, Arji M, el Kirat A
Service de chirurgie cardiovasculaire, Hôpital militaire d'instruction Mohamed V, Rabat, Maroc.
Arch Mal Coeur Vaiss. 2002 Feb;95(2):109-16.
Vascular involvement in Behcet's disease is common, especially in deep vein thrombosis. Aneurysmal or occlusive arterial disease is, however, rare. The authors report five cases of vascular Behcet's disease reviewed over a period of 4 years (1996-1999). All these patients were men and the mean age was 38 years. The arterial disease was the presenting symptom of Behcet's disease in 3 cases. The other patients had been followed up for Behcet's disease for 4 years. The average time of onset of arterial disease was 7.2 years with respect to the presenting symptom, the range being 2 to 20 years. In all, seven arteries were involved, two patients having two arterial sites at the same time. The femoral artery was involved in 3 cases. The iliac artery was involved twice. One patient had a coronary thrombosis and the last case was of a pseudoaneurysm of the infra-renal abdominal aorta which ruptured into the retroperitoneal space. Six lesions were aneurysmal. All patients underwent surgery. The histological analysis of the resected lesions showed non-specific panvasculitis. The postoperative period was marked by short and medium term complications: four prosthetic thromboses and two anastomotic pseudo-aneurysms which required several surgical procedures and which led to two deaths. These results and a review of the literature underline the need to search for Behcet's disease in all cases of aneurysmal or occlusive arterial disease in young patients, especially those born in the Mediterranean regions. Surgical treatment should not be delayed. In these inflammatory conditions with pronounced perivascular involvement, the surgery is difficult and postoperative complications are common, especially anastomotic disunion. Medical treatment has no surgical implication, but does not prevent progression of the disease.
血管受累在白塞病中很常见，尤其是在深静脉血栓形成方面。然而，动脉瘤样或闭塞性动脉疾病却很罕见。作者报告了在4年（1996 - 1999年）期间回顾的5例血管型白塞病病例。所有这些患者均为男性，平均年龄为38岁。在3例中，动脉疾病是白塞病的首发症状。其他患者因白塞病已随访4年。相对于首发症状，动脉疾病的平均发病时间为7.2年，范围为2至20年。总共有7条动脉受累，2例患者同时有两个动脉部位受累。股动脉受累3例。髂动脉受累2次。1例患者发生冠状动脉血栓形成，最后1例是肾下腹主动脉假性动脉瘤破裂进入腹膜后间隙。6处病变为动脉瘤样。所有患者均接受了手术。切除病变的组织学分析显示为非特异性全血管炎。术后短期内和中期出现并发症：4例人工血管血栓形成和2例吻合口假性动脉瘤，这需要多次外科手术，导致2例死亡。这些结果以及文献回顾强调，对于所有年轻患者的动脉瘤样或闭塞性动脉疾病病例，尤其是那些出生在地中海地区的患者，都需要排查白塞病。手术治疗不应延迟。在这些血管周围受累明显的炎症性疾病中，手术困难且术后并发症常见，尤其是吻合口裂开。药物治疗与手术无关，但不能阻止疾病进展。
