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白塞病腹主动脉瘤的外科治疗结果

Surgical treatment result of abdominal aortic aneurysm in Behçet's disease.

作者信息

Kwon T-W, Park S-J, Kim H-K, Yoon H-K, Kim G-E, Yu B

机构信息

Division of Vascular Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical center, Seoul, Korea.

出版信息

Eur J Vasc Endovasc Surg. 2008 Feb;35(2):173-80. doi: 10.1016/j.ejvs.2007.08.013. Epub 2007 Oct 26.

Abstract

OBJECTIVE

We report our surgical treatment results of abdominal aortic aneurysm (AAA) in Behçet's disease patient.

MATERIALS AND METHODS

Between September 1998 and June 2006, the authors have performed 21 procedures for AAA in 12 patients with Behçet's disease. Male to female sex ratio was 3:1 and mean age was 34 years old. Behçet's disease was diagnosed clinically using criteria of International Study Group for Behçet's Disease (1990). Retrospective analysis was made.

RESULTS

There were six infrarenal, five suprarenal, and one double (suprarenal and infrarenal)AAA. Six graft interposition, six patch closure, and one stent-graft insertion were performed (one graft interposition and one patch closure were simultaneously performed for double AAA). Eight recurrent aneurysms were noted in six (50%) patients. Four stent-graft insertion, two patch closures, one graft interposition and one explothoracotomy only were performed for recurrent aneurysms. Overall recurrence rate of 21 procedures was 38.1%; 14.3% for graft interposition, 62.5% for patch closure, and 40% for stent-graft insertion.

CONCLUSION

Though the resection and graft interposition is technically difficult in many occasions, it should be considered as the procedure of choice for abdominal aortic aneurysm in Behçet's disease. Endovascular interventions may be one of the treatment modality but the result needs further long-term follow-up.

摘要

目的

我们报告白塞病患者腹主动脉瘤(AAA)的外科治疗结果。

材料与方法

1998年9月至2006年6月期间,作者对12例白塞病患者实施了21例AAA手术。男女比例为3:1,平均年龄为34岁。白塞病根据国际白塞病研究组(1990年)的标准进行临床诊断。进行回顾性分析。

结果

有6例肾下腹主动脉瘤、5例肾上腹主动脉瘤和1例双(肾上和肾下)腹主动脉瘤。实施了6例移植物植入、6例补片修补和1例支架移植物植入(对双腹主动脉瘤同时进行了1例移植物植入和1例补片修补)。6例(50%)患者出现8例复发性动脉瘤。对复发性动脉瘤仅实施了4例支架移植物植入、2例补片修补、1例移植物植入和1例开胸手术。21例手术的总体复发率为38.1%;移植物植入为14.3%,补片修补为62.5%,支架移植物植入为40%。

结论

虽然在很多情况下切除和移植物植入技术上有难度,但应将其视为白塞病腹主动脉瘤的首选手术方式。血管内介入治疗可能是一种治疗方式,但结果需要进一步长期随访。

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