Goksel Onur S, Torlak Zuhal, Çınar Bayer, Sahin Sinan, Karatepe Celalettin, Eren Ergin
Department of Cardiovascular Surgery, Istanbul University, Istanbul, Turkey.
Ann Vasc Surg. 2012 Feb;26(2):277.e5-9. doi: 10.1016/j.avsg.2011.06.010. Epub 2011 Dec 20.
Vascular involvement in Behcet's disease is rare, but may be at the forefront of the clinical picture with possible life-threatening scenarios. We reviewed our preliminary results with endovascular treatment of abdominal aortic pathologies in Behçet's disease.
Data regarding seven patients with abdominal aortic pathologies (aneurysm, pseudoaneurysm, and aortoenteric fistula) and Behçet's disease were treated with endovascular stent-grafting between 2002 and 2006.
Seven patients (aged, 39.1 ± 9; range, 27-52 years) with a mean aortic diameter of 58.4 ± 6.3 mm received endovascular stent-grafts, two patients being in emergency settings. Two patients were in active disease state. Four tube-shaped, two aorto-bi-iliac, and one aorto-uni-iliac stents were implanted. One patient expired on day 28 with multiorgan failure after emergency stent-grafting owing to enlarging periprosthetic hematoma following open surgery for ruptured aneurysm. Another patient was declined for endovascular therapy owing to hypoplastic aortoiliac vasculature.
Endovascular approach provides a reasonable alternative to open repair for the treatment of abdominal aortic aneurysms in select cases; however, in emergency settings, endovascular repair may well have an important, but limited, role in select patients with aortoenteric fistulae, it may yet require a surgical intervention.
白塞病累及血管较为罕见,但可能在临床表现中最为突出,存在危及生命的情况。我们回顾了白塞病腹主动脉病变的血管内治疗初步结果。
回顾2002年至2006年间7例患有腹主动脉病变(动脉瘤、假性动脉瘤和主动脉肠瘘)且患有白塞病的患者接受血管内支架植入术的数据。
7例患者(年龄39.1±9岁;范围27 - 52岁),平均主动脉直径58.4±6.3mm,接受了血管内支架植入,其中2例为急诊情况。2例患者处于疾病活动期。共植入4个管状、2个主动脉双髂动脉和1个主动脉单髂动脉支架。1例患者在因破裂动脉瘤开放手术后假体周围血肿扩大接受急诊支架植入术后第28天因多器官衰竭死亡。另1例患者因主动脉髂血管发育不全被拒绝接受血管内治疗。
血管内治疗方法为特定病例的腹主动脉瘤治疗提供了一种合理的开放修复替代方案;然而,在急诊情况下,血管内修复在特定的主动脉肠瘘患者中可能具有重要但有限的作用,可能仍需要手术干预。