Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
J Vasc Surg. 2014 Mar;59(3):608-14. doi: 10.1016/j.jvs.2013.09.052. Epub 2013 Nov 16.
To evaluate the effectiveness of endovascular stent grafting for surgical management of aortic pseudoaneurysm in patients with Behcet's disease (BD).
We present a single-institution retrospective cohort of patients with aortic pseudoaneurysm and BD treated with aortic stent grafting. Computed tomography imaging was obtained preoperatively in all patients and once within 2 weeks postoperatively, and then annually. Clinical follow-up and erythrocyte sedimentation rate were used to follow BD activity. Immunosuppressant therapy was instituted prior to endovascular treatment unless a contraindication existed.
From 1998 to 2012, 10 patients (eight male, two female; median age, 39) with BD and aortic pseudoaneurysm were treated with endovascular stent grafting at this institution. Ninety percent of these patients received immunosuppressive therapy before and after surgical treatment. The median follow-up period was 57 months (interquartile range, 43-72). The locations of the 12 pseudoaneurysms treated in this cohort were infrarenal abdominal aorta (seven), descending thoracic aorta (four), and aortic arch (one). Median pseudoaneurysm size was 4.5 cm (interquartile range, 3.4-5.9). At long-term follow-up, complete resolution of the aortic pseudoaneurysm was noted in all patients. No endoleaks occurred. Newly developed pseudoaneurysm at the distal margin of the stent graft was noted in one patient 17 months after the stent graft procedure. One patient required a subsequent stent graft placement for an expanding pseudoaneurysm of the subclavian artery. No patient deaths occurred during the follow-up period.
Endovascular treatment of aortic pseudoaneurysm with stent-grafting in patients with BD is safe and effective with long-term durability.
评估血管内支架移植物在贝赫切特病（BD）患者外科治疗主动脉假性动脉瘤中的效果。
我们对在本机构接受主动脉支架移植物治疗的主动脉假性动脉瘤和 BD 患者进行了单中心回顾性队列研究。所有患者术前均行计算机断层扫描成像，术后 2 周内及术后每年均行一次。临床随访和红细胞沉降率用于监测 BD 活动情况。除非存在禁忌证，否则在血管内治疗前开始使用免疫抑制剂治疗。
1998 年至 2012 年，本机构治疗了 10 例（8 例男性，2 例女性；中位年龄 39 岁）BD 合并主动脉假性动脉瘤患者，均采用血管内支架移植物治疗。90%的患者在手术治疗前后接受了免疫抑制治疗。中位随访时间为 57 个月（四分位距，43-72）。该队列治疗的 12 个假性动脉瘤的位置分别为肾下腹部主动脉（7 个）、降主动脉（4 个）和主动脉弓（1 个）。假性动脉瘤大小的中位数为 4.5cm（四分位距，3.4-5.9）。长期随访发现，所有患者的主动脉假性动脉瘤均完全消失。无内漏发生。1 例患者在支架置入术后 17 个月发现支架移植物远端边缘新发假性动脉瘤，需再次进行支架置入。1 例患者因锁骨下动脉扩张性假性动脉瘤需要再次进行支架置入。随访期间无患者死亡。
血管内支架移植物治疗 BD 患者的主动脉假性动脉瘤安全有效，长期效果持久。
