Ding Ze-Yang, Jin Guan-Nan, Ai Xi, Li Li-Yan, Zheng Ping, Guan Yan, Wang Qi, Zhang Zhi-Wei, Yang Jun
From the Division of Vascular Surgery, Hepatic Surgery Center, Tongji Hospital (ZD, XA, LL, PZ, YG, QW, ZZ, JY); and Department of Nephrology, Union Hospital (GJ), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Medicine (Baltimore). 2016 May;95(19):e3545. doi: 10.1097/MD.0000000000003545.
Aneurysm or pseudoaneurysm formation is one of the vascular complications of Behcet disease. At present, the optimal treatment for the disease has not been established.The authors report a case of vasculo-Behcet disease (v-BD) with recurrent pseudoaneurysms in the left infrainguinal arteries (common femoral artery, superficial femoral artery, and popliteal artery), as well as thrombosis in the popliteal vein and posterior tibial vein. The patient underwent 3 rounds of surgery, but developed a new pseudoaneurysm several months after each surgery. Eventually, the patient was successfully treated with a combination of endovascular repair, using a fully covered stent graft, and prednisone. The pseudoaneurysm regressed without recurrence for more than 1 year.For v-BD, treatment with immunosuppressive therapy alone may not be sufficient to prevent the recurrence of pseudoaneurysms. For the endovascular treatment of pseudoaneurysms affecting the infrainguinal arteries in v-BD, a fully covered stent graft without oversizing is essential to prevent the recurrence of pseudoaneurysms.
动脉瘤或假性动脉瘤形成是白塞病的血管并发症之一。目前，该病的最佳治疗方法尚未确立。作者报告了一例血管白塞病（v-BD）患者，其左下肢动脉（股总动脉、股浅动脉和腘动脉）反复出现假性动脉瘤，同时腘静脉和胫后静脉发生血栓形成。该患者接受了3轮手术，但每次手术后数月均出现新的假性动脉瘤。最终，患者通过使用完全覆膜支架移植物进行血管腔内修复并联合泼尼松治疗获得成功。假性动脉瘤消退，1年多未复发。对于v-BD，单纯免疫抑制治疗可能不足以预防假性动脉瘤复发。对于v-BD累及下肢动脉的假性动脉瘤进行血管腔内治疗时，不过度扩张的完全覆膜支架移植物对于预防假性动脉瘤复发至关重要。
