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白塞病患者腘动脉破裂性动脉瘤的成功血管内治疗

Successful Endovascular Treatment of a Ruptured Popliteal Artery Aneurysm in a Patient with Behcet Disease.

作者信息

Kim Suh Min, Jung In Mok

机构信息

Department of Surgery, Dongguk University Ilsan Hospital, Goyang, Korea.

Department of Surgery, SMG-SNU Boramae Medical Center, Seoul, Korea.

出版信息

Ann Vasc Surg. 2018 Nov;53:274.e1-274.e5. doi: 10.1016/j.avsg.2018.05.076. Epub 2018 Aug 6.

Abstract

PURPOSE

Arterial involvement of Behcet disease is often found in the form of a rapidly expanding aneurysm. We report a case of successful treatment of a ruptured popliteal artery aneurysm with a stent-graft insertion.

CASE REPORT

A 55-year-old male patient was admitted because of pain and swelling in the right leg that had persisted for 15 days. Computed tomography (CT) angiography showed a contained rupture of a large right popliteal artery aneurysm. Laboratory tests showed elevated erythrocyte sedimentation rate (ESR) and C-reactive protein level. The patient had a history of recurrent oral and genital ulceration, folliculitis, and erythema nodosum. He was diagnosed as having Behcet disease with arterial involvement. After 5 days of immunosuppressant medications, the ESR decreased. A 7 mm × 10 cm stent graft was inserted into the right popliteal artery, and completion angiography showed the successfully excluded aneurysm. His symptoms were gradually relieved. The stent graft was patent on CT angiography 15 months after the procedure. He has been followed up for 16 months with dual antiplatelet agents and immunosuppressive medications.

CONCLUSIONS

Endovascular therapy for peripheral aneurysms in patients with Behcet disease is safe and minimally invasive. Careful follow-up to monitor disease progression is necessary.

摘要

目的

白塞病的动脉受累常表现为快速扩展的动脉瘤形式。我们报告一例通过植入覆膜支架成功治疗腘动脉破裂性动脉瘤的病例。

病例报告

一名55岁男性患者因右腿疼痛和肿胀持续15天入院。计算机断层扫描(CT)血管造影显示右侧大腘动脉瘤局限性破裂。实验室检查显示红细胞沉降率(ESR)和C反应蛋白水平升高。该患者有复发性口腔和生殖器溃疡、毛囊炎及结节性红斑病史。他被诊断为白塞病伴动脉受累。在使用免疫抑制剂治疗5天后,ESR下降。将一个7毫米×10厘米的覆膜支架植入右侧腘动脉,血管造影显示动脉瘤被成功隔绝。他的症状逐渐缓解。术后15个月CT血管造影显示覆膜支架通畅。他接受双联抗血小板药物和免疫抑制药物治疗并随访了16个月。

结论

白塞病患者外周动脉瘤的血管内治疗安全且微创。有必要进行仔细随访以监测疾病进展。

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