Chen Guo Xin, Wan Jiang Hong, Chen Chu Wen, Huang Bin
Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, China.
Department of Outpatient, West China Hospital, Sichuan University, Chengdu, China.
Front Cardiovasc Med. 2023 Sep 1;10:1097129. doi: 10.3389/fcvm.2023.1097129. eCollection 2023.
Behcet's disease is a vasculitis of unknown origin that can involve multiple organs or tissues. Aneurysm or pseudoaneurysm, also one of the complications of Behcet's disease, is usually accompanied by a poor prognosis. Surgery is usually accompanied by a high risk of complications, such as the recurrence of anastomotic pseudoaneurysms and blockage of the target vessel. Using hybrid surgery, we successfully treated a complex and recurrent abdominal aortic pseudoaneurysm in a patient with BD.
We report a 32-year-old female diagnosed with Behcet's disease with recurrent thoracoabdominal aortic aneurysm. Adequate immunotherapy was given during the perioperative period. The splanchnic artery branches were reconstructed, and the aneurysm was sequestered with endovascular repair. The patient recovered uneventfully and was discharged from the hospital 8 days after hybrid surgery. At the 60-month follow-up, no aneurysm was observed, the stent had no displacement or internal leakage, and the reconstructed blood vessels were unobstructed.
Hybrid surgery could be a feasible and effective strategy for BD aneurysms. Adequate preoperative and postoperative immunotherapy with arterial anastomosis away from the diseased artery may be the key to success.
白塞病是一种病因不明的血管炎,可累及多个器官或组织。动脉瘤或假性动脉瘤也是白塞病的并发症之一,通常预后较差。手术通常伴随着较高的并发症风险,如吻合口假性动脉瘤复发和靶血管阻塞。我们采用杂交手术成功治疗了一名白塞病患者的复杂复发性腹主动脉假性动脉瘤。
我们报告一名32岁女性,诊断为白塞病并伴有复发性胸腹主动脉瘤。围手术期给予了充分的免疫治疗。重建了内脏动脉分支,并用血管腔内修复术隔离了动脉瘤。患者恢复顺利,杂交手术后8天出院。在60个月的随访中,未观察到动脉瘤,支架无移位或内漏,重建血管通畅。
杂交手术可能是治疗白塞病动脉瘤的一种可行且有效的策略。术前和术后进行充分的免疫治疗,并将动脉吻合远离病变动脉可能是成功的关键。