Early and Midterm Outcomes of Endovascular Treatment in Arterial Manifestations of Vascular Behcet Disease

Abstract

Behcet's disease (BD), originally described by Hulusi Behcet in 1937, is a chronic relapsing inflammatory process of an immunologic syndrome and the involvement of the vascular system is called Vasculo-Behcet Disease. This is a retrospective study evaluating 21 patients diagnosed with Vascular-Behcet's disease who underwent endovascular treatment. This single-center study was conducted between January 2016 and January 2022. Early and mid-term endovascular outcomes of a total of 21 patients (16 males, 5 females with a median age of 42 years; range, 31 to 46 years), with a diagnosis of VBD, who underwent endovascular arterial repair in our hospital, were retrospectively analyzed. Follow-ups were scheduled for the first and sixth postoperative months and every 6 months thereafter. For symptomatic patients, imaging studies and additional interventions were planned. The primary outcomes were a procedural success and the requirement for re-intervention. Secondary outcomes were complications and all-cause of mortality. Twenty-one patients underwent endovascular repair. In this study, one balloon-expandable stent for brachial artery aneurysm (4,8%), 1 Viabahn graft for femoral artery aneurysm (4,8%), 2 tube endograft for ruptured iliac artery aneurysm (9,5%), 1 tube endograft (TEVAR) insertion at the aortic bifurcation for infrarenal abdominal aortic occlusion (4,8%), one Chimney-TEVAR for saccular arcus TAA (4,8%) and 7 TEVAR for saccular TAA (33,3%), 1 EVAR for an intact and symptomatic infrarenal AAA (4,8%), 1 EVAR (aorto-uniiliac) for ruptured iliac artery aneurysm (4,8%), 6 EVAR for ruptured abdominal aortic aneurysm (28,5%) were deployed. The technical success rate was 100% with a mean follow-up period of 50,4±10,7 months (8 - 66 months). The mean aneurysm diameter was 10,7±53mm. In the follow-up period, three patients presented with a hematoma at the insertion site of the sheath (14,3%). There were no early mortalities. Three patients required re-intervention (14,3%); one of these underwent open surgical repair due to a pseudoaneurysm of the access site (4,8%). The Kaplan-Meier analysis revealed freedom from reintervention rate as 94,1±5,7% at one year, 85,6±9,7% at three years, and 68,4±17,1% at five years. Awareness of the BD especially for vascular involvements in young ages is lifesaving. Endovascular therapy with proper medical treatment seems to be the treatment of choice according to the early and midterm successful results with low morbidity and mortality.