Challenging Saccular Aorto-iliac Aneurysms in Behcet’s Disease

Background: Behect’s disease is a systemic vasculitic disease with uncertain aetiology and affecting wide range of blood vessel sizes in young age group of patients. Vascular involvement in Behcet’s varies in the literature from 7 to 34%. Arterial lesions in Behect’s disease is very uncommon and carries a relatively high rate of mortality when rupture due to involvement of pulmonary or aorto-iliac arteries.

Methods: This is a retrospective review of nine patients with Behcet’s disease (BD) and saccular aorto-iliac aneurysms. All of them treated surgically. Six patients presented with aortic saccular aneurysms and 3 involved the common iliac artery. Open surgical repair was performed to 6 patients, 2 patients had endovascular treatment and 1 patient had both (hybrid procedure).

Result: Initial success of aneurysmal treatment was achieved in 8 cases. Two patients developed small false aneurysms at the arterial puncture sites. There is 1 case of operative mortality. Two cases developed recurrence at the anastomotic line. Three patients died in less than 18 months follow-up.

Conclusion: Arterial lesions of Behect’s disease are rare conditions with high potential risk of complications. Endovascular management might potentially result in better outcome.