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Aortic and Arterial Aneurysms in Behçet Disease: Management with Stent-Grafts—Initial Experience¹

¹ From the Departments of Radiology (J.H.P., J.W.C., J.H.J., S.Y.S., S.J.S.) and Surgery (S.J.K.), Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea; Department of Radiology, Medical College of Kosin University, Pusan, Korea (K.S.C.); and Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, Korea (D.Y.L., J.Y.W.). Received August 18, 2000; revision requested October 18; final revision received February 21, 2001; accepted March 2. Supported by grant HMP-98-G-2-043 of the ’98 Highly Advanced National Projects on the Development of Biomedical Engineering and Technology, Ministry of Health and Welfare, Republic of Korea. Address correspondence to J.H.P. (e-mail: parkjh@radcom.snu.ac.kr).

PURPOSE: To assess the application of stent-grafts in the management of aortic and arterial aneurysms in patients with Behçet disease.

MATERIALS AND METHODS: Nine aneurysms in seven patients were managed with various types of stent-grafts. Diagnoses were based on clinical findings. The aortic aneurysms (n = 3) were thoracic (n = 1), suprarenal (n = 1), or infrarenal (n = 1). The arterial aneurysms (n = 6) were in the right and left subclavian (n = 2), right common carotid (n = 2), right brachiocephalic (n = 1), or left common iliac arteries (n = 1). A tandem connection of Gianturco stent covered with polytetrafluorethylene was placed in three aneurysms, and a balloon-expandable stent was placed in six.

RESULTS: The stent-graft was successfully placed in all patients. Immediate follow-up angiography revealed complete exclusion of the aneurysm in all cases. Follow-up computed tomography performed 3 days to 2 weeks later revealed complete exclusion and thrombosis of the aneurysm and patency of the stent-graft in six patients. In one patient, total occlusion of the artery with a stent occurred due to flow disturbance caused by double lesions. During follow-up (range, 6–59 months; mean, 28 months), the aneurysm resolved and completely regressed in four patients. A recurrent aneurysm at the distal margin of previously inserted stent-graft was successfully managed with an additional stent-graft.

CONCLUSION: The findings in this initial experience suggest that stent-graft insertion may be a safe and effective alternative to surgical treatment of aortic and arterial aneurysms in patients with Behçet disease.

Index terms: Aneurysm, 9_*.629² • Aneurysm, CT, 9_*.1291, 9_*.12916 • Behçet disease, 9_*.1268 • Stents and prostheses, 9_*.1268

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