흉부대동맥류가 합병된 Behcet 증후군에서 Stent-Graft를 이용한 치료 1예

Abstract

Behc¸et´s syndrome is a multisystem disorder presenting with recurrent oral and genital ulcerations as well as ocular involvement. Vascular complications consist of venous thromboembolism, arterial aneurysms and occlusions, and they develop in about 25% of patients. Weakening of the aortic wall may lead to aneurysms that may rupture and cause life-threatening hemorrhage, but nothing in the surgical and nonsurgical techniques proposed for the treatment for aneurysms in Behcet s syndrome has proved to be satisfactory. The traditional treatment for thoracic aotic aneurysms is the surgical replacement of a prosthetic graft. Although advances in the operative care of patients with thoracic aortic aneurysms have been achieved, the associated morbidity and mortality are considerable, especially in those with coexisting conditions such as advanced age, coronary artery disease and heart failure. Currently, transluminally placed endovascular stent-grafts offer an alternative approach to treatment that is potentially less invasive with a lower risk. We report a 37-year-old male patient with thoracic aortic aneurysm associated with Behget´s syndrome. Transluminal endovascular stent-graft placement was attempted : the stent-graft was introduced through a 22-Fr sheath using a common femoral artery cut down and expanded to 25 - 30 mm in diamter. There was increased thrombosis of the aneurysm on a follow-up imaging study, and the patient was discharged without complications.