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Outcomes of endovascular treatment for aortic pseudoaneurysm in Behcet's disease

Authors
 Sung Won Kim  ;  Do Yun Lee  ;  Man Deuk Kim  ;  Jong Yun Won  ;  Sung Il Park  ;  Young Nam Yoon  ;  Donghoon Choi  ;  Young-Guk Ko 
Citation
 JOURNAL OF VASCULAR SURGERY, Vol.59(3) : 608-614, 2014 
Journal Title
 JOURNAL OF VASCULAR SURGERY 
ISSN
 0741-5214 
Issue Date
2014
MeSH
Adult ; Aneurysm, False/diagnosis ; Aneurysm, False/etiology ; Aneurysm, False/surgery* ; Aortic Aneurysm, Abdominal/diagnosis ; Aortic Aneurysm, Abdominal/etiology ; Aortic Aneurysm, Abdominal/surgery* ; Aortic Aneurysm, Thoracic/diagnosis ; Aortic Aneurysm, Thoracic/etiology ; Aortic Aneurysm, Thoracic/surgery* ; Aortography/methods ; Behcet Syndrome/complications* ; Behcet Syndrome/diagnosis ; Behcet Syndrome/drug therapy ; Blood Sedimentation ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation*/adverse effects ; Blood Vessel Prosthesis Implantation*/instrumentation ; Endovascular Procedures*/adverse effects ; Endovascular Procedures*/instrumentation ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; Male ; Middle Aged ; Recurrence ; Reoperation ; Republic of Korea ; Retrospective Studies ; Stents ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome
Keywords
Septic Shock ; Severe Sepsis ; Tigecycline ; Open Abdomen ; Abdominal Sepsis
Abstract
OBJECTIVE: To evaluate the effectiveness of endovascular stent grafting for surgical management of aortic pseudoaneurysm in patients with Behcet's disease (BD). METHODS: We present a single-institution retrospective cohort of patients with aortic pseudoaneurysm and BD treated with aortic stent grafting. Computed tomography imaging was obtained preoperatively in all patients and once within 2 weeks postoperatively, and then annually. Clinical follow-up and erythrocyte sedimentation rate were used to follow BD activity. Immunosuppressant therapy was instituted prior to endovascular treatment unless a contraindication existed. RESULTS: From 1998 to 2012, 10 patients (eight male, two female; median age, 39) with BD and aortic pseudoaneurysm were treated with endovascular stent grafting at this institution. Ninety percent of these patients received immunosuppressive therapy before and after surgical treatment. The median follow-up period was 57 months (interquartile range, 43-72). The locations of the 12 pseudoaneurysms treated in this cohort were infrarenal abdominal aorta (seven), descending thoracic aorta (four), and aortic arch (one). Median pseudoaneurysm size was 4.5 cm (interquartile range, 3.4-5.9). At long-term follow-up, complete resolution of the aortic pseudoaneurysm was noted in all patients. No endoleaks occurred. Newly developed pseudoaneurysm at the distal margin of the stent graft was noted in one patient 17 months after the stent graft procedure. One patient required a subsequent stent graft placement for an expanding pseudoaneurysm of the subclavian artery. No patient deaths occurred during the follow-up period. CONCLUSIONS: Endovascular treatment of aortic pseudoaneurysm with stent-grafting in patients with BD is safe and effective with long-term durability.
Full Text
http://www.sciencedirect.com/science/article/pii/S0741521413017953
DOI
10.1016/j.jvs.2013.09.052
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Kim, Sungwon(김성원) ORCID logo https://orcid.org/0000-0001-5455-6926
Park, Sung Il(박성일)
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Youn, Young Nam(윤영남)
Lee, Do Yun(이도연)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98348
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