The surgical therapy of Behçet aneurysms is often unsuccessful, resulting in graft
occlusions, anastomoses, and/or new aneurysms.
Twenty-nine aneurysms were documented in 24 Behçet's patients during a period of 19
years. All patients were male, ranging in age from 20 to 53 years (mean, 35 +/- 7.3
years). The mean duration of disease was 9 +/- 5 years. There were nine abdominal
aorta, four iliac, three common femoral, five superficial femoral, four popliteal,
one subclavian, one carotid, and one posterior tibial artery aneurysm. In addition,
in one patient an aneurysm developed from the arterialized venous conduit that had
been inserted for a common femoral artery aneurysm elsewhere. Five patients were already
under immunosuppressive therapy for ocular problems at the time of diagnosis. Fifteen
patients received immunosuppressive therapy after operation. We performed one abdominal
aneurysmorrhaphy, two iliac artery PTFE graft interpositions, two aortobiliac bypasses
(PTFE), six aortic tube graft (three PTFE, three Dacron) interpositions, one avrtofemoral
bypass (PTFE), two iliofemoral bypasses (PTFE), two superficial femoral artery graft
(PTFE) interpositions, and three popliteal graft interpositions (one PTFE, two vein
graft). Also as an initial procedure one carotid, one subclavian, four superficial
femoral, one popliteal, and one posterior tibial artery were ligated.
Nineteen patients were followed up for a mean duration of 47.3 +/- 27 months (range,
1 to 108 months). The patient with a subclavian aneurysm died of massive bleeding
on postoperative day 15. Four patients were lost to follow-up. In the abdominal aortic
aneurysm group one patient died of gastrointestinal bleeding 4 years after the operation.
Another patient from the same group died 5 years after operation without any vascular
disease. In the common femoral artery group the patient with an occluded iliofemoral
graft died of an exsanguinating pulmonary artery aneurysm in the first year after
operation. Overall, there were five anastomotic aneurysms. In addition, after the
initial operation two iliofemoral, one aortofemoral, and one popliteal interposition
graft were occluded without disabling ischemia.
Aneurysms limited to the extremities could be ligated without disabling ischemia.
Abdominal aortic aneurysms could be treated with tube graft insertion, giving satisfactory
results. Patients could tolerate graft occlusion without major ischemia.