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      Ruptured true aneurysm of the superficial femoral artery leading to Behçet disease diagnosis

      case-report

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          Abstract

          Femoral artery aneurysms are rare, and aneurysms of the superficial femoral artery (SFA) are even rarer, with ruptured true aneurysms of the SFA the rarest. In the present report, we have described the case of a young patient whose SFA had clinical findings suggestive of an aneurysm rupture, which resulted in the diagnosis of Behçet disease, in accordance with the clinical features of the disease. The patient underwent standard treatment, with aneurysmectomy and interposition of a synthetic graft.

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          The International Criteria for Behçet's Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria.

          F Davatchi, S Assaad-Khalil, K.T. Calamia … (2014)
          Behçet's disease (BD) is a chronic, relapsing, inflammatory vascular disease with no pathognomonic test. Low sensitivity of the currently applied International Study Group (ISG) clinical diagnostic criteria led to their reassessment. An International Team for the Revision of the International Criteria for BD (from 27 countries) submitted data from 2556 clinically diagnosed BD patients and 1163 controls with BD-mimicking diseases or presenting at least one major BD sign. These were randomly divided into training and validation sets. Logistic regression, 'leave-one-country-out' cross-validation and clinical judgement were employed to develop new International Criteria for BD (ICBD) with the training data. Existing and new criteria were tested for their performance in the validation set. For the ICBD, ocular lesions, oral aphthosis and genital aphthosis are each assigned 2 points, while skin lesions, central nervous system involvement and vascular manifestations 1 point each. The pathergy test, when used, was assigned 1 point. A patient scoring ≥4 points is classified as having BD. In the training set, 93.9% sensitivity and 92.1% specificity were assessed compared with 81.2% sensitivity and 95.9% specificity for the ISG criteria. In the validation set, ICBD demonstrated an unbiased estimate of sensitivity of 94.8% (95% CI: 93.4-95.9%), considerably higher than that of the ISG criteria (85.0%). Specificity (90.5%, 95% CI: 87.9-92.8%) was lower than that of the ISG-criteria (96.0%), yet still reasonably high. For countries with at least 90%-of-cases and controls having a pathergy test, adding 1 point for pathergy test increased the estimate of sensitivity from 95.5% to 98.5%, while barely reducing specificity from 92.1% to 91.6%. The new proposed criteria derived from multinational data exhibits much improved sensitivity over the ISG criteria while maintaining reasonable specificity. It is proposed that the ICBD criteria to be adopted both as a guide for diagnosis and classification of BD. © 2013 The Authors Journal of the European Academy of Dermatology and Venereology © 2013 European Academy of Dermatology and Venereology.
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            Peripheral arterial involvement in Behcet's disease: an analysis of the results from a Korean referral center.

            Shin-Seok Yang, Keun-Myoung Park, Yang Park … (2013)
            The purposes of this study are to review the results of endovascular and surgical interventions and to evaluate clinical appearances of recurrent arterial involvement in patients with peripheral arterial Behçet disease (BD). A total of 28 patients with peripheral arterial BD were identified. There were 24 males (85.7%), with mean age of 40.0 ± 9.0 years (range 21-59). Arterial involvements were confirmed with computed tomography angiography, magnetic resonance image angiography, or ultrasound. Immunosuppressive agents were administrated to all patients. Indications of intervention were acute symptoms due to arterial occlusion and aneurysmal changes with or without rupture. Among 28 patients with peripheral arterial BD, 10 endovascular and 24 surgical interventions were performed in 21 patients. All 21 patients who underwent endovascular and surgical intervention were followed up for a mean duration of 78.7 ± 52.5 months (range 0-182 months). There was one mortality due to the rupture of pseudoaneurysm in patient who underwent stent-graft insertion for abdominal aortic aneurysm. New arterial involvements of BD occurred in 10 patients. All patients were male, and median age was 33.5 years (range 29-59 years). Mean time of onset of the new arterial lesion was 32.7 ± 32.1 months. In conclusion, the result of endovascular and surgical interventions is satisfactory in patients with acute peripheral arterial BD. Accurate diagnosis with immunosuppressive therapy is mandatory to prevent recurrence and activation of peripheral arterial BD.
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              A review of current management of vasculo-Behcet's.

              Mira Merashli, Rozana El Eid, Imad Uthman (2018)
              To give an overview of recently published articles about the management of vasculo-Behcet's with particular emphasis on anticoagulation.
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                Author and article information

                Contributors
                Panagitsa Christoforou
                Journal
                Journal ID (nlm-ta): J Vasc Surg Cases Innov Tech
                Journal ID (iso-abbrev): J Vasc Surg Cases Innov Tech
                Title: Journal of Vascular Surgery Cases, Innovations and Techniques
                Publisher: Elsevier
                ISSN (Electronic): 2468-4287
                Publication date PMC-release: 06 July 2022
                Publication date Collection: September 2022
                Publication date (Electronic): 06 July 2022
                Volume: 8
                Issue: 3
                Pages: 473-476
                Affiliations
                [1]Department of Vascular Surgery, Nicosia General Hospital, Nicosia, Cyprus
                Author notes
                [∗ ]Correspondence: Panagitsa Christoforou, MD, MSc, PhD, Department of Vascular Surgery, Nicosia General Hospital, 215, Paleos Dromos Lefkosia-Lemesos St, 2029 Strovolos, Nicosia 2029, Cyprus panagitsachristoforou@ 123456yahoo.gr
                Article
                Publisher Item ID: S2468-4287(22)00091-0
                DOI: 10.1016/j.jvscit.2022.06.002
                PMC ID: 9411185
                PubMed ID: 36035229
                SO-VID: 7d40097c-d152-47c6-8c17-de42c080e2ab
                Copyright © © 2022 The Author(s)
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 3 April 2022
                Date accepted : 2 June 2022
                Categories
                Subject: Case report

                Keywords: behçet disease,ruptured aneurysm,superficial femoral artery,true femoral aneurysm
                Data availability:
                Keywords: behçet disease, ruptured aneurysm, superficial femoral artery, true femoral aneurysm

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