Endovascular treatment of aortic saccular aneurysms associated with Adamantiades-Behçet disease

Adamantiades-Behçet disease is a multisystemic disorder that classically presents with oral and genital ulcers and ocular involvement, with vascular involvement in up to 38% of cases. Aortic involvement is one of the most serious manifestations and is associated with high mortality rates, occurring in 1.5 to 2.7% of cases. We report a case of a saccular abdominal aorta aneurysm in a 49-year-old male patient with complicated Adamantiades-Behçet disease that was treated with endovascular repair.

Keywords:
Behçet syndrome; aortic aneurysm; endovascular procedures

Authorship

Patrick Bastos Metzger

Escola Bahiana de Medicina e Saúde Pública – EBMSP, Salvador, BA, Brasil.Escola Bahiana de Medicina e Saúde PúblicaBrasilSalvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública – EBMSP, Salvador, BA, Brasil.

http://orcid.org/0000-0002-1717-1370

Kamilla Rosales Costa

http://orcid.org/0000-0003-1920-5666

Simone Lessa Metzger

Universidade Salvador – UNIFACS, Salvador, BA, Brasil.Universidade SalvadorBrasilSalvador, BA, BrasilUniversidade Salvador – UNIFACS, Salvador, BA, Brasil.

Obra Sociais Irmã Dulce – OSID, Hospital Santo Antônio, Salvador, BA, Brasil.Obra Sociais Irmã DulceBrasilSalvador, BA, BrasilObra Sociais Irmã Dulce – OSID, Hospital Santo Antônio, Salvador, BA, Brasil.

Leonardo Cortizo de Almeida

Hospital Geral Roberto Santos – HGRS, Salvador, BA, Brasil.Hospital Geral Roberto SantosBrasilSalvador, BA, BrasilHospital Geral Roberto Santos – HGRS, Salvador, BA, Brasil.

Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

Correspondence Patrick Bastos Metzger Escola Bahiana de Medicina e Saúde Pública – EBMSP Rua Professor Diógenes Rebouças, Pituba CEP 41830-570 - Salvador (BA), Brasil Tel.: +55 (71) 99977-6356 E-mail: patrickvascular@gmail.com

Author information PBM - PhD in Medicina, Universidade de São Paulo (USP); Vascular and endovascular surgeon, Sociedade Brasileira de Angiologia e Cirurgia Vascular; Interventional Radiologist, Colégio Brasileiro de Radiologia (SBACV/CBR). KRC - 9th semester medical student, Escola Bahiana de Medicina e Saúde Pública (EBMSP). SLM - Geriatrician, Sociedade Brasileira de Geriatria e Gerontologia; Assistant professor, Escola Bahiana de Medicina e Saúde Pública (EBMSP); Assistant professor, Universidade Salvador (UNIFACS); Preceptor at Residência de Geriatria, Obras Sociais Irmã Dulce (OSID). LCA - Vascular and endovascular surgeon, Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV).

Author contributions Conception and design: PBM Analysis and interpretation: KRC, PBM, SLM Data collection: PBM Writing the article: KRC, PBM, SLM Critical revision of the article: PBM, SLM Final approval of the article*: KRC, PBM, SLM, LCA Statistical analysis: KRC, PBM, SLM Overall responsibility: KRC, PBM, SLM, LCA *All authors have read and approved of the final version of the article submitted to J Vasc Bras.

SCIMAGO INSTITUTIONS RANKINGS

Universidade Salvador – UNIFACS, Salvador, BA, Brasil.Universidade SalvadorBrasilSalvador, BA, BrasilUniversidade Salvador – UNIFACS, Salvador, BA, Brasil.

Hospital Geral Roberto Santos – HGRS, Salvador, BA, Brasil.Hospital Geral Roberto SantosBrasilSalvador, BA, BrasilHospital Geral Roberto Santos – HGRS, Salvador, BA, Brasil.

Figures | Tables

Figures (3)
Tables (1)

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Figure 1
(A) Asymmetrical edema of the left lower limb secondary to iliofemoral deep venous thrombosis; (B) Genital ulcer.

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Figure 2
(A) Sagittal image from angiotomography of the abdominal aorta, showing large volume posterior saccular aneurysm; (B) Volumetric angiotomography reconstruction, showing large volume posterior saccular aneurysm; (C) Sagittal angiotomography image of the abdominal aorta, showing aneurysm neck and dimensions.

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Figure 3
(A) Anteroposterior abdominal aortography before deployment, the large volume saccular aneurysm; (B) Control angiography after deployment of the endograft, with no leaks.

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Table 1
International Study Group for Behçet's Disease diagnostic criteria^* * Criteria from International Study Group for Behçet’s Disease5

Figure 1 (A) Asymmetrical edema of the left lower limb secondary to iliofemoral deep venous thrombosis; (B) Genital ulcer.

Figure 2 (A) Sagittal image from angiotomography of the abdominal aorta, showing large volume posterior saccular aneurysm; (B) Volumetric angiotomography reconstruction, showing large volume posterior saccular aneurysm; (C) Sagittal angiotomography image of the abdominal aorta, showing aneurysm neck and dimensions.

Figure 3 (A) Anteroposterior abdominal aortography before deployment, the large volume saccular aneurysm; (B) Control angiography after deployment of the endograft, with no leaks.

Table 1 International Study Group for Behçet's Disease diagnostic criteria^* * Criteria from International Study Group for Behçet’s Disease5

Primary criterion:

• Recurrent oral ulcers; at least 3 times in a 1-year period.

Secondary criteria:

• Recurrent aphthous genital ulcers

• Ocular:

Anterior and/or posterior uveitis.

Retinal vasculitis.

• Cutaneous manifestations:

Erythema nodosum, pseudofolliculitis, acneiform papulopustular lesions outside of puberty and without corticoids.

Positive pathergy test.

Diagnosis is confirmed if the primary criterion and two secondary criteria are present.
^*
Criteria from International Study Group for Behçet’s Disease5

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Endovascular treatment of aortic saccular aneurysms associated with Adamantiades-Behçet disease

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[1] Conflicts of interest: No conflicts of interest declared concerning the publication of this article.