Major arterial involvement and review of Behcet's disease

Abstract

Behcet's disease was first defined by Hulusi Behcetin 1937 as a multisystemic disorder with characteristic pathologic findings including recurrent orogenitalulcers, vascular disorders, and ocular and cutaneous lesions. The disease is mostly encountered at the third and fourth decades of life and especially prevalent in Mediterranean and Far East Asia.Behcet's disease may have both venous and arterial manifestations. The arterial form is rare but it is bore with its manner and to consider recurrent surgical treatments. In this retrospective study, we reviewed the literature related to Behcet's disease and discussed in respect to vascular involvement and the prognosis of surgical treatment.Thirty-one consecutive patients with vasculo-Behcet's disease visiting the departments of cardiovascular surgery, dermatology, and internal medicine in Medical Faculty of Istanbul have been reviewed retrospectively. All available clinical,pathologic, and postoperative data were reviewed and analyzed. Venous system pathologies were present in 15 patients. The pathologies in the remaining patients were related to the arterial tree. Ten patients with aneurysms and/or pseudoaneurysms and six patients with occlusive lesions have undergone surgical treatment. Pseudoaneurysms occurred in six patients at least twice or more. Vascular manifestations are the main predictors of mortality and morbidity in Behcet's disease. Arterial complications may lead to difficult surgical problems.Any invasive methods to arterial system may cause pseudoaneurysms. Repairs by using autogenous veins or synthetic grafts may lead to anastomotic false aneurysms. Surgical treatment should not to be applied in the acute phase of the disease and systemic therapy including colchicine, aspirin,and corticosteroids should be considered for all patients.