Cases reported "Behcet Syndrome"

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1/9. Behcet's disease: endovascular management of a ruptured peripheral arterial aneurysm.

    Traditionally, bypass grafts are at a high risk for thrombosis or anastomotic degeneration in patients with Behcet's disease. We report the successful deployment of a vein-covered stent across the neck of a ruptured peripheral arterial aneurysm, via a remote site access, with intermediate-term follow-up. Covered stents may represent an attractive alternative to open surgical bypass for the management of aneurysms in patients with Behcet's disease.
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2/9. Coronary stent implantation in Behcet's disease.

    Behcet's disease (BD) is a systemic vasculitis that rarely involves the coronary arteries. Coronary arteritis may lead to myocardial infarction and death, and the management of coronary lesions due to BD has been described only in a small number of patients. The outcome of a young patient with BD is reported who was admitted with acute coronary syndrome and underwent balloon angioplasty and coronary stent implantation. Coronary stent implantation is an alternative treatment for coronary artery lesions of BD but careful monitoring is mandatory due to the progressive vasculities.
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3/9. Treatment of recurrent perforating intestinal ulcers with thalidomide in Behcet's disease.

    OBJECTIVE: To report the beneficial effects of thalidomide on recurrent perforating intestinal ulcers in a patient with Behcet's disease (BD). CASE SUMMARY: A 24-year-old Turkish woman with BD was admitted to our hospital because of severe abdominal pain and vomiting. She had been receiving colchicine 1.5 mg/day and azathioprine 150 mg/day for treatment of BD for 2 years. During emergency laparatomy, 2 perforating ulcers were detected in the anterior cecum, which were treated with debridement and primary repair. She experienced 2 more episodes of intestinal perforations during the second and fifth weeks despite intense immunosuppressive treatment with methylprednisolone and cyclophosphamide. New intestinal perforations were found in the posterolateral cecum and transverse colon during the second operation and in the terminal ileum during the third one. thalidomide 100 mg/day was then started, and the symptoms disappeared within 2 weeks. The woman experienced no other intestinal perforation during the follow-up period of 4 months. DISCUSSION: The mode of action of thalidomide in BD is still unclear. In BD, various cytokines have been shown to be abnormally expressed and neutrophils are overactive. This is a possible mechanism of action with thalidomide reducing both tumor necrosis factor and the neutrophil migration. CONCLUSIONS: thalidomide may be an effective alternative treatment for BD patients with recurrent and perforating intestinal ulcers despite intense immunosuppressive therapy.
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4/9. Behcet's disease: treatment of popliteal pseudoaneurysm by an endovascular stent graft implantation.

    Behcet's disease is a multisystemic chronic autoimmune process that can be responsible for some vascular lesions, in addition to its typical dermatologic lesions. Arterial pseudoaneurysm formation can be diagnosed in this group of patients and generally surgery is indicated. In this report, we discuss an alternative endovascular intervention and its advantages. An endovascular stent graft was placed in the popliteal artery pseudoaneurysm of a 37-year-old male with Behcet's disease. Early results of this procedure are good thus far. Implantation of an endovascular stent graft, an alternative modality in the treatment of pseudoaneurysms, can result in a shorter hospital stay and a significantly shorter period before returning to normal life. General anesthesia and surgical dissection are avoided, thus diminishing morbidity.
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5/9. Endovascular management of multiple arterial aneurysms in Behcet's disease.

    We report a case of Behcet's disease complicated by four arterial aneurysms successfully treated by coil embolisation and stent placement. Percutaneous endovascular repair offers a safe alternative to surgical management of this serious condition.
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6/9. Endovascular stent-grafting for recurrent aneurysm in Behcet's disease.

    Arterial aneurysms represent a severe complication of Behcet's disease. A 42-year-old woman with Behcet's disease had a recurrence of an aneurysm after two surgical repair attempts using grafts. A covered stent-graft was implanted in her iliac external artery to occlude the neck of the aneurysm at the anastomosis of the bypass graft to her external iliac artery. The procedure reduced the size of the aneurysm by allowing the formation of a thrombus within its cavity. The implantation of an endovascular stent-graft may be a sound alternative to surgical repair for aneurysms associated with Behcet's disease.
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7/9. Non-invasive assessment of bleeding pulmonary artery aneurysms due to Behcet disease.

    Because of its ability to depict intravascular, intramural, and extramural pathology, non-invasive imaging is well suited to assessing life-threatening hemoptysis that may complicate Behcet disease. We made exclusive use of CT angiography supplemented by MR to identify pulmonary thromboembolism, mediastinal lymphadenopathy, and bilateral pulmonary artery aneurysms with signs of previous unilateral rupture. Two-dimensional reformatted CT images provided surgeons with a road map of upstream and downstream vascular relationships prior to aneurysm resection. Imaging findings were confirmed by surgery and pathology. Non-invasive imaging proved to be a useful alternative to standard catheter arteriography in the preoperative assessment of hemoptysis in this patient with Behcet disease.
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8/9. Aortic stump closure with a titanium permanent clamp: a useful emergency method.

    Successful aortic stump closure in a patient with Behcet's disease was accomplished with a permanent titanium clamp. In May 1990, a saccular infrarenal abdominal aortic aneurysm was detected in this patient, and prosthetic graft replacement was carried out. One year later, this graft was removed because of perigraft fluid collection; the aortic stump was sutured closed, and a right axillobifemoral bypass was done. In November 1994, the patient was admitted to the hospital because of an aortoenteric fistula. An emergency operation was performed, and the aortic stump was managed successfully with a permanent clamp. In patients with Behcet's disease, use of a permanent clamp may offer an alternative to traditional methods for closing blown-out aortic stumps.
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9/9. Endovascular treatment of abdominal aneurysmal aortitis in Behcet's disease.

    Arterial complications of Behcet's disease are rare and affect mainly the aorta and iliac arteries. Perforation of the arterial wall is the most common lesion, predisposing to false aneurysm or rupture. Open surgical repair is difficult, and anastomotic false aneurysms often occur because of aortic wall fragility. We report here the case of using a bifurcated stent to treat aortoiliac false aneurysms in a 37-year-old patient. Endovascular repair could be an alternative treatment of aneurysmal manifestations in Behcet's disease.
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