Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.180121
Jornal Vascular Brasileiro
Case Report

Tratamento endovascular da doença de Behçet: relato de caso

Endovascular treatment for Behçet’s disease: a case report

Sergio Quilici Belczak; Ingredy Tavares da Silva; Gustavo Garcia Marques; Letícia Flores Copetti; Vanessa Stefaniak; Gustavo Gomes Quintas; Kaique Bernardo Uchimura

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Resumo

Resumo: A doença de Behçet (DB) é uma vasculite multissistêmica de etiologia desconhecida. O acometimento cardiovascular é bem descrito na literatura, sendo que a principal causa de morte na DB é secundária a complicações aneurismáticas. Relata-se aqui o caso de um paciente portador de DB com aneurisma de aorta abdominal reincidente, o qual foi corrigido por meio de endoprótese customizada. O tratamento ideal para portadores de DB ainda é bastante controverso e desafiador, tendo em vista as dificuldades técnicas e as recidivas frequentes. A intervenção endovascular apresenta-se como uma alternativa viável e consideravelmente menos mórbida do que a cirurgia convencional.

Palavras-chave

Síndrome de Behçet, procedimentos endovasculares, stents, aneurisma

Abstract

Abstract: Behçet’s disease (BD) is a multisystemic vasculitis of unknown etiology. Cardiovascular involvement has been thoroughly described in the literature and the major cause of death in BD is secondary to aneurysm complications. In this case report, a patient with BD presented with a recurrent abdominal aortic aneurysm, which was corrected using a custom-made endoprosthesis. The optimal treatment for patients with BD remains highly controversial and challenging because of technical difficulties and frequent recurrence. Endovascular intervention seems to be a feasible alternative with considerably less morbidity than conventional surgery.
 

Keywords

Behçet syndrome, endovascular procedures, stents, aneurysm

References

Gürler A, Boyvat A, Türsen U. Clinical manifestations of Behçet’s disease: an analysis of 2147 patients. Yonsei Med J. 1997;38(6):423-7. http://dx.doi.org/10.3349/ymj.1997.38.6.423. PMid:9509912.

Park JH, Han MC, Bettmann MA. Arterial manifestations of Behçet disease. AJR Am J Roentgenol. 1984;143(4):821-5. http://dx.doi.org/10.2214/ajr.143.4.821. PMid:6332492.

Tüzün H, Beşirli K, Sayin A, et al. Management of aneurysms in Behçet’s syndrome: an analysis of 24 patients. Surgery. 1997;121(2):150-6. http://dx.doi.org/10.1016/S0039-6060(97)90284-1. PMid:9037226.

Camargo PA, Bertanha M, Moura R, et al. Correção endovascular de pseudoaneurisma toracoabdominal em paciente com Doença de Behçet. J Vasc Bras. 2015;14(4):351-5. http://dx.doi.org/10.1590/1677-5449.01115.

Belczak SQ, Aun R, Valentim L, Sincos IR, Nascimento LD, Puech-Leão P. Tratamento endovascular de aneurismas da aorta em pacientes com doença de Behçet: relato de dois casos. J Vasc Bras. 2010;9(2):89-94. http://dx.doi.org/10.1590/S1677-54492010000200014.

Chajek T, Fainaru M. Behçet’s disease. Report of 41 cases and a review of the literature. Medicine (Baltimore). 1975;54(3):179-96. http://dx.doi.org/10.1097/00005792-197505000-00001. PMid:1095889.

Kizilkilic O, Albayram S, Adaletli I, Ak H, Islak C, Kocer N. Endovascular treatment of Behçet’s disease-associated intracranial aneurysms: report of two cases and review of the literature. Neuroradiology. 2003;45(5):328-34. http://dx.doi.org/10.1007/s00234-003-0952-x. PMid:12690419.

Park JH, Chung JW, Joh JH, et al. Aortic and arterial aneurysms in behçet disease: management with stent-grafts--initial experience. Radiology. 2001;220(3):745-50. http://dx.doi.org/10.1148/radiol.2203001418. PMid:11526277.

Ko GY, Byun JY, Choi BG, Cho SH. The vascular manifestations of Behçet’s disease: angiographic and CT findings. Br J Radiol. 2000;73(876):1270-4. http://dx.doi.org/10.1259/bjr.73.876.11205670. PMid:11205670.

Kim WH, Choi D, Kim JS, Ko YG, Jang Y, Shim WH. Effectiveness and safety of endovascular aneurysm treatment in patients with vasculo-Behçet disease. J Endovasc Ther. 2009;16(5):631-6. http://dx.doi.org/10.1583/09-2812.1. PMid:19842735.

Kim SW, Lee DY, Kim MD, et al. Outcomes of endovascular treatment for aortic pseudoaneurysm in Behcet’s disease. J Vasc Surg. 2014;59(3):608-14. http://dx.doi.org/10.1016/j.jvs.2013.09.052. PMid:24246540.

Bartlett ST, McCarthy WJ 3rd, Palmer AS, Flinn WR, Bergan JJ, Yao JS. Multiple aneurysms in Behçet’s disease. Arch Surg. 1988;123(8):1004-8. http://dx.doi.org/10.1001/archsurg.1988.01400320090018. PMid:3395230.

Tohmé A, Aoun N, El-Rassi B, Ghayad E. Vascular manifestations of Behçet’s disease. Eighteen cases among 140 patients. Joint Bone Spine. 2003;70(5):384-9. PMid:14563470.

Fei Y, Li X, Lin S, et al. Major vascular involvement in Behçet’s disease: a retrospective study of 796 patients. Clin Rheumatol. 2013;32(6):845-52. http://dx.doi.org/10.1007/s10067-013-2205-7. PMid:23443336.

Kwon Koo B, Shim WH, Yoon YS, et al. Endovascular therapy combined with immunosuppressive treatment for pseudoaneurysms in patients with Behçet’s disease. J Endovasc Ther. 2003;10(1):75-80. http://dx.doi.org/10.1583/1545-1550(2003)010<0075:ETCWIT>2.0.CO;2. PMid:12751935.

Vasseur M-A, Haulon S, Beregi JP, Tourneau TL, Prat A, Warembourgh H. Endovascular treatment of abdominal aneurysmal aortitis in Behçet’s disease. J Vasc Surg. 1998;27(5):974-6. http://dx.doi.org/10.1016/S0741-5214(98)70281-2. PMid:9620153.

Sakane T, Takeno M, Suzuki N, Inaba G. Behçet’s disease. N Engl J Med. 1999;341(17):1284-91. http://dx.doi.org/10.1056/NEJM199910213411707. PMid:10528040.

Ohira S, Masuda S, Matsushita T. Nine-year experience of recurrent anastomotic pseudoaneurysms after thoracoabdominal aneurysm graft replacement in a patient with Behçet disease. Heart Lung Circ. 2014;23(10):e210-3. http://dx.doi.org/10.1016/j.hlc.2014.05.009. PMid:25017043.

Sakalihasan N, Limet R, Defawe OD. Abdominal aortic aneurysm. Lancet. 2005;365(9470):1577-89. http://dx.doi.org/10.1016/S0140-6736(05)66459-8. PMid:15866312.

Park MC, Hong BK, Kwon HM, Hong YS. Surgical outcomes and risk factors for postoperative complications in patients with Behcet’s disease. Clin Rheumatol. 2007;26(9):1475-80. http://dx.doi.org/10.1007/s10067-006-0530-9. PMid:17235654.

Dake MD, Miller DC, Semba CP, Mitchell RS, Walker PJ, Liddell RP. Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms. N Engl J Med. 1994;331(26):1729-34. http://dx.doi.org/10.1056/NEJM199412293312601. PMid:7984192.
 

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