Arterial aneurysms in Behcet's disease: Three case reports

Purpose. - Results that were obtained from three patients and a literature review allow the authors to better define the place of medical and surgical treatments according to the different locations of arterial aneurysm occurring in the course of Behcet's disease. Methods. - Retrospective report of five cases of arterial aneurysm that occurred during Behcet's disease in three patients. Results. - Due to the unusual symptoms, diagnosis can be hampered. Though lesions may be observed in various areas, they were mostly aortic (two patients). Surgical revascularization was done in all three patients. It mainly involved prosthetic grafts. Two patients were subsequently treated by postoperative immunosuppressive drugs. The mean follow-up was 22 months. Relapsing aneurysm was observed in one patient, while in another patient aneurysm developed in a new location. Conclusion. - These types of arterial lesions respond poorly to medical treatment when a combination of colchicine and intermittent intravenous bolus of cyclophosphamide is used. Surgical indications should be given great yet selected weight, using prosthetic rather than venous autologous grafts (due to the risk of spontaneous venous involvement). Since either complication or recurrence is possible, prolonged monitoring is required.