ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Femoral Pseudoaneurysm in Behçet’s Disease
Öztekin OTO, Hüdai ÇATALYÜREK, Hüseyin OKUTAN, Egemen TÜZÜN, Eyüp HAZAN, Ünal AÇIKEL, Nejat SARIOSMANOĞLU, Erdem SİLİSTRELİ
Dokuz Eylül Üniversitesi Tıp Fakültesi, Göğüs, Kalp ve Damar Cerrahisi Anabilim Dalı, İzmir

Behçet’s disease is a multisystem inflammatory chronic disorder. An autoimmune etiology is suggested. The disease generally begins in the 3rd decade. Up to 24 percent of patients with Behçet’s disease have been reported to suffer at some time from vascular complications. The arterial system is rarely affected. Complications which have been reported are vasculitis, leading to arterial thrombosis and aneurysm of the aorta and less commonly a peripheral arteries. Arterial aneurysm and pseudoaneurysm formation may be rarely seen during the course of Behçet’s disease.

Arterial pseudoaneurysm’s are most commonly caused by penetrating trauma. A 42 years old male patient who suffered from pain at his swelled left leg for a week was admitted to the hospital. On physical examination left femoral region was tender and hot and the diameter up to 10 cm increased. All peripheral pulses were intact. Behçet’s disease had been diagnosed four years previously, by the help of the criteiron used for diagnosis of Behçet’s disease. He had been followed by the appearance of episodes of thrombophlebitis and deep venous thrombosis (DVT) attack, orogenital ulcers, uveitis.

In the intravenous digital substracted angiography examination, a large pseudoaneurysm of 8x10 cm was detected on the mid portion of the left femoral artery. The pseudoaneurysm was excised with the adjacent granulotions. A 14 cm length Gore-Tex® 8 mm tubular graft was interposed for arterial reconstruction. Pathological examination of the excised pseudoaneurysm showed organazing thrombus and no spesific changes.

There were no problems at the postoperative course, the peripheral pulses were intact and the graft was patent on IV DSA examination and MR Arterial complications in Behçet’s disease present difficult surgical problems. Repairs, whether using autogenous vein or synthetic graft, nearly always result in anastomotic false aneurysm formation. Because of the past history of superficial thrombophlebitis involving the leg veins, the use of a synthetic graft was prefered to autogenous vein.

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