Endovascular repair with a physician-modified fenestrated endograft to treat abdominal aortic pseudoaneurysm with Behcet’s disease: a case report
Abstract Background Aortic involvement in patients with Behcet’s disease (BD) is rare, but it is one of the most severe manifestations. Open surgical repair of aortic aneurysm is challenging considering the high risk of postoperative recurrent anastomotic pseudoaneurysms and is associated with a muc...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-024-02523-2 |
| _version_ | 1827326238656561152 |
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| author | Wenzhuo Lian Xitao Song Liqiang Cui Yuehong Zheng Changwei Liu Leng Ni |
| author_facet | Wenzhuo Lian Xitao Song Liqiang Cui Yuehong Zheng Changwei Liu Leng Ni |
| author_sort | Wenzhuo Lian |
| collection | DOAJ |
| description | Abstract Background Aortic involvement in patients with Behcet’s disease (BD) is rare, but it is one of the most severe manifestations. Open surgical repair of aortic aneurysm is challenging considering the high risk of postoperative recurrent anastomotic pseudoaneurysms and is associated with a much higher mortality rate. Recently, endovascular treatment has proven to be a feasible, less invasive alternative to surgery for these patients. Case presentation We report a total endovascular repair of a paravisceral abdominal aortic pseudoaneurysm in a 25-year-old male patient with BD. The pseudoaneurysm was successfully excluded, and the blood supply of visceral arteries was preserved with a physician-modified three-fenestration endograft under 3D image fusion guidance. Immunosuppressive therapy was continued for 1 year postoperatively. At 18 months, the patient was asymptomatic without abdominal pain. Computed tomography angiography demonstrated the absence of pseudoaneurysm recurrence, good patency of visceral vessels. Discussion and conclusions Endovascular repair using physician-modified fenestrated endografts is a relatively safe and effective approach for treating paravisceral aortic pseudoaneurysm in BD patients. This technique enables the preservation of the visceral arteries and prevents aneurysm recurrence at the proximal and distal landing zones, which are common complications of open surgical repair in these patients. Furthermore, we emphasize the importance of adequate immunosuppressive therapy before and after surgical repair in BD patients, which is a major risk factor for recurrence and poor prognosis. |
| first_indexed | 2024-03-07T14:41:39Z |
| format | Article |
| id | doaj.art-5711bdc4ace147f79519fdebebaa045f |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-03-07T14:41:39Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-5711bdc4ace147f79519fdebebaa045f2024-03-05T20:18:50ZengBMCJournal of Cardiothoracic Surgery1749-80902024-02-011911610.1186/s13019-024-02523-2Endovascular repair with a physician-modified fenestrated endograft to treat abdominal aortic pseudoaneurysm with Behcet’s disease: a case reportWenzhuo Lian0Xitao Song1Liqiang Cui2Yuehong Zheng3Changwei Liu4Leng Ni5Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Background Aortic involvement in patients with Behcet’s disease (BD) is rare, but it is one of the most severe manifestations. Open surgical repair of aortic aneurysm is challenging considering the high risk of postoperative recurrent anastomotic pseudoaneurysms and is associated with a much higher mortality rate. Recently, endovascular treatment has proven to be a feasible, less invasive alternative to surgery for these patients. Case presentation We report a total endovascular repair of a paravisceral abdominal aortic pseudoaneurysm in a 25-year-old male patient with BD. The pseudoaneurysm was successfully excluded, and the blood supply of visceral arteries was preserved with a physician-modified three-fenestration endograft under 3D image fusion guidance. Immunosuppressive therapy was continued for 1 year postoperatively. At 18 months, the patient was asymptomatic without abdominal pain. Computed tomography angiography demonstrated the absence of pseudoaneurysm recurrence, good patency of visceral vessels. Discussion and conclusions Endovascular repair using physician-modified fenestrated endografts is a relatively safe and effective approach for treating paravisceral aortic pseudoaneurysm in BD patients. This technique enables the preservation of the visceral arteries and prevents aneurysm recurrence at the proximal and distal landing zones, which are common complications of open surgical repair in these patients. Furthermore, we emphasize the importance of adequate immunosuppressive therapy before and after surgical repair in BD patients, which is a major risk factor for recurrence and poor prognosis.https://doi.org/10.1186/s13019-024-02523-2Abdominal aortic aneurysmBehcet’s diseaseEndovascular aneurysm repairPhysician-modified fenestrated endograft3D image fusion guidance |
| spellingShingle | Wenzhuo Lian Xitao Song Liqiang Cui Yuehong Zheng Changwei Liu Leng Ni Endovascular repair with a physician-modified fenestrated endograft to treat abdominal aortic pseudoaneurysm with Behcet’s disease: a case report Journal of Cardiothoracic Surgery Abdominal aortic aneurysm Behcet’s disease Endovascular aneurysm repair Physician-modified fenestrated endograft 3D image fusion guidance |
| title | Endovascular repair with a physician-modified fenestrated endograft to treat abdominal aortic pseudoaneurysm with Behcet’s disease: a case report |
| title_full | Endovascular repair with a physician-modified fenestrated endograft to treat abdominal aortic pseudoaneurysm with Behcet’s disease: a case report |
| title_fullStr | Endovascular repair with a physician-modified fenestrated endograft to treat abdominal aortic pseudoaneurysm with Behcet’s disease: a case report |
| title_full_unstemmed | Endovascular repair with a physician-modified fenestrated endograft to treat abdominal aortic pseudoaneurysm with Behcet’s disease: a case report |
| title_short | Endovascular repair with a physician-modified fenestrated endograft to treat abdominal aortic pseudoaneurysm with Behcet’s disease: a case report |
| title_sort | endovascular repair with a physician modified fenestrated endograft to treat abdominal aortic pseudoaneurysm with behcet s disease a case report |
| topic | Abdominal aortic aneurysm Behcet’s disease Endovascular aneurysm repair Physician-modified fenestrated endograft 3D image fusion guidance |
| url | https://doi.org/10.1186/s13019-024-02523-2 |
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