Multiple Recurrent Pseudoaneurysms after Endovascular Repair of Abdominal Aortic Aneurysm in a Patient with Behçet’s Disease

Yohei Yamamoto; Yoshinori Inoue; Tsuyoshi Ichinose; Masato Nishizawa; Kimihiro Igari; Takahiro Toyofuku; Toshifumi Kudo

doi:10.5761/atcs.cr.17-00081

Case Reports

Multiple Recurrent Pseudoaneurysms after Endovascular Repair of Abdominal Aortic Aneurysm in a Patient with Behçet’s Disease

Yohei Yamamoto, Yoshinori Inoue, Tsuyoshi Ichinose, Masato Nishizawa, Kimihiro Igari, Takahiro Toyofuku, Toshifumi Kudo

Author information

Yohei Yamamoto
Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
Yoshinori Inoue
Ambulatory Vascular Surgical Clinic Tokyo, Tokyo, Japan
Tsuyoshi Ichinose
Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
Masato Nishizawa
Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
Kimihiro Igari
Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
Takahiro Toyofuku
Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
Toshifumi Kudo
Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan

Keywords: Behçet’s disease, pseudoaneurysm, endovascular aneurysm repair, chimney technique, immunosuppressive therapy

JOURNAL FREE ACCESS

2018 Volume 24 Issue 6 Pages 315-319

DOI https://doi.org/10.5761/atcs.cr.17-00081

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Abstract

In Behçet’s disease (BD) patients, endovascular repair is a reasonable alternative treatment for aortic aneurysms to avoid postoperative anastomotic pseudoaneurysms. However, there are some complications that may occur after endovascular repair. We herein report the case of a 40-year-old man with active BD developed recurrent aortic pseudoaneurysms at the proximal and distal margins of the stent graft and a femoral puncture site pseudoaneurysm 3 months after endovascular abdominal aortic aneurysm (AAA) repair. The aortic pseudoaneurysms were treated endovascularly, including the use of the chimney technique for the proximal pseudoaneurysm close to the renal arteries and the femoral pseudoaneurysm with surgical excision and reconstruction. Intensive immunosuppressive therapy was initiated immediately after the operation. The patient is in good condition without any complications at 8-month follow-up. This case suggests the utility of the chimney technique and postoperative immediate intensive immunosuppressive therapy in treating recurrent aortic pseudoaneurysms in emergency, active BD patients.

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