Scholarly Journal of Surgery
Volume 1: 1
Scholarly J Surg 2016
Surgical Repair of Behçet’s Aortic Aneurysms in the Era of Endovascular Surgery
Article Information
Ahmed Mousa
1, 2*
Ibrahim Hanbal
1
Alaa Sharabi
1
Ossama M. Zakaria
2
Ahmed M. Odeh
2
Abdelfattah K. Nassar
3
Sami Abdulhakim
3
1
Department of Vascular and Endovascular Surgery, Al-Hussain University
Hospital, Faculty of Medicine for Males, Al-Azhar University, Cairo, Egypt
2
Divisions of Vascular and General Surgery, Department of Surgery, College of
Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
3
Department of Rheumatology and Rehabilitation, Al-Hussain University
Hospital, Faculty of Medicine for Males, Al-Azhar University, Cairo, Egypt
Article Type: Research
Article Number: SJS101
Received Date: 06 January, 2016
Accepted Date: 24 January, 2016
Published Date: 27 February, 2016
*Corresponding author: Dr. Ahmed Mousa, Assistant
Professor of Vascular Surgery, Department of Vascular
Surgery, Al-Hussain University Hospital, Faculty of Medicine
for Males, Al-Azhar University, Cairo, Egypt. Assistant
Professor of Vascular Surgery, Department of Surgery,
College of Medicine, King Faisal University, Al-Ahsa, Saudi
Arabia. Tel: +20 122 413 7887; +966 559904848 E-mails:
isvascular@yahoo.com & asgbi@azhar.edu.eg
Citation: Mousa A, Hanbal I, Sharabi A, Zakaria OM,
Odeh AM, et al. (2016) Surgical Repair of Behçet’s Aortic
Aneurysms in the Era of Endovascular Surgery. Scholarly J
Surg. Vol: 1, Issu: 1 (01-07).
Copyright: © 2016 Mousa A, et al. This is an open-access
article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the
original author and source are credited.
Abstract
Background: We described an operative surgical repair of abdominal
aortic aneurysms in patients with Behçet’s disease followed by the
application of an outer layer of the same used graft material wrapped
around the vascular anastomoses in combination with pre- and post-
operative immunosuppressive therapy to protect it from postoperative
pseudoaneurysm formation.
Methods: We retrospectively evaluated both the open surgical
repair of abdominal aortic aneurysms repair and immunosuppressive
medication as an adjuvant treatment in patients with Behçet’s disease,
during the period from January 2010 to December 2013. Patients’ data
were collected, and clinically evaluated. The imaging investigations,
the surgical procedure, graft selection, graft-related complications
were analyzed. Operative intervention was performed for symptomatic
patients, and patients with expanding aneurysms ≥ 5.5 cm. Those
patients who had having Behçet’s carotid aneurysms, patients with
thoraco-abdominal aortic aneurysms, patients with peripheral arterial
aneurysms and those patients with venous system involvement were
excluded from the study.
Results: Ten patients included in the study. There were 8 males and 2
females; the male-to-female ratio, (4:1) with the mean age of 34 ± 2 years
(range 25-40 years old). Nine out of 10 patients were presented with
concomitant infrarenal abdominal aortic aneurysms and bilateral iliac
artery aneurysms and the remaining patient presented with an isolated
infrarenal abdominal aortic aneurysm. Immunosuppressive therapy
was given pre- and post-operatively. Heparin-bonded synthetic Dacron
®
Y-shaped graft was used for patients with concomitant abdominal aortic
and iliac aneurysms (n=9) and tube graft was used for the isolated
infrarenal abdominal aortic aneurysm (n=1). None of the postoperative
complications were observed especially, anastomotic pseudoaneurysm,
however, no other graft-related complications were observed after 2
years of follow up.
Conclusion: Surgical repair of abdominal aortic aneurysms in
patients with Behçet’s disease using the wrapping technique at the
site of vascular anastomoses as a prophylactic measure to prevent
postoperative pseudoaneurysm formation, in combination with
immunosuppressive therapy is feasible, safe and effective technique
associated with low morbidity and mortality.
Keywords: Abdominal aortic aneurysm, Behçet’s disease, Anastomotic
pseudoaneurysm, Heparin-bonded Dacron
®
graft, Prosthetic
prophylactic wrapping, Reinforcement of vascular anastomosis.