Reoperation results of arterial involvement in Behcet's disease

Objectives: to retrospectively evaluate the role of vascular interventions in Behcet's disease with arterial involvement. So far, little information i s available on the surgical approach for arterial involvement in Behcet's d isease. Material and methods: between February 1989 and August 1997, among 178 pati ents with Behcet's disease referred to our clinic, vascular involvement was established in total of 67 patients (38%) which consisted of 59 venous (33 %) and 12 (7%) arterial involvements requiring urgent surgical intervention . Primary arterial lesions were occlusive in one patient, aneurysm formatio n in nine or both; in four. Results: twelve primary operations and 12 reoperations were performed. The reasons for reoperations were anastomotic aneurysms, graft occlusion, occlu sion of native vessel, graft infection, bleeding from anastomosis and aorto enteric fistula. First reoperation was performed after a mean period of 6.4 months (1-15 months). Postoperative follow-up was 12-60 months (mean 36 mo nths) and three patients died during follow-up. Conclusions: the surgical results were not satisfactory because of progress ive graft thrombosis and formation of new aneurysms at the anastomosis. Agg ressive medical treatment should be combined when major vessel involvement occurs. All types of arterial punctures for angiography or blood gases shou ld be minimised because of the risk of new aneurysm formation. Surgical int ervention is indicated only in patients with a growing aneurysm, acute rupt ure or severe ischaemia.