Management of Aortic Aneurysms Associated with Behçet Disease: A Single-Center Experience with Endovascular Repair.

Purpose: Behçet disease can cause aortitis and aortic aneurysms. Although open surgery has been a standard treatment, endovascular repair may be beneficial when combined with immunosuppressive therapies. This study assessed the outcome of endovascular stent-graft placement with adjuvant immunosuppressive therapy in aortic aneurysms and pseudoaneurysms associated with Behçet disease. Materials and Methods: Nine patients with Behçet disease were diagnosed with 10 aortic aneurysms between February 2018 and August 2023. Immunosuppressive medication was administered to all patients prior to intervention to achieve remission. We reviewed procedural details and follow-up imaging to assess technical success, complications, and reinterventions. After discharge, patients received routine follow-up at 3-month intervals. Results: All patients were male, with a mean age of 42.1 years. Tube stent-grafts were used in all patients; one patient additionally underwent endovascular aneurysm repair with a bifurcated graft. Three patients underwent debranching procedures prior to endovascular stent-graft placement. Technical success was achieved in all procedures. During follow-up, two patients died (one on postoperative day 6 due to myocardial infarction and another on postoperative day 40 due to mediastinitis). Two patients developed access-site pseudoaneurysms, and one patient required secondary intervention for stent-graft migration with a type Ib endoleak. No graft infection, sac expansion, or attachment-site pseudoaneurysm was identified. Conclusion: In patients with Behçet disease, endovascular stent-graft repair combined with immunosuppressive therapy appears to be safe and effective treatments for aortic aneurysms or pseudoaneurysms.