Case Report

Endovascular Repair of a Common Carotid Pseudoaneurysm in a Patient with Behçet’s Disease: A Case Report and Review of Literature


Behçet’s disease (BD) is a multisystem inflammatory disorder. Physicians should be alerted to the possibility of BD in a patient with a carotid artery pseudoaneurysm and no clear predisposing factor such as neck trauma or surgery. Endovascular repair of carotid pseudoaneurysms is technically feasible with excellent midterm follow-up results. Administration of immunosuppressive therapy before endovascular intervention is mandatory to reduce the chance of vascular complications accompanied by BD.
A 40-year-old man presented with a painful and pulsatile neck mass with 2 episodes of transient ischemic attacks. The patient also complained of recurrent urogenital ulcers and aphthous lesions together with painful rashes. Ultrasonography and computed tomography angiography revealed 2 aneurysmal dilations in the left common carotid artery at the bifurcation level. He was referred to a rheumatologist, who made the diagnosis of BD. High-dose corticosteroids and cyclophosphamide were commenced. One week later, 2 overlapping self-expanding stent grafts were deployed. The final angiogram showed no residual endoleak, and the flow of the carotid and cerebral arteries was satisfactory. The patient was discharged with no neurological complications. Follow-up ultrasonography and computed tomography angiography 6 months later showed no endoleak, as well as significant shrinkage of the aneurysm sac.

1. Alpagut U, Ugurlucan M, Dayioglu E. Major arterial involvement and review of Behcet's disease. Ann Vasc Surg 2007;21:232-239.
2. Iscan, ZH, Vural KM, Bayazit M. Compelling nature of arterial manifestations in Behcet disease. J Vasc Surg 2005;41:53-58.
3. Güneş T, Önem G, Taştan H, Alur İ. Rapidly occurring carotid artery aneurysm in a patient with Behcet disease. Ann Vasc Surg 2015;29:836.e5-8.
4. Shimizu, T. Behcet disease (Behcet syndrome). Semin Arthritis Rheum 1979;8:223-260.
5. Suzuki J, Akashi K, Shimada M, Abe S, Kawakami Y. A case of Behçet's disease with a rapidly enlarging aneurysm in the common carotid artery. Jpn J Med 1991;30:251-254.
6. Bonnotte B, Krause D, Fanton AL, Theron J, Chauffert B, Lorcerie B. False aneurysm of the internal carotid artery in Behçet's disease: successful combined endovascular treatment with stent and coils. Rheumatology (Oxford) 1999;38:576-577.
7. Kassaian SE, Abbasi K, Shirzad M, Anvari MS, Shahrzad M, Molavi B. Endovascular repair of supra-celiac and abdominal aortic pseudo aneurysms concomitant with a right atrial mass in a patient with Behçet's disease: a case report. J Teh Univ Heart Ctr 2014;9:179-182.
8. Bastounis E, Maltezos C, Giambouras S, Vayiopoulos G, Balas P. Arterial aneurysms in Behçet's disease. Int Angiol 1994;13:196-201.
9. Saadoun D, Wechsler B, Desseaux K, Le Thi Huong D, Amoura Z, Resche-Rigon M, Cacoub P. Mortality in Behçet's disease. Arthritis Rheum 2010;62:2806-2812.
10. Sener E, Bayazit M, Göl MK, Mavitas B, Tasdemir O, Bayazit K. Surgical approach to pseudoaneurysms with Behçet's disease. Thorac Cardiovasc Surg 1992;40:297-299.
11. Hosaka A, Miyata T, Shigematsu H, Shigematsu K, Okamoto H, Ishii S, Miyahara T, Yamamoto K, Akagi D, Nagayoshi M, Nagawa H. Long-term outcome after surgical treatment of arterial lesions in Behçet disease. J Vasc Surg 2005;42:116-121.
12. Desbois AC, Wechsler B, Resche-Rigon M, Piette JC, Huong Dle T, Amoura Z, Koskas F, Desseaux K, Cacoub P, Saadoun D. Immunosuppressants reduce venous thrombosis relapse in Behçet's disease. Arthritis Rheum 2012;64:2753-2760.
13. Vasseur MA, Haulon S, Beregi JP, Le Tourneau T, Prat A, Warembourgh H. Endovascular treatment of abdominal aneurysmal aortitis in Behçet's disease. J Vasc Surg 1998;27:974-976.
14. Park JH, Chung JW, Joh JH, Song SY, Shin SJ, Chung KS, Lee DY, Won JY, Kim SJ. Aortic and arterial aneurysms in behçet disease: management with stent-grafts--initial experience. Radiology 2001;220:745-750.
15. Liu CW, Ye W, Liu B, Zeng R, Wu W, Dake MD. Endovascular treatment of aortic pseudoaneurysm in Behçet disease. J Vasc Surg 2009;50:1025-1030.
IssueVol 15 No 3 (2020): J Teh Univ Heart Ctr QRcode
SectionCase Report(s)
Carotid arteries Aneurysm; false Behcet syndrome Stents

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Kassaian SE, Molavi B, Abbasi K, Sadeghian M, Yazdani S. Endovascular Repair of a Common Carotid Pseudoaneurysm in a Patient with Behçet’s Disease: A Case Report and Review of Literature. J Tehran Heart Cent. 15(3):131-135.