The thrombosis of a 13 years old aneurysmal arteriovenous fistula.

A 46 years old female, with chronic stage renal failure for 15 years, presents to the emergency room with a thrombosis of her brachiocephalic arteriovenous fistula (functional for 13 years). The cephalic vein was aneurismal (6cm diameter) and the brachial artery was not dilated. After proximal and distal control of the brachial artery and the proximal cephalic vein, the aneurismal arteriovenous fistula was excise, the cephalic vein was ligatured, and the brachial artery was repaired with an end to end anastomosis.

[False aneurysm of the internal iliac artery in Behçet's disease]. / Faux anévrisme de l'artère iliaque interne au cours de l'évolution d'une maladie de Behçet.

OBJECTIVES: This case illustrates a very rare localization of false aneurysm in Behçet's disease and demonstrates the importance of monitoring treated patients. CASE REPORT: The diagnosis of severe Behçet's disease was established in a young man after discovery of a cerebral venous thrombosis. One year later, the patient required emergency surgery for a symptomatic pseudoaneurysm of the internal iliac artery. RESULTS: Performed after a 3-day regimen of corticosteroid boluses, the pseudoaneurysm was treated by ligation of the hypogastric artery. Corticosteroids were then given for immunosuppression. DISCUSSION: Arterial involvement in Behçet's disease can be at the forefront of the clinical features and can cause potentially fatal complications. False aneurysm of the internal iliac artery is exceptional with only two cases reported in the literature. These false aneurysms occur on a fragile artery wall. Treatment requires the administration of immunosuppressive drugs. CONCLUSION: This rare clinical presentation highlights the importance of clinical and radiological monitoring in young patients with Behçet's disease.