Direct repair of a giant extracranial vertebral artery pseudoaneurysm through the aneurysmal cavity

Spontaneous Pseudoaneurysm of the Vertebral Artery in Behçet's Disease

A pulsatile mass and severe neck pain developed suddenly in a 15-year-old female patient suffering from Behçet's disease. Magnetic resonance imaging showed a pseudoaneurysm at the C3-C4 level that was 51 x 49 x 45 mm in size, originating from the left vertebral artery, with a thin neck and thrombus inside. Repair of the vertebral artery wall by percutaneous transluminal intervention was not successful. Because of the possibility of rupture, the patient underwent surgical repair. Ligation of the left vertebral artery was applied 1 cm above the origin of the subclavian artery. During the subsequent postoperative period, no further complications were seen. From our review of the literature, this is the first reported case of surgical treatment of spontaneous development of a pseudoaneurysm at the vertebral artery in association with Behçet's disease. Ligation of the vertebral artery can be safely used to control a pseudoaneurysm related to Behçet's disease.