Vascular features of Behçet syndrome

Unlike other systemic vasculitides, Behçet syndrome can simultaneously involve arteries and veins of all sizes. Vascular complications (thromboses and aneurysms) are characteristic of the syndromeBettiol, 2020.

Venous disease in Behçet syndrome is more common than arterial involvement. Any obstructive venous lesions can occur, includingYazici, 2021:

• phlebitis and thrombophlebitis, superficial and deep vein thrombosis
• hepatic vein occlusion (Budd-Chiari syndrome)
• superior or inferior vena caval occlusion
• cerebral venous sinus thrombosis—an uncommon cause of stroke associated with Behçet syndrome.

Arterial disease is most commonly a small-vessel vasculitis, but medium- and large-vessel disease may also occur (eg cerebral arteries, pulmonary arteries, aorta)Yazici, 2021. Large-vessel involvement may lead to development of aneurysms, which are life-threatening and may require surgical repair.

Cerebrovascular disease in Behçet syndrome associated with central nervous system (CNS) symptoms (eg signs of stroke) may also be classified as nonparenchymal CNS disease.