{
  "abstract": "Background: Behçet's syndrome with femoral artery pseudoaneurysm (BS–FAP) is exceedingly rare, and its long-term postoperative recurrence profile remains undefined. We aimed to ascertain event-free survival (EFS) and examine associations of immunosuppressive adherence and five inflammatory biomarkers ( N LR, PLR, SII, SIRI, IBI) with relapse. External validation was performed via systematic review and individual patient data (IPD) meta-analysis.\n\nMethods: This retrospective study included 13 BS–FAP patients who underwent femoral artery surgery at Peking Union Medical College Hospital (2002–2022). The primary endpoint was EFS, a composite of same-site recurrence, de novo aneurysm, re-intervention, death, or amputation. Five inflammatory indices were derived from preoperative blood counts. EFS was estimated using Kaplan–Meier with log-rank comparisons. A systematic literature search was conducted for descriptive IPD meta-analysis.\n\nResults: The cohort (median age 34 years, 85% male) underwent endovascular ( n = 6), open ( n = 6), or hybrid ( n = 1) repair. Median follow-up was 60 months (all ≥36 months). Five-year EFS was 69.2% in primary analysis and 76.9% in sensitivity analysis. Endovascular and open approaches showed comparable EFS ( p = 0.992). Elevated NLR, PLR, SIRI, and IBI were associated with lower 5-year EFS (50.0% vs. 85.7%), with SIRI showing the strongest trend ( p = 0.131); SII ( p = 0.787) and ESR ( p = 0.994) showed no trend. Three patients (23.1%) developed de novo aneurysms beyond 5 years, all after immunosuppressive discontinuation. In a supplementary four-level adherence analysis, no patient was fully adherent perioperatively; preoperative-only use ( n = 2) showed the highest disease-specific 5-year EFS (100%). The cohort showed mucocutaneous predominance (oral ulcers 92.3%) and venous involvement in 38.5%. IPD meta-analysis (40 individual cases + 12 series) confirmed a temporal mortality decline from 26%–40% (early open) to 0%–5.8% (contemporary endovascular). Published case reports (median follow-up 6 months) reported 11% recurrence, vs. 31% in our 60-month cohort, confirming systematic underestimation.\n\nConclusion: The recurrence burden after BS–FAP surgery is systematically underestimated in short-follow-up literature; surveillance should extend beyond 5 years. Immunosuppressive adherence is a modifiable target for recurrence control. SIRI emerges as the most promising biomarker for risk stratification. Endovascular and open repair offer comparable long-term EFS. This exploratory study supports a comprehensive pathway of “surgical intervention—uninterrupted immunosuppression—extended surveillance,” with adherence incorporated into quality metrics.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , ,"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yanfei Yang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yuexin Chen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4wcv99kn61b5b.bib",
  "cited_by": 0,
  "doi": "10.3389/fcvm.2026.1942219",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672031/?tool=EBI",
  "id": "4wcv99kn61b5b",
  "issns": [
    "2297-055X"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13672031",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2731|Ocular Diseases and Behçet’s Syndrome"
    ]
  ],
  "openalex": "W7215076105",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672031/pdf/?tool=EBI",
  "pmcid": "PMC13672031",
  "pmid": null,
  "published": "2026-10-02",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/4wcv99kn61b5b.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:25Z",
      "native_id": "PMC:PMC13672031",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13672031"
    },
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "10.3389/fcvm.2026.1942219",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fcvm.2026.1942219/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2297-055X",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Femoral artery pseudoaneurysm in Behçet's syndrome: long-term outcomes and associated factors",
  "title_text": "Femoral artery pseudoaneurysm in Behçet's syndrome: long-term outcomes and associated factors",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:10Z",
  "url": "https://research.draconitic.com/paper/4wcv99kn61b5b",
  "venue": "Frontiers in cardiovascular medicine",
  "versions": []
}