Abstract
BACKGROUND: Behçet's disease (BD) is a systemic vasculitis, causing thoracic aortic aneurysm (TAA), which carry a high rupture risk. The management of BD-related aneurysms remains particularly challenging, and conventional endovascular approaches have been associated with a relatively high mortality rate. CASE SUMMARY: A 43-year-old woman presented with sudden back pain and was diagnosed with TAA in the setting of active BD. Immunosuppressive therapy was initiated, followed by thoracic endovascular aortic repair using a physician-modified micropore stent graft (PMSG). DISCUSSION: PMSG provides effective hemodynamic modification and minimizes complex manipulation, achieving complete aneurysm exclusion while preserving supra-aortic branch perfusion without complications. This case highlights endovascular treatment using PMSG for complex TAA can be considered a treatment option. TAKE-HOME MESSAGE: Endovascular treatment using PMSG may offer a safe, less-invasive solution for BD-related TAA requiring complex landing zone reconstruction.