In addition to generalized arteriosclerosis, connective tissue diseases, systemic necrotic arteritis, large-vessel vasculitis, and genetic metabolic diseases have been described as the cause of stenotic and aneurysmal vessel wall alterations. Although unusual, these must be considered in the diagnosis of a generalized vascular disease with arterial occlusion and aneurysm formation in order to determine the appropriate treatment procedure for the individual patient. Operative treatment should be avoided as long as possible for patients with Behçet's disease or Marfan's syndrome but is indicated for any kind of juvenile arteriosclerosis combined with arterial stenosis and dilatation. The patient described in this case report could be successfully treated surgically even though the cause of juvenile arteriosclerosis was inexplicable, and the local complications accompa nying the threatening rupture of the aneurysm could be controlled.
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