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1 Author's response to reviews Title: Endovascular treatment of huge saccular abdominal aortic aneurysm in a young Behcet patient: mid-term result Authors: Ramazan Kutlu (rkutlu@inonu.edu.tr) Riza Turkoz (rturkoz@yahoo.com) Ahmet Akbulut (ahmeta@inonu.edu.tr) Oner Gulcan (alara@ttnet.net.tr) Tamer Baysal (tbaysal@inonu.edu.tr) Version: 3 Date: 2 Mar 2002 PDF covering letter

2 Dear Editor, We made the following changes to our manuscript. Thank you for consideration of our manuscript. We look forward to hearing from you soon, Sincerely yours, Ramazan Kutlu, MD 1. Our department s phone and fax numbers are changed and the new numbers are given [Phone: (Extn: 5703), Fax: (Attn: Dr. Ramazan Kutlu)]. 2. Third author (Ahmet Akbulut, MD) has a new position in the Malatya State Hospital and his institution is changed. He has a new (ahmeta@inonu.edu.tr) and this was corrected. 3. Title of the manuscript is changed according to the reviewer s advice to ENDOVASCULAR TREATMENT OF HUGE SACCULAR ABDOMINAL AORTIC ANEURYSM IN A YOUNG BEHCET PATIENT: MID-TERM RESULT. 4. Abstract was structured. 5. Third sentence of abstract is changed to A case of huge saccular abdominal aortic aneurysm in a young Behcet patient who was successfully treated with endovascular stent graft placement is reported, diagnostic and interventional procedures are discussed, and mid-term follow-up results are presented.. 6. A conclusions section was added ( Endovascular treatment of abdominal aortic aneurysm complications of young Behcet patients who are not suitable for open surgery and need intervention could be an alternative treatment modality even without performing preprocedural angiography. ) 7. The last sentence of the Background section is deleted according to the advice of Prof Claude Juhan. 8. We have no competing interests and the sentence Competing interests: None declared was added. 9. The sentence According to our literature search this is the first successfully treated huge saccular abdominal aortic aneurysm in Behcet disease. in the abstract section is removed. 10. More specific new references (9 th reference [Blankensteijn JD. Mortality and morbidity rates after conventional abdominal aortic aneurysm repair. Semin Interv Cardiol 2000: 5:7-13] and 10 th reference [Cruz CP, Drouilhet JC, Southern FN, Eidt JF, Barnes RW, Moursi MM. Abdominal aortic aneurysm repair. Vasc Surg 2001: 35:335-44]) about the mortality rate of AAA open surgery are added. The sentence There are reports of mortality rates of between % for open surgery (9, 10). in discussion section of the version 1 is changed to Although there is disagreement in reported mortality rates for open surgery (9), there are reports of mortality rates of between 1.6 % (10) to 7,6 % (11, 12). 11. The meanings of DSA and CTA are given. 12. The heading Case Report is added between Introduction and Discussion. 13. The usage of and is revised.

3 14. Dr S Erpenbach commented in compulsory revisions section of his report as 1)p4 line 13: documentation of the measurements are very important, for that is what is new in Your preinterventional diagnostic procedures. What about Sup.Mes.Artery, patent? we think that our paragraph is sufficient enough to stress his concerns [ One of the crucial points of endovascular treatment of aneurysms is accurate and precise measurement of aneurysm. Although CT is highly effective, most of the vascular radiologists still would like to have preprocedural angiography. But in Behcet disease vessel wall vulnerability is extremely high and even minor lesions resulting from diagnostic procedures (e.g. intraarterial angiography etc.) could lead to the formation of aneurysms at the puncture site (13). Due to the fragility of the aneurysm inherent in Behcet patients and the size of aneurysm, we did not perform diagnostic angiography. All measurements based on CT images and 3D reconstructions helped us to better understand and characterize the neck, dimensions and relations of the aneurysm to other arteries. ] Also for the specific question about patency of Superior Mesenteric Artery, it was patent (Figure 5E). For the clarification, we changed the sentence All the measurements made by using abdominal CT and CTA images. in Case Report section of our manuscript to All the measurements made by using abdominal CT and CTA images that revealed favorable lengths and diameters for endovascular treatment. 15. Manufacturer of stent graft was added (Stenford Grouppe Valendons fa Nanterre, France). 16. The patient diagnosed as having AAA on July 12, Patient had some medical insurance problems that were solved in three weeks. The interval between order and arrival of the stent graft was 10 days. So the procedure was performed on August 10, Patient was hospitalized and closely observed between diagnosis and treatment period. We thought that this information would be redundant and thus we did not mentioned in the manuscript. But if it is necessary, we can add this information. 17. The material and manufacturer of Dacron graft (Hemashield, Meadox) is added. 18. Patient was discharged with steroid therapy and this information is added. 19. We added a new reference (13) and discussed why we did not perform preinterventional angiography. 20. Patient s name and surname were erased from the figures. New versions of figures were uploaded. 1 'Author details' form - Author list matches that on the manuscript 2 'Author details' form - each author has a different address 3 'Manuscript details' form - Title of manuscript correct matches that on the manuscript 4 'Manuscript details' form - Abstract matches that on the manuscript Title page of manuscript: **************************** 5 Please check the form of your manuscript title. Titles should be as concise and informative as possible. Ideally they should include the type of intervention, the condition or type of particpants or subjects, and the methodology, as in the following examples: A versus B in the treatment of C: a randomized controlled trial. Or: X in the aetiology of Y: a case control study.

4 6 Authors' affiliations provided in the following format: Department, Institute, City, Country 7 Each affiliation is linked to an author 8 All authors linked to their corresponding affiliation(s) using superscript numerals 9 One corresponding author should be indicated 10 All unnecessary capitals should be removed from title Manuscript sections: ************************ 11 We strongly suggest that your abstract is no longer than 250 words, as PubMed will truncate the record at 250 words 12 Abstracts should not cite references 13 Abstracts must be structured into Background, Methods, Results, Conclusions 14 Manuscript sections should include (in the following order): Abstract, Background, Methods, Results, Discussion, Conclusions, Acknowledgements, Competing Interests, References, Figure legends, Tables (if any), Description of Additional files (if any) 15 Please note: Figures must be uploaded as separate files (see below) 16 All unnecessary capitals should be removed from sections headings Competing interests: *********************** 17 We will require you to include a Competing Interests section in your manuscript; please consider the following points, write a declaration, and include it as a separate section of your manuscript located before the References. In the context of medical research, a competing interest exists when your interpretation of data or presentation of information could possibly be influenced by non-scientific considerations. Such considerations may include financial gain or strongly held religious or political beliefs, although we do not insist that you declare anything other than financial interests here. If you are able to say 'no' to all these questions, your declaration should read 'none declared'. Have you in the past five years received reimbursements, fees, funding, or salary from an organisation that may in any way gain or lose financially from the publication of this paper? Do you hold any stocks or shares in an organisation that may in any way gain or lose financially from the publication of this paper? Do you have any other financial competing interests? Are there any non-financial competing interests you would like to declare in relation to this paper? References: ************* 18 References must be cited in text using consecutive numbers in square brackets

5 19 Reference list should be provided in BioMed Central style - example journal reference: 1. P Chomczynski, Sacchi N: Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol-chloroform extraction. Anal Biochem 1987, 162: Figures: ********* 20 Each figure must be provided as a separate file using the 'Figure files' buttons in the 'upload' page in web submissoin, not as part of the main manuscript document 21 The image file should not include the legend (eg Figure 1...etc), which should be part of the main manuscript after the References 22 Figures must be closely cropped, so only a small white border appears around the actual image 23 Figures must be uploaded to the site in the order in which they are to appear 24 Please use the 'preview' button on the 'upload' page in web submission to examine the quality of your images, as these previews will be identical to the final version we publish on the web - - if you do not check your preview we cannot guarantee to make changes to the figures at a later date. If your figures are appearing badly in preview please contact editorial@biomedcentral.com Tables: ******** 25 Tables less than one side of A4 can appear within the body of the article; if you wish them to do so they must be included at the end of your main manuscript document 26 Tables larger than this, or those that you do not wish to appear in the body of the article should be uploaded as additional files 27 The borders of Tables included as part of the main manuscript must be visible black lines. Tables must be divided into cells / fields. Tables generated with tabbed text are not acceptable Additional Files: ****************** 28 May consist of larger tables or other files such as movies, pdf files, etc, that are not intended to appear within the body of the article 29 Additional files must have the appropriate three letter file extension for the program you have used to generate them (eg..xls for Excel;.pdf for Acrobat files etc) 30 If you have uploaded additional files, you must include a separate section of manuscript listing: file name, file format, title of data, and short description of data 31 Additional files must be mentioned in the text, and referred to in the following way: 'see Additional file 1:[filename]...' My submission to BioMed Central conforms to this checklist. Name: Ramazan Kutlu, MD

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