Thoracic Endovascular Aortic Repair for Mycotic Thoracic Aortic Aneurysm After BCG Intravesical Therapy

Bacille Calmette-Guérin( BCG) intravesical therapy is an effective and safe treatment for bladder cancer; however, mycotic aneurysms have been reported as a rare complication. Case 1:A 64-year-old man with a history of BCG intravesical therapy underwent emergent thoracic endovascular aortic repair (...

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Bibliographic Details
Published inKyobu geka. The Japanese journal of thoracic surgery Vol. 76; no. 13; p. 1083
Main Authors Obi, Hayato, Nagao, Kanetsugu, Aoki, Masaya, Nagura, Saori, Yamashita, Shigeyuki, Doi, Toshio, Yamashita, Akio, Fukahara, Kazuaki, Yoshimura, Naoki, Kotoh, Keiju
Format Journal Article
LanguageJapanese
Published Japan 01.12.2023
Subjects
Aged
Aneurysm, Infected - diagnostic imaging
Aneurysm, Infected - etiology
Aneurysm, Infected - surgery
Aortic Aneurysm, Thoracic - diagnostic imaging
Aortic Aneurysm, Thoracic - etiology
Aortic Aneurysm, Thoracic - surgery
BCG Vaccine - adverse effects
Blood Vessel Prosthesis Implantation
Endovascular Aneurysm Repair
Endovascular Procedures
Humans
Male
Middle Aged
Treatment Outcome
Urinary Bladder Neoplasms - drug therapy
Urinary Bladder Neoplasms - surgery
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Summary:Bacille Calmette-Guérin( BCG) intravesical therapy is an effective and safe treatment for bladder cancer; however, mycotic aneurysms have been reported as a rare complication. Case 1:A 64-year-old man with a history of BCG intravesical therapy underwent emergent thoracic endovascular aortic repair (TEVAR) for a ruptured thoracic aortic aneurysm (TAA). He was diagnosed with BCG infection by hemosputum specimen culture five months later;then, antituberculous therapy was initiated. However, his follow-up computed tomography scan revealed stent-graft infection and new aneurysm formation. Therefore, we performed a repeated TEVAR with abdominal 4-vessel debranching. There was no recurrence of infection for six years while continuing postoperative antituberculous therapy. Case 2:A 72-year-old man who had undergone BCG intravesical therapy underwent TEVAR for a rapidly enlarging mycotic TAA. He received anti-tuberculous therapy for one year with no recurrent infection for one year. TEVAR may be an effective alternative to the open surgical procedure;however, multidisciplinary treatment including anti-tuberculous therapy and careful long-term follow up are required.
ISSN:0021-5252