Mycotic aortic aneurysms post-Intravesical BCG treatment for early-stage bladder carcinoma

Aman Wadhwani,Darshan Bakshi,Randy D Moore,Anirudh Mirakhur

doi:10.1186/s42155-018-0036-y

Aman Wadhwani, Darshan Bakshi + Show 2 more

Open Access

https://doi.org/10.1186/s42155-018-0036-y

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Journal: CVIR Endovascular	Publication Date: Aug 22, 2018
Citations: 17	License type: open-access

Affiliation: University of Calgary, Foothills Medical Centre

Abstract

BackgroundIntravesicular Bacillus Calmette-Guérin (BCG) is an effective adjunctive therapy for superficial bladder cancer that has been shown to delay recurrence and progression of disease. Serious side effects are relatively rare but are difficult to diagnose and are often overlooked. Vascular complications are particularly rare.Case presentationWe report two cases of mycotic aortic aneurysms secondary to BCG treatment, one managed with endovascular stent-graft placement and the other with open surgical repair. The present understanding of disseminated BCGosis, including a literature review, will be discussed.ConclusionThe incidence of mycotic aneurysms from BCG treatment is rare and very few cases have been reported in the literature. These cases further expand the current knowledge on vascular complications related to BCG treatment. In the absence of formal guidelines, we recommend a multidisciplinary approach involving vascular surgery, diagnostic and interventional radiology, and infectious disease to manage these patients.

Highlights

Intravesicular Bacillus Calmette-Guérin (BCG) is an effective adjunctive therapy for superficial bladder cancer that has been shown to delay recurrence and progression of disease
The incidence of mycotic aneurysms from BCG treatment is rare and very few cases have been reported in the literature
These cases further expand the current knowledge on vascular complications related to BCG treatment

Summary

Conclusion

The incidence of such vascular complications from BCG treatment is rare and very few cases have been reported in the literature. As both patients had varied medical profiles, different treatment options were pursued. AM: Case write up, data analysis, image analysis, endovascular bypass grafting. Consent for publication Case reports are exempt from the purview of our institutional health research ethics board and no approval is required from the ethics board for publication. Author details 1Department of Radiology, University of Calgary, Calgary, AB, Canada.

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