# Successful complex endovascular treatment of a contained rupture of a thoracoabdominal aortic aneurysm caused by Mycobacterium bovis after intravesical Bacillus Calmette-Guerin immunotherapy for bladder cancer

## TL;DR

A man developed an infected aortic aneurysm after bladder cancer treatment, successfully treated with a specialized endovascular graft.

## Contribution

This is the first reported case of an infected native aortic aneurysm treated with an inner branched endograft.

## Key findings

- Endovascular repair with an inner branched endograft successfully managed a contained rupture of a thoracoabdominal aortic aneurysm.
- Mycobacterium bovis was identified as the cause of infection following Bacillus Calmette-Guérin therapy for bladder cancer.
- The case suggests endovascular repair is a feasible option for high-risk patients with infected aortic aneurysms.

## Abstract

A 71-year-old man underwent urgent endovascular repair using an inner branched endograft for a contained rupture of the visceral aorta. The patient initially improved, but later deteriorated. Positron emission tomography with computed tomography 9 months after surgery revealed perigraft inflammation. Mycobacterium bovis Bacillus Calmette-Guérin was identified from a hematoma puncture. He had undergone intravesical Bacillus Calmette-Guérin therapy 16 months earlier for bladder cancer. This led to an infected native aortic aneurysm. To our knowledge, this is the first reported case of infected native aortic aneurysm treated with an inner branched endograft. This case highlights the diagnostic challenges and suggests endovascular repair as a feasible option in selected high-risk patients.