Arteriocutaneous Fistula Associated with Bilateral Femoral Pseudoaneurysms Caused by Bacillus Calmette-Guerin. Apropos of a Case and Review of Literature
Por:
Torres-Blanco Á, Gómez-Palonés F and Edo-Fleta G
Publicada:
1 feb 2017
Ahead of Print:
26 nov 2016
Resumen:
Vascular complications of intravesical instillation of bacillus
Calmette-Guerin (BCG) are rare. BCG is an attenuated strain of
Mycobacterium bovis that was initially developed for vaccination against
tuberculosis, but it has also been used as an adjuvant treatment for
bladder transitional carcinoma. We report a patient with a history of
instillation of BCG 2 years before, who underwent surgical treatment of
2 pseudoaneurysms. The first, located in the left superficial femoral
artery (SFA), was resected, and the artery was ligated because he had a
history of femoropopliteal occlusion. After 4 weeks, he presented
another one associated with hemorrhage by cutaneous fistula, in the
right common femoral artery. In this case, revascularization was
performed by means a common-to-deep femoral artery bypass with
polytetrafluorethylene graft and reimplantation of SFA. Initially,
bacterial cultures were negative, but bacilli cultures identified M.
bovis after 3 weeks. Antituberculosis therapy was administered. After 13
months, the patient was asymptomatic and duplex ultrasound showed no
signs of recurrent infection. This exposure should be considered if
presentation of the false aneurysm is spontaneous and there is a history
of bladder carcinoma.
Filiaciones:
:
Department of Angiology, Endovascular and Vascular Surgery, Hospital Universitario Dr. Peset, Valencia, Spain.
:
Department of Angiology, Endovascular and Vascular Surgery, Hospital Universitario Dr. Peset, Valencia, Spain
:
Department of Angiology, Endovascular and Vascular Surgery, Hospital Universitario Dr. Peset, Valencia, Spain
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