Impending rupture in the apparent healing phase after chimney endovascular aneurysm repair for a Bacillus Calmette-Guérin-related paravisceral infective aortic aneurysm

<h2>Abstract</h2> We describe a 75-year-old man with a paravisceral infective native aortic aneurysm secondary to intravesical Bacillus Calmette–Guérin (BCG) therapy for bladder cancer. He initially underwent chimney endovascular aneurysm repair without antituberculosis therapy. After referral to our hospital, <i>Mycobacterium bovis</i> was isolated from retroperitoneal abscess and antituberculosis multidrug therapy was started. Despite clinical improvement and radiological appearance of abscess liquefaction, computed tomography at 3 months demonstrated endograft migration and rapid enlargement of the aneurysm. Emergent total radical excision of infected paravisceral aorta, all endografts and retroperitoneal abscess was performed with extra-anatomical revascularization, with no evidence of reinfection to date.