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Endovascular treatment of intracranial infectious aneurysms

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

Intracranial infectious aneurysm (IIA) accounts for less than 5 % of all intracranial aneurysms. The aim of this study was to evaluate the role of endovascular treatment for IIA.

Methods

During a 14-year period, 15 patients (age range, 2–68 years; mean, 42.8 years) with 17 aneurysms were diagnosed with IIA and treated via an endovascular route at our institution. The IIA diagnosis was based on clinical and laboratory findings of infection, echocardiography results, and digital subtraction angiography that were collected retrospectively. All patients were clinically and radiologically followed. The modified Rankin scale was used to evaluate clinical outcome.

Results

Among 15 patients, 12 presented with ruptured aneurysms (7 intraparenchymal hematoma, 4 subarachnoid hemorrhage, 1 subdural hematoma), 2 with cerebral infarcts, and 1 with pansinusitis and epidural abscess. All but one aneurysm were distally located in intracranial circulation, 14 were in anterior, and the remaining 3 were in posterior circulation. The final diagnosis was based on aneurysm morphology, location, and clinical laboratory findings. Endovascular treatment was scheduled initially for all IIAs; 13 of 17 IIAs underwent endovascular parent vessel occlusion, 3 underwent spontaneous parent vessel occlusion while waiting for intervention, and the remaining patient was treated by intrasaccular coil occlusion. There were no instances of perioperative neurological complications. Late clinical and radiological outcomes included absence of endovascular treatment related to mortality and aneurysm recurrence.

Conclusion

Endovascular treatment may be performed safely at the time of diagnosis for at least symptomatic IIAs under the protective effect of antibiotic treatment.

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Authors and Affiliations

  1. Trakya University Medical Faculty, Department of Radiology, Division of Interventional Radiology, 22030, Edirne, Turkey

    Asim Esenkaya

  2. Celal Bayar University Medical Faculty, Department of Radiology, Manisa, Turkey

    Fatih Duzgun

  3. Ege University Medical Faculty, Department of Radiology, Division of Interventional Radiology, Izmir, Turkey

    Celal Cinar, Halil Bozkaya & Ismail Oran

  4. Ege University Medical Faculty, Department of Radiology, Division of Neuroadiology, Izmir, Turkey

    Cenk Eraslan

  5. Ege University Medical Faculty, Department of Neurosurgery, Izmir, Turkey

    Erkin Ozgiray

Authors
  1. Asim Esenkaya
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  2. Fatih Duzgun
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  3. Celal Cinar
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  4. Halil Bozkaya
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  5. Cenk Eraslan
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  6. Erkin Ozgiray
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  7. Ismail Oran
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Corresponding author

Correspondence to Asim Esenkaya.

Ethics declarations

We declare that all human and animal studies have been approved by the Ege University Institutional Ethical Committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study

Conflict of interest

We declare that we have no conflict of interest.

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Esenkaya, A., Duzgun, F., Cinar, C. et al. Endovascular treatment of intracranial infectious aneurysms. Neuroradiology 58, 277–284 (2016). https://doi.org/10.1007/s00234-015-1633-2

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  • DOI: https://doi.org/10.1007/s00234-015-1633-2

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