Abstract
The previously commonly used term “mycotic aneurysm” is a misnomer and recently was replaced with “infectious aneurysm.” Infectious aneurysm applies to all aneurysms of infectious origin, regardless of their underlying microbial etiology.
An infectious aneurysm has its own specific pathological and radiographic features, which are discussed in detail in the chapter. The natural history and the criteria for diagnosing the infectious aneurysm are also discussed by reviewing the current literature. The principles and timing of treatment of the infectious aneurysm are controversial. The current literature is reviewed, and the treatment recommendation is suggested based on the literature review. The reported strategies and techniques for endovascular treatment of the infectious aneurysm are described, including occlusion/sacrifice of the parent vessel, reconstructive coiling/stenting, and, recently, flow diverter treatment.
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References
Grandhi R, Zwagerman NT, Linares G, et al. Onyx embolization of infectious intracranial aneurysms. J Neurointerv Surg. 2014;6(5):353–6.
Singla A, Fargen K, Blackburn S, et al. National treatment practices in the management of infectious intracranial aneurysms and infective endocarditis. J Neurointerv Surg. 2016;8(7):741–6.
Alawieh A, Chaudry MI, Turner RD, Turk AS, Spiotta AM. Infectious intracranial aneurysms: a systematic review of epidemiology, management, and outcomes. J Neurointerv Surg. 2018;10(7):708–16.
Pruitt AA, Rubin RH, Karchmer AW, Duncan GW. Neurologic complications of bacterial endocarditis. Medicine (Baltimore). 1978;57(4):329–43.
van der Meulen JH, Weststrate W, van Gijn J, Habbema JD. Is cerebral angiography indicated in infective endocarditis? Stroke. 1992;23(11):1662–7.
Masuda J, Yutani C, Waki R, Ogata J, Kuriyama Y, Yamaguchi T. Histopathological analysis of the mechanisms of intracranial hemorrhage complicating infective endocarditis. Stroke. 1992;23(6):843–50.
Esenkaya A, Duzgun F, Cinar C, et al. Endovascular treatment of intracranial infectious aneurysms. Neuroradiology. 2016;58(3):277–84.
Goldschmidt E, Faraji AH, Salvetti D, Zussman BM, Jadhav A. Republished: intracranial vessel occlusion preceding the development of mycotic aneurysms in patients with endocarditis. J Neurointerv Surg. 2020;12(2):e1.
Park W, Ahn JS, Park JC, Kwun BD, Lee DH. Treatment strategy based on experience of treating intracranial infectious aneurysms. World Neurosurg. 2017;97:351–9.
Hui FK, Bain M, Obuchowski NA, et al. Mycotic aneurysm detection rates with cerebral angiography in patients with infective endocarditis. J Neurointerv Surg. 2015;7(6):449–52.
Kannoth S, Thomas SV, Nair S, Sarma PS. Proposed diagnostic criteria for intracranial infectious aneurysms. J Neurol Neurosurg Psychiatry. 2008;79(8):943–6.
Fusco MR, Stapleton CJ, Griessenauer CJ, Thomas AJ, Ogilvy CS. Endovascular treatment of intracranial infectious aneurysms in eloquent cortex with super-selective provocative testing: case series and literature review. Interv Neuroradiol. 2016;22(2):148–52.
Bartakke S, Kabde U, Muranjan MN, Bavdekar SB. Mycotic aneurysm: an uncommon cause for intra-cranial hemorrhage. Indian J Pediatr. 2002;69(10):905–7.
Corr P, Wright M, Handler LC. Endocarditis-related cerebral aneurysms: radiologic changes with treatment. AJNR Am J Neuroradiol. 1995;16(4):745–8.
Rice CJ, Cho SM, Marquardt RJ, et al. Clinical course of infectious intracranial aneurysm undergoing antibiotic treatment. J Neurol Sci. 2019;403:50–5.
Peters PJ, Harrison T, Lennox JL. A dangerous dilemma: management of infectious intracranial aneurysms complicating endocarditis. Lancet Infect Dis. 2006;6(11):742–8.
Morawetz RB, Karp RB. Evolution and resolution of intracranial bacterial (mycotic) aneurysms. Neurosurgery. 1984;15(1):43–9.
Moskowitz MA, Rosenbaum AE, Tyler HR. Angiographically monitored resolution of cerebral mycotic aneurysms. Neurology. 1974;24(12):1103–8.
Allen LM, Fowler AM, Walker C, et al. Retrospective review of cerebral mycotic aneurysms in 26 patients: focus on treatment in strongly immunocompromised patients with a brief literature review. AJNR Am J Neuroradiol. 2013;34(4):823–7.
Nakahara I, Taha MM, Higashi T, et al. Different modalities of treatment of intracranial mycotic aneurysms: report of 4 cases. Surg Neurol. 2006;66(4):405–9. discussion 409-410
Zhao PC, Li J, He M, You C. Infectious intracranial aneurysm: endovascular treatment with onyx case report and review of the literature. Neurol India. 2010;58(1):131–4.
Matsubara N, Miyachi S, Izumi T, et al. Results and current trends of multimodality treatment for infectious intracranial aneurysms. Neurol Med Chir (Tokyo). 2015;55(2):155–62.
Gross BA, Puri AS. Endovascular treatment of infectious intracranial aneurysms. Neurosurg Rev. 2013;36(1):11–9. discussion 19
Kannoth S, Iyer R, Thomas SV, et al. Intracranial infectious aneurysm: presentation, management and outcome. J Neurol Sci. 2007;256(1–2):3–9.
Phuong LK, Link M, Wijdicks E. Management of intracranial infectious aneurysms: a series of 16 cases. Neurosurgery. 2002;51(5):1145–51. discussion 1151-1142
Bohmfalk GL, Story JL, Wissinger JP, Brown WE Jr. Bacterial intracranial aneurysm. J Neurosurg. 1978;48(3):369–82.
Clare CE, Barrow DL. Infectious intracranial aneurysms. Neurosurg Clin N Am. 1992;3(3):551–66.
Cloft HJ, Kallmes DF, Jensen ME, Lanzino G, Dion JE. Endovascular treatment of ruptured, peripheral cerebral aneurysms: parent artery occlusion with short Guglielmi detachable coils. AJNR Am J Neuroradiol. 1999;20(2):308–10.
Desai B, Soldozy S, Desai H, et al. Evaluating the safety and efficacy of various endovascular approaches for treatment of infectious intracranial aneurysms: a systematic review. World Neurosurg. 2020;
Eddleman CS, Surdell D, DiPatri A Jr, Tomita T, Shaibani A. Infectious intracranial aneurysms in the pediatric population: endovascular treatment with onyx. Childs Nerv Syst. 2008;24(8):909–15.
La Barge DV 3rd, Ng PP, Stevens EA, Friedline NK, Kestle JR, Schmidt RH. Extended intracranial applications for ethylene vinyl alcohol copolymer (onyx): mycotic and dissecting aneurysms. Technical note. J Neurosurg. 2009;111(1):114–8.
OuYang M, Huang X, Wang Y. Endovascular treatment of infectious Pseudoaneurysm of internal carotid artery. World Neurosurg. 2019;125:42–3.
Ghali MG, Ghali EZ. Intracavernous internal carotid artery mycotic aneurysms: comprehensive review and evaluation of the role of endovascular treatment. Clin Neurol Neurosurg. 2013;115(10):1927–42.
Imamura H, Sakai N, Alexander MJ. Flow-diverter stenting of Intracavernous internal carotid artery mycotic aneurysm. J Stroke Cerebrovasc Dis. 2019;28(7):e81–2.
Kobets AJ, Scoco A, Nakhla J, et al. Flow-diverting stents for the obliteration of symptomatic, infectious cavernous carotid artery aneurysms. Oper Neurosurg (Hagerstown). 2018;14(6):681–5.
Appelboom G, Kadri K, Hassan F, Leclerc X. Infectious aneurysm of the cavernous carotid artery in a child treated with a new-generation of flow-diverting stent graft: case report. Neurosurgery. 2010;66(3):E623–4; discussion E624.
Ares WJ, Tonetti DA, Greene S, et al. Pipeline embolization of an infectious basilar artery aneurysm in a 2-year-old child: case report, discussion of the literature and perioperative considerations. Oper Neurosurg (Hagerstown). 2019;17(5):E224–8.
Han MS, Jung SH, Kim TS, Joo SP. Reconstructive Endovascular Treatment of an Intracranial Infectious Aneurysm in Bacterial Meningitis: A Case Report and Review of Literature. World Neurosurg. 2016;90:700 e701–5.
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Ren, Z. (2022). Infectious Aneurysms (Mycotic Aneurysms). In: Eight Aneurysms. Springer, Cham. https://doi.org/10.1007/978-3-030-97216-5_14
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DOI: https://doi.org/10.1007/978-3-030-97216-5_14
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