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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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Endovascular management of ruptured cerebral mycotic aneurysms

S Dhomne1, C Rao, M Shrivastava

  • 1Department of Radiology, Neuro-interventional Division, King Edward Memorial Hospital, Mumbai, India.

British Journal of Neurosurgery
|January 29, 2008
PubMed

Insights

Endovascular treatment for cerebral mycotic aneurysms, often linked to rheumatic heart disease, proved safe and effective. This approach led to good neurological outcomes in most patients, demonstrating its reliability.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Infectious Diseases

Background:

  • Cerebral mycotic aneurysms are rare but serious complications, frequently associated with infective endocarditis.
  • Management options for these aneurysms have evolved, with endovascular techniques gaining prominence.

Purpose of the Study:

  • To evaluate the safety and efficacy of endovascular management for cerebral mycotic aneurysms.
  • To assess clinical outcomes and technical success rates of endovascular treatment in a cohort of patients.

Main Methods:

  • Retrospective analysis of 13 patients with cerebral mycotic aneurysms treated between 2001 and 2007.
  • Endovascular techniques included parent vessel occlusion for distal aneurysms and selective treatment for proximal ones.

Main Results:

  • Technical success was achieved in all patients undergoing endovascular treatment.
  • No rebleeding occurred post-embolization; however, two patients died due to increased mass effect from prior bleeds.
  • Eleven patients had favorable outcomes, with eight achieving normal neurological status and three experiencing permanent disability related to the initial stroke.

Conclusions:

  • Endovascular approach is a reliable and safe technique for managing cerebral mycotic aneurysms.
  • The study highlights the potential for good long-term outcomes with timely endovascular intervention.

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