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[Therapeutic and endovascular management of cerebral mycotic aneurysms]

A Consoli1, O Coskun1, M Perier2

  • 1Service de neuroradiologie diagnostique et thérapeutique, hôpital Foch, 40, rue Worth, 92151, Suresnes, France.

Annales De Cardiologie Et D'Angeiologie
|November 2, 2020
PubMed

Insights

Infective endocarditis can cause neurological issues like mycotic aneurysms. Current data on their natural history and bleeding risk is limited, with no single best treatment approach identified.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Cardiology

Background:

  • Infective endocarditis frequently leads to neurological complications.
  • Mycotic aneurysms occur in approximately 5% of patients during the acute/sub-acute infection phase.
  • Existing data on mycotic aneurysm natural history and hemorrhagic risk is fragmented.

Purpose of the Study:

  • To review the diagnostic and therapeutic challenges of mycotic aneurysms.
  • To discuss the limited evidence regarding optimal management strategies.
  • To highlight the need for a multidisciplinary approach.

Main Methods:

  • Literature review of mycotic aneurysms associated with infective endocarditis.
  • Analysis of diagnostic methods and treatment options (medical, surgical, endovascular).
  • Assessment of available data on natural history and hemorrhagic risk.

Main Results:

  • Mycotic aneurysms are a recognized complication of infective endocarditis.
  • Treatment options include medical management, surgical intervention, and selective embolization.
  • No definitive evidence supports the superiority of any single therapeutic approach.

Conclusions:

  • Mycotic aneurysms present significant diagnostic and therapeutic challenges.
  • Management requires a comprehensive, multidisciplinary strategy.
  • Further research is needed to clarify natural history and optimize treatment outcomes.
Keywords:
Accidents vasculaires cérébrauxAneurysms: MycoticAnévrismesComplicationEmbolisationEndocarditeEndocarditisHemorrhageHémorragieInfectionStrokemycotique

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