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Updated: Oct 7, 2025

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Safety Profile and Factors Associated With Good Outcome for Endovascularly Treated Infectious Intracranial Aneurysms

Pui Man Rosalind Lai1, Seamus Caragher, Nirav J Patel

  • 1Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Neurosurgery
|January 7, 2022
PubMed
Abstract

Insights

Endovascular treatment is safe and effective for infectious intracranial aneurysms (IIAs), both ruptured and unruptured. Hypertension is linked to ruptured IIAs and poorer outcomes, but procedures are generally well-tolerated.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Infectious intracranial aneurysms (IIAs), also known as mycotic aneurysms, are serious inflammatory lesions.
  • IIAs can lead to severe neurological deficits or death.
  • Systematic reviews indicate endovascular treatment is effective for managing IIAs.

Purpose of the Study:

  • To compare the safety of various endovascular methods for treating ruptured and unruptured IIAs.
  • To identify factors associated with favorable clinical and radiographic outcomes in IIA patients.

Main Methods:

  • Retrospective analysis of 38 patients with IIAs (20 ruptured, 18 unruptured) treated endovascularly from 2003-2019.
  • Utilized univariate and multivariate analyses to assess patient presentation, treatment modalities, and outcomes.
  • Evaluated clinical and radiographic outcomes, including complications like recanalization, hemorrhage, and infarcts.

Main Results:

  • No postprocedural hemorrhage or infarcts were observed.
  • One patient needed retreatment for recanalization; two experienced new infarcts post-embolization.
  • No significant differences in clinical or radiographic outcomes were found between different endovascular treatment modalities.
  • Hypertension was associated with ruptured IIA status and worse 6-month clinical outcomes (OR 0.03).

Conclusions:

  • Endovascular intervention is a safe and effective strategy for both ruptured and unruptured IIAs.
  • Hypertension is a significant factor associated with ruptured IIA status and adverse clinical outcomes.
  • Endovascular procedures for IIAs are generally well-tolerated, offering good patient outcomes.

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