| Title: | Results and current trends of multimodality treatment for infectious intracranial aneurysms |
| Author(s): | Matsubara N; Miyachi S; Izumi T; Yamanouchi T; Asai T; Ota K; Wakabayashi T; |
| Address: | "Department of Neurosurgery, Nagoya University Graduate School of Medicine" |
| ISSN/ISBN: | 1349-8029 (Electronic) 0470-8105 (Print) 0470-8105 (Linking) |
| Abstract: | "The authors retrospectively reviewed their cases of infectious intracranial aneurysms and discuss results and trends of current treatment modalities including medical, neurosurgical, and endovascular. Twenty patients (10 males and 10 females; mean age 46 years) with 23 infectious aneurysms were treated by various treatment modalities during a 15-year period. Fifteen cases (75.0%) were caused by infective endocarditis. Eleven aneurysms (47.8%) were ruptured. Two aneurysms (8.7%) presented a mass effect and 7 (30.4%) were unruptured and asymptomatic. The average aneurysm size was 6.5 +/- 4.8 mm (range 1-22 mm). The aneurysms were located in proximal cerebral circulation in 7 (30.4%) and distal in 16 (69.6%). Six (26.1%) aneurysms were treated surgically (5: trapping, 1: neck clipping), 10 (43.5%) endovascularly (7: trapping, 2: proximal occlusion, 1: saccular coiling), and the remaining 7 (30.4%) medically. Endovascular treatment was gradually increased with time. Medical and surgical treatments were continuously performed during the study period. Surgery was preferred for the patient with intraparenchymal hematoma or treated by bypass surgery. Three periprocedural minor complications occurred in endovascular treatment. There was one postoperative infarction with permanent deficit developed from surgical treatment. During the follow-up period (mean 28.8 months), none of the aneurysms presented a recurrence or rebleeding. Thirteen patients (65.0%) had favorable clinical outcomes (modified Rankin Scale: 0-2), although four (20.0%) had poor outcomes (modified Rankin Score: 5-6). A multimodal approach for the management of infectious aneurysms achieved satisfactory results. Endovascular intervention is a feasible and efficacious treatment option and surgical intervention is still an indispensable procedure" |
| Keywords: | "Adolescent Adult Aged Aneurysm, Infected/diagnostic imaging/*therapy Aneurysm, Ruptured/diagnostic imaging/therapy Combined Modality Therapy/*methods/trends Female Follow-Up Studies Humans Intracranial Aneurysm/diagnostic imaging/*therapy Male Middle Aged;" |
| Notes: | "MedlineMatsubara, Noriaki Miyachi, Shigeru Izumi, Takashi Yamanouchi, Takashi Asai, Takumi Ota, Keisuke Wakabayashi, Toshihiko eng Research Support, Non-U.S. Gov't Japan 2015/03/10 Neurol Med Chir (Tokyo). 2015; 55(2):155-62. doi: 10.2176/nmc.oa.2014-0197. Epub 2015 Jan 26" |
