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颅内感染性动脉瘤的血管内治疗

Endovascular treatment for intracranial infectious aneurysms.

作者信息

Wajnberg Eduardo, Rueda Fernanda, Marchiori Edson, Gasparetto Emerson L

机构信息

Médico do Serviço de Serviço de Radiodiagnóstico, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brasil.

出版信息

Arq Neuropsiquiatr. 2008 Dec;66(4):790-4. doi: 10.1590/s0004-282x2008000600002.

Abstract

OBJECTIVE

To re-enforce an alternative, less aggressive treatment modality in the management of intracranial infectious aneurysms.

METHOD

We present a series of five patients with infectious endocarditis and intracranial infectious aneurysms (mycotic aneurysms) managed by means of endovascular treatment.

RESULTS

Endovascular treatment was executed technically uneventfully in all patients. Three patients had favorable clinical outcome: two were classified as Glasgow Outcome Scale 4/5, and one had total neurological recovery (GOS 5/5). Two patients died (GOS 1/5), one in consequence of the initial intracranial bleeding and the other after cardiac complications from endocarditis and open-heart surgery.

CONCLUSION

Endovascular techniques are an expanding option for the treatment of IIAs. It has been especially useful for infectious endocarditis patients with IIA, who will be submitted to cardiac surgery with cardiopulmonary bypass and anticoagulation, with the risk of intracranial bleeding.

摘要

目的

在颅内感染性动脉瘤的治疗中强化一种替代性的、侵入性较小的治疗方式。

方法

我们报告了一系列5例患有感染性心内膜炎和颅内感染性动脉瘤(霉菌性动脉瘤)并接受血管内治疗的患者。

结果

所有患者的血管内治疗在技术上均顺利进行。3例患者临床预后良好:2例格拉斯哥预后评分4/5,1例神经功能完全恢复(格拉斯哥预后评分5/5)。2例患者死亡(格拉斯哥预后评分1/5),1例死于初始颅内出血,另1例死于心内膜炎和心脏直视手术后的心脏并发症。

结论

血管内技术是治疗颅内感染性动脉瘤不断扩展的选择。对于患有颅内感染性动脉瘤且将接受体外循环心脏手术和抗凝治疗并有颅内出血风险的感染性心内膜炎患者尤其有用。

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