Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
J Neurointerv Surg. 2014 Jun;6(5):353-6. doi: 10.1136/neurintsurg-2013-010755. Epub 2013 May 4.
Infectious intracranial aneurysms (IIAs) are rare and potentially devastating. First-line management involves intravenous antibiotics, with surgical or endovascular management reserved for cases of failed medical treatment or aneurysmal rupture. Endovascular therapy has become the primary approach for treating these small, distally located aneurysms. Liquid embolic agents are well suited for use because of their ability to fill the aneurysm and parent vessel. We present our experience in treating these aneurysms via Onyx embolization and review the literature.
We retrospectively reviewed the endovascular treatment of IIAs at our institution from 2010 to 2012. Eight patients with 16 IIAs ranging in size from 1 to 16 mm underwent treatment. Seven of the patients initially presented after aneurysmal rupture. Onyx was pushed until the aneurysm and parent artery were filled. Confirmation of aneurysmal occlusion was made by repeat cerebral angiography.
One symptomatic stroke occurred after embolization. Fourteen of the 16 aneurysms have been evaluated with follow-up angiography and remain occluded.
Treatment of IIAs using an endovascular approach with Onyx is safe and effective.
感染性颅内动脉瘤（IIA）较为罕见，但极具破坏性。一线治疗方法为静脉内使用抗生素，对于治疗失败或动脉瘤破裂的病例，则保留手术或血管内治疗。血管内治疗已成为治疗这些小而位于远端的动脉瘤的主要方法。由于液体栓塞剂能够填充动脉瘤和母血管，因此非常适合使用。我们介绍了通过 Onyx 栓塞治疗这些动脉瘤的经验，并对文献进行了回顾。
我们回顾性分析了 2010 年至 2012 年我院的 IIA 血管内治疗。8 例 16 个大小为 1 至 16 毫米的 IIA 患者接受了治疗。7 例患者最初因动脉瘤破裂而就诊。将 Onyx 推注至动脉瘤和母动脉充满。通过重复脑血管造影术确认动脉瘤闭塞。
栓塞后发生 1 例症状性卒中。16 个动脉瘤中的 14 个已通过随访血管造影进行评估，且仍然闭塞。
使用 Onyx 的血管内方法治疗 IIA 是安全有效的。
