Systematic Review of Endovascular, Surgical, and Conservative Options for Infectious Intracranial Aneurysms and Cardiac Considerations.
J Stroke Cerebrovasc Dis
; 28(3): 838-844, 2019 Mar.
Article
em En
| MEDLINE
| ID: mdl-30594429
ABSTRACT
INTRODUCTION:
With rising rates of intravenous drug use, Infectious Intracranial aneurysms (IIAs) are a relevant topic for investigation. We performed a systematic review to better understand current practice patterns and limits of current published literature.METHOD:
131 publications with a total of 499 patients (665 aneurysms) were included. Of the 499 patients, 83 were single case reports, and 20.5% of the total had multiple aneurysms. 35.8% of all aneurysms were ruptured. Of those reporting treatment, options included conservative antibiotic therapy (30.0%), open surgical intervention (31.1%), and endovascular occlusion (31.8%). Chronologically, publication of IIAs has increased. Usage of endovascular therapies has grown, while conservative and surgical management have declined in the literature. Overall, 56.2% of aneurysms for which conservative therapy was initiated eventually either underwent intervention or death of patient occurred.RESULTS:
The issue of cardiac valve surgery in relationship to aneurysm therapy was discussed in 20.8% (80 patients) of all 384 infectious endocarditis patients; of which 15.0% (12) underwent valve surgery before aneurysm treatment and 85.0 patients (68)% underwent valve surgery after aneurysm treatment. For 51 of the patients where valve surgery followed aneurysm management, the corresponding aneurysm treatment modality could be determined; 58.8% (30) of whom were managed endovascularly. 32.7% (26) of all cases reporting cardiac surgery details underwent cardiac surgery during their admission with the IIA.CONCLUSIONS:
Overall, increasing trend of endovascular management of IIAs is evident, and a strong temporal preference exhibited by providers to perform cardiac surgery subsequently to IIA management.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Aneurisma Infectado
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Aneurisma Intracraniano
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Aneurisma Roto
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Procedimentos Neurocirúrgicos
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Endocardite Bacteriana
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Procedimentos Endovasculares
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Tratamento Conservador
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Procedimentos Cirúrgicos Cardíacos
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Antibacterianos
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article