Clinical characteristics and treatment of infectious intracranial aneurysm related to infective endocarditis
- VernacularTitle:感染性心内膜炎相关颅内动脉瘤特征与治疗
- Author:
Hongkun QING
1
;
Weiteng WANG
2
;
Fanyu CHEN
1
;
Lixi GAN
1
;
Lanxin YE
1
;
Oudi CHEN
3
;
Guangzhong CHEN
4
;
Xuhua JIAN
1
Author Information
1. Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510010, P. R. China
2. Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, P. R. China
3. Department of Echocardiography, Guangdong Cardiovascular Institute, Guangdong Provincial People s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510010, P. R. China
4. Department of Neurosurgery, Guangdong Provincial People s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510010, P. R. China
- Publication Type:Journal Article
- Keywords:
Infective endocarditis;
infectious intracranial aneurysm;
intracranial hemorrhage;
endovascular therapy
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(05):670-676
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical features of infectious intracranial aneurysm (IIA) related to infective endocarditis (IE) and share our experiences in the diagnosis and treatment of IIA. Methods A retrospective analysis was conducted on the clinical data of 554 patients who underwent cardiac surgery for IE at the Department of Cardiac Surgery, Guangdong Provincial People's Hospital from September 2018 to August 2023. Patients with secondary IIA were included and reviewed. Based on the treatment strategies, patients were stratified into two groups: an antibiotic-only group and an endovascular treatment group. Results The cohort comprised 21 males and 10 females, with a median age of 33 years (IQR 26-53). Fifteen (48.4%) patients showed no significant neurological symptoms before IIA diagnosis. Seven patients received antibiotic therapy alone, while 24 underwent additional endovascular embolization, achieving technical success in 23 (95.8%) patients. The median interval between endovascular embolization and cardiac surgery was 2 days (IQR 0-6), with 9 patients undergoing concurrent procedures. In the antibiotic-only group, 3 (42.9%) patients suffered fatal IIA rupture. In contrast, only 1 (4.2%) death due to aneurysm rupture occurred in the endovascular treatment group. All surviving patients recovered well without new neurological deficits. Conclusion Routine neuroimaging screening for IIA is critical in IE patients. For those requiring cardiac surgery, endovascular embolization combined with antimicrobial therapy represents a reasonable strategy to mitigate rupture risks and improve outcomes.
