HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Chapot, R. Articles by Merland, J.-J. Search for Related Content PubMed PubMed Citation Articles by Chapot, R. Articles by Merland, J.-J.

Endovascular Treatment of Cerebral Mycotic Aneurysms¹

¹ From the Departments of Interventional Neuroradiology (R.C., E.H., J.P.S.M., A.A., C.M., J.J.M.) and Neurosurgery (G.L.), Hôpital Lariboisière, 1 rue Ambroise Paré, 75475 Paris Cedex 10, France. Received February 8, 2001; revision requested March 26; revision received June 26; accepted July 16. Address correspondence to R.C. (e-mail: rene.chapot@lrb.ap-hop-paris.fr).

View larger version (197K): [in a new window]   Figure 1a. Patient 5. Digital subtraction angiograms show a left frontoparietal hematoma that did not require surgical evacuation. (a) Lateral view of the left internal carotid artery shows a distal MA (arrow) located in the precentral artery. Note the delayed filling of the vessel distal to the aneurysm. (b) Nonsubtracted oblique view obtained during endovascular navigation with a microcatheter (arrows) illustrates the selective injection of contrast material into the parent vessel and the aneurysm. (c) Lateral view of the left internal carotid artery obtained in the late arterial phase after occlusion of the parent artery and the aneurysm with cyanoacrylate. The proximal segment (arrows) and distal segment (arrowheads) are patent. The distal segment is refilled by collateral vessels.

View larger version (162K): [in a new window]   Figure 1b. Patient 5. Digital subtraction angiograms show a left frontoparietal hematoma that did not require surgical evacuation. (a) Lateral view of the left internal carotid artery shows a distal MA (arrow) located in the precentral artery. Note the delayed filling of the vessel distal to the aneurysm. (b) Nonsubtracted oblique view obtained during endovascular navigation with a microcatheter (arrows) illustrates the selective injection of contrast material into the parent vessel and the aneurysm. (c) Lateral view of the left internal carotid artery obtained in the late arterial phase after occlusion of the parent artery and the aneurysm with cyanoacrylate. The proximal segment (arrows) and distal segment (arrowheads) are patent. The distal segment is refilled by collateral vessels.

View larger version (193K): [in a new window]   Figure 1c. Patient 5. Digital subtraction angiograms show a left frontoparietal hematoma that did not require surgical evacuation. (a) Lateral view of the left internal carotid artery shows a distal MA (arrow) located in the precentral artery. Note the delayed filling of the vessel distal to the aneurysm. (b) Nonsubtracted oblique view obtained during endovascular navigation with a microcatheter (arrows) illustrates the selective injection of contrast material into the parent vessel and the aneurysm. (c) Lateral view of the left internal carotid artery obtained in the late arterial phase after occlusion of the parent artery and the aneurysm with cyanoacrylate. The proximal segment (arrows) and distal segment (arrowheads) are patent. The distal segment is refilled by collateral vessels.

View larger version (189K): [in a new window]   Figure 2a. Patient 5. Digital subtraction angiograms show an asymptomatic MA associated with a ruptured MA of the middle cerebral artery. (a) Lateral view of left vertebral artery shows a distal MA (arrow) in the posterior cerebral artery. (b) Same view obtained after 2 months of antibiotic treatment shows slight enlargement of the aneurysm (arrow). (c) Magnified lateral view of the posterior cerebral arteries illustrates the selective injection of contrast material into the parent vessel (arrowheads) prior to embolization. (d) Lateral view of the left vertebral artery after embolization shows that the aneurysm resolved after the parent vessel was occluded with cyanoacrylate.

View larger version (179K): [in a new window]   Figure 2b. Patient 5. Digital subtraction angiograms show an asymptomatic MA associated with a ruptured MA of the middle cerebral artery. (a) Lateral view of left vertebral artery shows a distal MA (arrow) in the posterior cerebral artery. (b) Same view obtained after 2 months of antibiotic treatment shows slight enlargement of the aneurysm (arrow). (c) Magnified lateral view of the posterior cerebral arteries illustrates the selective injection of contrast material into the parent vessel (arrowheads) prior to embolization. (d) Lateral view of the left vertebral artery after embolization shows that the aneurysm resolved after the parent vessel was occluded with cyanoacrylate.

View larger version (175K): [in a new window]   Figure 2c. Patient 5. Digital subtraction angiograms show an asymptomatic MA associated with a ruptured MA of the middle cerebral artery. (a) Lateral view of left vertebral artery shows a distal MA (arrow) in the posterior cerebral artery. (b) Same view obtained after 2 months of antibiotic treatment shows slight enlargement of the aneurysm (arrow). (c) Magnified lateral view of the posterior cerebral arteries illustrates the selective injection of contrast material into the parent vessel (arrowheads) prior to embolization. (d) Lateral view of the left vertebral artery after embolization shows that the aneurysm resolved after the parent vessel was occluded with cyanoacrylate.

View larger version (169K): [in a new window]   Figure 2d. Patient 5. Digital subtraction angiograms show an asymptomatic MA associated with a ruptured MA of the middle cerebral artery. (a) Lateral view of left vertebral artery shows a distal MA (arrow) in the posterior cerebral artery. (b) Same view obtained after 2 months of antibiotic treatment shows slight enlargement of the aneurysm (arrow). (c) Magnified lateral view of the posterior cerebral arteries illustrates the selective injection of contrast material into the parent vessel (arrowheads) prior to embolization. (d) Lateral view of the left vertebral artery after embolization shows that the aneurysm resolved after the parent vessel was occluded with cyanoacrylate.

View larger version (200K): [in a new window]   Figure 3a. Patient 14. Digital subtraction angiograms illustrate the angiographic follow-up of the patient and the treatment of a third, incidental MA after the patient had been treated for two ruptured MAs. (a) Magnified anteroposterior view of the internal carotid artery at time of treatment of the second MA shows an atypical aneurysm in the middle cerebral artery bifurcation (arrowheads). It is unclear whether the aneurysm is of mycotic origin. (b) Same view obtained after 10 weeks of antibiotic treatment shows that the aneurysm (arrows) has enlarged. The combination of the evolution of the aneurysm on successive angiograms and the presence of other MAs suggests that this aneurysm is an MA. (c) Magnified anteroposterior view of the right internal carotid artery at time of EVT shows the selective occlusion of the aneurysm (arrow) with Guglielmi detachable coils. (d) Nonsubtracted magnified anteroposterior view of the right internal carotid artery shows the Guglielmi detachable coils (arrowhead) that have been placed in the aneurysm.

View larger version (202K): [in a new window]   Figure 3b. Patient 14. Digital subtraction angiograms illustrate the angiographic follow-up of the patient and the treatment of a third, incidental MA after the patient had been treated for two ruptured MAs. (a) Magnified anteroposterior view of the internal carotid artery at time of treatment of the second MA shows an atypical aneurysm in the middle cerebral artery bifurcation (arrowheads). It is unclear whether the aneurysm is of mycotic origin. (b) Same view obtained after 10 weeks of antibiotic treatment shows that the aneurysm (arrows) has enlarged. The combination of the evolution of the aneurysm on successive angiograms and the presence of other MAs suggests that this aneurysm is an MA. (c) Magnified anteroposterior view of the right internal carotid artery at time of EVT shows the selective occlusion of the aneurysm (arrow) with Guglielmi detachable coils. (d) Nonsubtracted magnified anteroposterior view of the right internal carotid artery shows the Guglielmi detachable coils (arrowhead) that have been placed in the aneurysm.

View larger version (207K): [in a new window]   Figure 3c. Patient 14. Digital subtraction angiograms illustrate the angiographic follow-up of the patient and the treatment of a third, incidental MA after the patient had been treated for two ruptured MAs. (a) Magnified anteroposterior view of the internal carotid artery at time of treatment of the second MA shows an atypical aneurysm in the middle cerebral artery bifurcation (arrowheads). It is unclear whether the aneurysm is of mycotic origin. (b) Same view obtained after 10 weeks of antibiotic treatment shows that the aneurysm (arrows) has enlarged. The combination of the evolution of the aneurysm on successive angiograms and the presence of other MAs suggests that this aneurysm is an MA. (c) Magnified anteroposterior view of the right internal carotid artery at time of EVT shows the selective occlusion of the aneurysm (arrow) with Guglielmi detachable coils. (d) Nonsubtracted magnified anteroposterior view of the right internal carotid artery shows the Guglielmi detachable coils (arrowhead) that have been placed in the aneurysm.

View larger version (196K): [in a new window]   Figure 3d. Patient 14. Digital subtraction angiograms illustrate the angiographic follow-up of the patient and the treatment of a third, incidental MA after the patient had been treated for two ruptured MAs. (a) Magnified anteroposterior view of the internal carotid artery at time of treatment of the second MA shows an atypical aneurysm in the middle cerebral artery bifurcation (arrowheads). It is unclear whether the aneurysm is of mycotic origin. (b) Same view obtained after 10 weeks of antibiotic treatment shows that the aneurysm (arrows) has enlarged. The combination of the evolution of the aneurysm on successive angiograms and the presence of other MAs suggests that this aneurysm is an MA. (c) Magnified anteroposterior view of the right internal carotid artery at time of EVT shows the selective occlusion of the aneurysm (arrow) with Guglielmi detachable coils. (d) Nonsubtracted magnified anteroposterior view of the right internal carotid artery shows the Guglielmi detachable coils (arrowhead) that have been placed in the aneurysm.