Safety and efficacy of endovascular treatment for intracranial infectious aneurysms: A systematic review and meta-analysis

Ondra Petr, Waleed Brinjikji, Anthony M. Burrows, Harry Cloft, David F. Kallmes, Giuseppe Lanzino

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations


Introduction Intracranial infectious aneurysms (IIAs), or mycotic aneurysms are rare, representing between 0.7% and 5.4% of all intracranial aneurysms. To clarify the safety and efficacy of endovascular treatment of IIAs, we conducted a systematic review of the literature analyzing periprocedural and long-term clinical and angiographic outcomes. Methods A comprehensive review of the literature for studies with ≥ 3 patients related to endovascular treatment of IIAs published through September 2015 was performed. Random-effects meta-analysis was used to pool the following outcomes: complete occlusion, technical success, aneurysm recurrence, rebleeding, perioperative mortality, iatrogenic rupture, perioperative stroke, procedure-related morbidity and mortality, long-term neurological morbidity and mortality, and overall good neurological outcome. Results We included 11 non-comparative studies with 86 target IIAs. Complete occlusion rates were 95.3% (95% CI = 91.2–99.4%). Recurrence occurred in 7.9% (95% CI = 2.7–13.0%). Rebleeding occurred in 5.8% (95% CI = 1.4–10.3%) of patients. Procedure-related morbidity was 12.6% (95% CI = 6.1–19.2%) and procedure-related mortality was 6.1% (95% CI = 1.5–10.8%). Long-term good neurological outcome was 68.0% (95% CI = 55.1–80.9%). Conclusion Our meta-analysis demonstrated that endovascular treatment is technically feasible and effective with high rates of IIA occlusion. Despite the comorbidities of patients, endovascular approach was associated with acceptable rates of procedure-related morbidity and satisfactory rates of overall good neurological outcome.

Original languageEnglish (US)
Pages (from-to)309-316
Number of pages8
JournalJournal of Neuroradiology
Issue number5
StatePublished - 2016


  • Endovascular treatment
  • Intracranial infectious aneurysms (IIAs)
  • Meta-analysis
  • Mycotic

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology


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