Title:Ruptured Multiple Mycotic Aneurysms Following Infective Endocarditis: Effectiveness of Catheter-based Techniques Using N-butyl Cyanoacrylate in a Hemorrhage-induced Coagulopathy
Volume: 13
Author(s): Junya Tsurukiri*, Akira Hoshiai, Eitaro Okumura, Hiroshi Yamanaka, Hidefumi Sano and Hiroyuki Jimbo
Affiliation:
- Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0998,Japan
Keywords:
Craniotomy, endovascular treatment, infection, splenectomy, visceral infarction, mycotic aneurysm.
Abstract: Background: Visceral bleeding caused by ruptured mycotic aneurysms, especially intracerebral
hematoma, is a most serious complication. In such cases, not only surgical techniques but
also a variety of modalities such as catheter-based technique is required to comprehensively treat a
patient with hemorrhage-induced coagulopathy.
Case Reports: We treated an infectious endocarditis (IE) patient with coagulopathy caused by ruptured
multiple mycotic aneurysms who underwent endovascular embolization using n-butyl cyanoacrylate
(NBCA) and successful surgical removal assisted with catheter-based hemostasis. We
also reviewed published literatures about mycotic aneurysm treated using NBCA using PUBMED.
Upon review of the existing literature, it was evident that there are only a very limited number of
publications related to “infectious” or “mycotic aneurysm” treated using NBCA, and only three case
references were retrieved.
Conclusion: Catheter-based techniques using n-butyl-2-cyanoacrylate (NBCA) which has been used
as a liquid embolic agents is effective for patients with hemorrhage-induced coagulopathy caused by
ruptured mycotic aneurysms before surgical treatment.
