arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2022-28-6-718-727arthyper-2245Research ArticleКлинические случаиCase ReportПервый случай успешного применения низкопрофильного потокперенаправляющего стента в лечении инфекционной церебральной аневризмы у пациентки с механическим клапаном сердца. Клиническое наблюдение и обзор литературыFirst case of successful usage of a low-profile flow-diverting stent for treatment of intracranial infectious aneurysm in patient with a mechanical heart valve. Clinical case and literature reviewhttps://orcid.org/0000-0002-3904-2393КоломинЕ. Г.KolominE. G.

Коломин Егор Геннадьевич — врач-нейрохирург нейрохирургического отделения № 3, младший научный сотрудник научно-исследовательской лаборатории хирургии сосудов головного и спинного мозга 

ул. Маяковская, д. 12, Санкт-Петербург, 191014

Egor G. Kolomin, neurosurgeon of the neurosurgical department no. 3, junior researcher at the research laboratory of surgery of cerebral and spinal vessels 

12 Mayakovskaya street, St Petersburg, 191014 

neurokolomin@yandex.ruhttps://orcid.org/0000-0002-0974-460XРожченкоЛ. В.RozhchenkoL. V.

Рожченко Лариса Витальевна — кандидат медицинских наук, руководитель научно-исследовательской лаборатории хирургии сосудов головного и спинного мозга, врач-нейрохирург нейрохирургического отделения № 3, 

Санкт-Петербург

Larisa V. Rozhchenko, MD, PhD, head of research laboratory of surgery of cerebral and spinal vessels, neurosurgeon of the neurosurgical department No. 3

St Petersburg

https://orcid.org/0000-0003-0956-6994БобиновВ. B.BobinovV. V.

Бобинов Василий Витальевич — научный сотрудник НИЛ хирургии сосудов головного и спинного мозга, врачнейрохирург нейрохирургического отделения № 3

Санкт-Петербург

Vasiliy V. Bobinov, researcher of research laboratory of surgery of cerebral and spinal vessels, neurosurgeon of the neurosurgical department No. 3,

St Petersburg

https://orcid.org/0000-0001-7297-3213ГорощенкоС. А.GoroshchenkoS. A.

Горощенко Сергей Анатольевич — кандидат медицинских наук, старший научный сотрудник НИЛ хирургии сосудов головного и спинного мозга, врач-нейрохирург нейрохирургического отделения № 3 

Санкт-Петербург

Sergey A. Goroshchenko, MD, PhD, senior researcher of research laboratory of surgery of cerebral and spinal vessels, neurosurgeon of the neurosurgical department No. 3

St Petersburg

https://orcid.org/0000-0002-3112-6584ПетровА. Е.PetrovA. E.

Петров Андрей Евгеньевич — врач-нейрохирург, заведующий нейрохирургическим отделения № 3

Санкт-Петербург

Andrey E. Petrov, neurosurgeon and head of the neurosurgical department no. 3

St Petersburg

https://orcid.org/0000-0002-4952-2219ФроловаО. А.FrolovaO. A.

Фролова Ольга Андреевна — врач-терапевт 

Санкт-Петербург

Olga A. Frolova, therapist

St Petersburg

https://orcid.org/0000-0001-5295-4912СамочерныхК. А.SamochernykhK. A.

Самочерных Константин Александрович — доктор медицинских наук, директор 

Санкт-Петербург

Konstantin A. Samochernykh, MD, PhD, DSc, Professor, Director

St Petersburg

Российский научно-исследовательский нейрохирургический институт имени профессора А. Л. Поленова — филиал Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияPolenov Research Neurosurgical Institute — branch of Almazov National Medical Research CenterRussian Federation202222112022286718727Copyright © Коломин Е.Г., Рожченко Л.В., Бобинов В.B., Горощенко С.А., Петров А.Е., Фролова О.А., Самочерных К.А., 20232023Коломин Е.Г., Рожченко Л.В., Бобинов В.B., Горощенко С.А., Петров А.Е., Фролова О.А., Самочерных К.А.Kolomin E.G., Rozhchenko L.V., Bobinov V.V., Goroshchenko S.A., Petrov A.E., Frolova O.A., Samochernykh K.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/2245

Инфекционные аневризмы (ИА) — это церебральные аневризмы, формирующиеся вследствие инфекционного воспаления стенки артерии. Они являются достаточно редкой патологией и в большинстве случаев — осложнением инфекционного (бактериального) эндокардита левых камер сердца. Своевременная диагностика ИА в догеморрагическом периоде является проблематичной из-за вариабельности клинической картины ИА, стертого или малосимптомного клинического течения, возможности формирования ИА в отдаленном периоде после септических эмболий, даже на фоне проводимой антибактериальной терапии. Представленный клинический случай иллюстрирует первое успешное применение низкопрофильного потокотклоняющего стента для лечения пациентки молодого возраста с механическим клапаном сердца и ИА левой средней мозговой артерии, развившейся на месте септической эмболии в остром периоде септического бактериального эндокардита, сопровождавшегося ишемическим инсультом. Данное наблюдение демонстрирует эффективность выбранного метода лечения, особенности адекватной предоперационной подготовки, возможные послеоперационные осложнения и детализированную коррекцию антикоагулянтной и дезагрегантной терапии.

Infectious aneurysms (IA) are cerebral aneurysms that are formed due to the infectious inflammation of the arterial wall. They are a rather rare pathology and in most cases prove to be a complication of infectious (bacterial) endocarditis of the left heart chambers. Timely diagnosis of IA in the pre-hemorrhagic period is problematic due to the variability of the clinical picture of IA, frequent blurred or low-symptomatic clinical course, the possibility of IA formation in the remote period after septic embolism, even despite the background of antibiotic therapy. The presented clinical case illustrates the first successful use of a low-profile flow-diverting stent for the treatment of a young patient with a mechanical heart valve and an infectious aneurysm of the left middle cerebral artery, developed at the site of septic embolism in the acute period of septic bacterial endocarditis accompanied by ischemic stroke. This observation demonstrates the effectiveness of the chosen method of treatment, peculiarities of adequate preoperative preparation, possible postoperative complications and detailed correction of anticoagulant and antiplatelet therapy.

инфекционная церебральная аневризмаинфекционный эндокардитмеханический клапан сердцанизкопрофильный потокоперенаправляющий стентдезагрегантная и антикоагулянтная терапияinfectious cerebral aneurysminfective endocarditismechanical heart valvelow-profile flowdiverting stentantiplatelet and anticoagulant therapyReferencesSonneville R, Mirabel M, Hajage D, Tubach F, Vignon P, Perez P et al. ENDOcardite en REAnimation Study Group. Neurologic complications and outcomes of infective endocarditis in critically ill patients: the ENDOcardite en REAnimation prospective multicenter study. Crit Care Med. 2011;39:1474–81. doi: 10.1097/CCM.0b013e3182120b41.Sonneville R, Mirabel M, Hajage D, Tubach F, Vignon P, Perez P et al. ENDOcardite en REAnimation Study Group. Neurologic complications and outcomes of infective endocarditis in critically ill patients: the ENDOcardite en REAnimation prospective multicenter study. Crit Care Med. 2011;39:1474–81. doi: 10.1097/CCM.0b013e3182120b41.Røder BL, Wandall DA, Espersen F, Frimodt-Møller N, Skinhøj P, Rosdahl VT. Neurologic manifestations in Staphylococcus aureus endocarditis: a review of 260 bacteremic cases in nondrug addicts. Am J Med. 1997, 102(4):379-86. doi: 10.1016/s0002-9343(97)00090-9.Røder BL, Wandall DA, Espersen F, Frimodt-Møller N, Skinhøj P, Rosdahl VT. Neurologic manifestations in Staphylococcus aureus endocarditis: a review of 260 bacteremic cases in nondrug addicts. Am J Med. 1997, 102(4):379-86. doi: 10.1016/s0002-9343(97)00090-9.Eishi K, Kawazoe K, Kuriyama Y, Kitoh Y, Kawashima Y, Omae T. Surgical management of infective endocarditis associated with cerebral complications. Multi-center retrospective study in Japan. J Thorac Cardiovasc Surg. 1995;110:1745–55. doi: 10.1016/S0022-5223(95)70038-2.Eishi K, Kawazoe K, Kuriyama Y, Kitoh Y, Kawashima Y, Omae T. Surgical management of infective endocarditis associated with cerebral complications. Multi-center retrospective study in Japan. J Thorac Cardiovasc Surg. 1995;110:1745–55. doi: 10.1016/S0022-5223(95)70038-2.Heiro M, Nikoskelainen J, Engblom E, Kotilainen E, Marttila R, Kotilainen P. Neurologic manifestations of infective endocarditis: a 17-year experience in a teaching hospital in Finland. Arch Intern Med. 2000, 160(18):2781-87. doi: 10.1001/archinte.160.18.2781.Heiro M, Nikoskelainen J, Engblom E, Kotilainen E, Marttila R, Kotilainen P. Neurologic manifestations of infective endocarditis: a 17-year experience in a teaching hospital in Finland. Arch Intern Med. 2000, 160(18):2781-87. doi: 10.1001/archinte.160.18.2781.Ducruet AF, Hickman ZL, Zacharia BE, Narula R, Grobelny BT, Gorski J et al. Intracranial infectious aneurysms: a comprehensive review. Neurosurg Rev. 2010; 33(1):37-46. doi: 10.1007/s10143-009-0233-1.Ducruet AF, Hickman ZL, Zacharia BE, Narula R, Grobelny BT, Gorski J et al. Intracranial infectious aneurysms: a comprehensive review. Neurosurg Rev. 2010; 33(1):37-46. doi: 10.1007/s10143-009-0233-1.Kannoth S, Iyer R, Thomas SV, Furtado SV, Rajesh BJ, Kesavadas C et al. Intracranial infectious aneurysm: presentation, management and outcome. J Neurol Sci. 2007; 256(1-2):3-9. doi:10.1016/j.jns.2007.01.044.Kannoth S, Iyer R, Thomas SV, Furtado SV, Rajesh BJ, Kesavadas C et al. Intracranial infectious aneurysm: presentation, management and outcome. J Neurol Sci. 2007; 256(1-2):3-9. doi:10.1016/j.jns.2007.01.044.Горощенко С.А., Асатурян Г.А., Иванов А.Ю., Петров А.Е., Рожченко Л.В. Результаты хирургического лечения аневризм среедней мозговой артерии. Современные проблемы науки и образования. 2016; 9(6): 56-66.Горощенко С.А., Асатурян Г.А., Иванов А.Ю., Петров А.Е., Рожченко Л.В. Результаты хирургического лечения аневризм среедней мозговой артерии. Современные проблемы науки и образования. 2016; 9(6): 56-66.Trivedi MP, Carroll C, Rutherford S. Infective endocarditis complicated by rupture of intracranial mycotic aneurysm during pregnancy. Int J Obstet Anesth. 2008;17(2):182-87. doi:10.1016/j.ijoa.2007.07.007.Trivedi MP, Carroll C, Rutherford S. Infective endocarditis complicated by rupture of intracranial mycotic aneurysm during pregnancy. Int J Obstet Anesth. 2008;17(2):182-87. doi:10.1016/j.ijoa.2007.07.007.Biondi A. Intracranial aneurysms associated with other lesions, disorders or anatomic variations. Neuroimaging Clin N Am. 2006;16(3):467-82, viii. doi: 10.1016/j.nic.2006.05.004.Biondi A. Intracranial aneurysms associated with other lesions, disorders or anatomic variations. Neuroimaging Clin N Am. 2006;16(3):467-82, viii. doi: 10.1016/j.nic.2006.05.004.Tunkel AR, Kaye D. Neurologic complications of infective endocarditis. Neurol Clin. 1993;11(2):419-40.Tunkel AR, Kaye D. Neurologic complications of infective endocarditis. Neurol Clin. 1993;11(2):419-40.Church W. Aneurysm of the right cerebral artery in a boy of thirteen. Trans Pathol Soc London. 1869;20:109.Church W. Aneurysm of the right cerebral artery in a boy of thirteen. Trans Pathol Soc London. 1869;20:109.Peters PJ, Harrison T, Lennox JL. A dangerous dilemma: management of infectious intracranial aneurysms complicating endocarditis. Lancet Infect Dis. 2006 ;6(11):742-48. doi:10.1016/S1473-3099(06)70631-4.Peters PJ, Harrison T, Lennox JL. A dangerous dilemma: management of infectious intracranial aneurysms complicating endocarditis. Lancet Infect Dis. 2006 ;6(11):742-48. doi:10.1016/S1473-3099(06)70631-4.Regelsberger J, Elsayed A, Matschke J, Lindop G, Grzyska U, van den Boom L et al. Diagnostic and therapeutic considerations for "mycotic" cerebral aneurysms: 2 case reports and review of the literature. Cent Eur Neurosurg. 2011; 72(3):138-43. doi: 10.1055/s-0031-1279756.Regelsberger J, Elsayed A, Matschke J, Lindop G, Grzyska U, van den Boom L et al. Diagnostic and therapeutic considerations for "mycotic" cerebral aneurysms: 2 case reports and review of the literature. Cent Eur Neurosurg. 2011; 72(3):138-43. doi: 10.1055/s-0031-1279756.Sommerville RL, Allen EV, Edwards JE. Bland and infected arteriosclerotic abdominal aortic aneurysms: a clinicopathologic study. Medicine (Baltimore). 1959; 38:207-21. doi: 10.1097/00005792-195909000-00001.Sommerville RL, Allen EV, Edwards JE. Bland and infected arteriosclerotic abdominal aortic aneurysms: a clinicopathologic study. Medicine (Baltimore). 1959; 38:207-21. doi: 10.1097/00005792-195909000-00001.Alawieh A, Chaudry MI, Turner RD, Turk AS, Spiotta AM. Infectious intracranial aneurysms: a systematic review of epidemiology, management, and outcomes. J Neurointerv Surg. 2018 ;10(7):708-16. doi: 10.1136/neurintsurg-2017-013603.Alawieh A, Chaudry MI, Turner RD, Turk AS, Spiotta AM. Infectious intracranial aneurysms: a systematic review of epidemiology, management, and outcomes. J Neurointerv Surg. 2018 ;10(7):708-16. doi: 10.1136/neurintsurg-2017-013603.Miller DV, Oderich GS, Aubry MC, Panneton JM, Edwards WD. Surgical pathology of infected aneurysms of the descending thoracic and abdominal aorta: clinicopathologic correlations in 29 cases (1976 to 1999). Hum Pathol. 2004 ;35(9):1112-20.doi: 10.1016/j.humpath.2004.05.013.Miller DV, Oderich GS, Aubry MC, Panneton JM, Edwards WD. Surgical pathology of infected aneurysms of the descending thoracic and abdominal aorta: clinicopathologic correlations in 29 cases (1976 to 1999). Hum Pathol. 2004 ;35(9):1112-20.doi: 10.1016/j.humpath.2004.05.013.Fowler VG, Scheld VM, Bayler AS. Endocarditis and intravascular infections. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s Principles and Practices of Infectious Diseases. Philadelphia, PA: Churchill Livingston Elsevier; 2010: 1067–1112Fowler VG, Scheld VM, Bayler AS. Endocarditis and intravascular infections. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s Principles and Practices of Infectious Diseases. Philadelphia, PA: Churchill Livingston Elsevier; 2010: 1067–1112Molinari GF, Smith L, Goldstein MN, Satran R. Pathogenesis of cerebral mycotic aneurysms. Neurology. 1973;23(4):325-32. doi: 10.1212/wnl.23.4.325.Molinari GF, Smith L, Goldstein MN, Satran R. Pathogenesis of cerebral mycotic aneurysms. Neurology. 1973;23(4):325-32. doi: 10.1212/wnl.23.4.325.Zanaty M, Chalouhi N, Starke RM, Tjoumakaris S, Gonzalez LF, Hasan D et al. Endovascular treatment of cerebral mycotic aneurysm: a review of the literature and single center experience. Biomed Res Int. 2013;2013:151643. doi: 10.1155/2013/151643.Zanaty M, Chalouhi N, Starke RM, Tjoumakaris S, Gonzalez LF, Hasan D et al. Endovascular treatment of cerebral mycotic aneurysm: a review of the literature and single center experience. Biomed Res Int. 2013;2013:151643. doi: 10.1155/2013/151643.Wilson WR, Bower TC, Creager MA, Amin-Hanjani S, O'Gara PT, Lockhart PB et al; American Heart Association Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Surgery and Anesthesia; Council on Peripheral Vascular Disease; and Stroke Council. Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association. Circulation. 2016;134(20): 412-460. doi: 10.1161/CIR.0000000000000457.Wilson WR, Bower TC, Creager MA, Amin-Hanjani S, O'Gara PT, Lockhart PB et al; American Heart Association Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Surgery and Anesthesia; Council on Peripheral Vascular Disease; and Stroke Council. Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association. Circulation. 2016;134(20): 412-460. doi: 10.1161/CIR.0000000000000457.Frazee JG, Cahan LD, Winter J. Bacterial intracranial aneurysms. J Neurosurg. 1980 Nov;53(5):633-41. doi: 10.3171/jns.1980.53.5.0633.Frazee JG, Cahan LD, Winter J. Bacterial intracranial aneurysms. J Neurosurg. 1980 Nov;53(5):633-41. doi: 10.3171/jns.1980.53.5.0633.Fusco MR, Stapleton CJ, Griessenauer CJ, Thomas AJ, Ogilvy CS. Endovascular treatment of intracranial infectious aneurysms in eloquent cortex with super-selective provocative testing: Case series and literature review. Interv Neuroradiol. 2016 ;22(2):148-52. doi: 10.1177/1591019915617326.Fusco MR, Stapleton CJ, Griessenauer CJ, Thomas AJ, Ogilvy CS. Endovascular treatment of intracranial infectious aneurysms in eloquent cortex with super-selective provocative testing: Case series and literature review. Interv Neuroradiol. 2016 ;22(2):148-52. doi: 10.1177/1591019915617326.Kannoth S, Thomas SV. Intracranial microbial aneurysm (infectious aneurysm): current options for diagnosis and management. Neurocrit Care. 2009;11(1):120-29. doi: 10.1007/s12028-009-9208-x.Kannoth S, Thomas SV. Intracranial microbial aneurysm (infectious aneurysm): current options for diagnosis and management. Neurocrit Care. 2009;11(1):120-29. doi: 10.1007/s12028-009-9208-x.Bartakke S, Kabde U, Muranjan MN, Bavdekar SB. Mycotic aneurysm: an uncommon cause for intra-cranial hemorrhage. Indian J Pediatr. 2002;69(10):905-7. doi: 10.1007/BF02723719.Bartakke S, Kabde U, Muranjan MN, Bavdekar SB. Mycotic aneurysm: an uncommon cause for intra-cranial hemorrhage. Indian J Pediatr. 2002;69(10):905-7. doi: 10.1007/BF02723719.van der Meulen JH, Weststrate W, van Gijn J, Habbema JD. Is cerebral angiography indicated in infective endocarditis? Stroke. 1992 ;23(11):1662-7. doi: 10.1161/01.str.23.11.1662.van der Meulen JH, Weststrate W, van Gijn J, Habbema JD. Is cerebral angiography indicated in infective endocarditis? Stroke. 1992 ;23(11):1662-7. doi: 10.1161/01.str.23.11.1662.Hung SC, Tai CT. Infective endocarditis complicated with thalamic infarction and mycotic aneurysm rupture: a case report. Zhonghua Yi Xue Za Zhi (Taipei). 1998 ;61(1):53-8.Hung SC, Tai CT. Infective endocarditis complicated with thalamic infarction and mycotic aneurysm rupture: a case report. Zhonghua Yi Xue Za Zhi (Taipei). 1998 ;61(1):53-8.Клинические рекомендации «Инфекционный эндокардит и инфекция внутрисердечных устройств». Утверждены Минздравом РФ от 24.12.2021 г. Доступно: https://cr.minzdrav.gov.ru/schema/54_2Клинические рекомендации «Инфекционный эндокардит и инфекция внутрисердечных устройств». Утверждены Минздравом РФ от 24.12.2021 г. Доступно: https://cr.minzdrav.gov.ru/schema/54_2Fukuda W, Daitoku K, Minakawa M, Fukui K, Suzuki Y, Fukuda I. Management of infective endocarditis with cerebral complications. Ann Thorac Cardiovasc Surg. 2014;20(3):229-36. doi: 10.5761/atcs.oa.13.02265.Fukuda W, Daitoku K, Minakawa M, Fukui K, Suzuki Y, Fukuda I. Management of infective endocarditis with cerebral complications. Ann Thorac Cardiovasc Surg. 2014;20(3):229-36. doi: 10.5761/atcs.oa.13.02265.Duval X, Iung B, Klein I, Brochet E, Thabut G, Arnoult et al; IMAGE (Resonance Magnetic Imaging at the Acute Phase of Endocarditis) Study Group. Effect of early cerebral magnetic resonance imaging on clinical decisions in infective endocarditis: a prospective study. Ann Intern Med. 2010;152(8):497-504, W175. doi: 10.7326/0003-4819-152-8-201004200-00006.Duval X, Iung B, Klein I, Brochet E, Thabut G, Arnoult et al; IMAGE (Resonance Magnetic Imaging at the Acute Phase of Endocarditis) Study Group. Effect of early cerebral magnetic resonance imaging on clinical decisions in infective endocarditis: a prospective study. Ann Intern Med. 2010;152(8):497-504, W175. doi: 10.7326/0003-4819-152-8-201004200-00006.Yoon DY, Lim KJ, Choi CS, Cho BM, Oh SM, Chang SK. Detection and characterization of intracranial aneurysms with 16-channel multidetector row CT angiography: a prospective comparison of volume-rendered images and digital subtraction angiography. AJNR Am J Neuroradiol. 2007; 28(1):60-7.Yoon DY, Lim KJ, Choi CS, Cho BM, Oh SM, Chang SK. Detection and characterization of intracranial aneurysms with 16-channel multidetector row CT angiography: a prospective comparison of volume-rendered images and digital subtraction angiography. AJNR Am J Neuroradiol. 2007; 28(1):60-7.Walkoff L, Brinjikji W, Rouchaud A, Caroff J, Kallmes DF. Comparing magnetic resonance angiography (MRA) and computed tomography angiography (CTA) with conventional angiography in the detection of distal territory cerebral mycotic and oncotic aneurysms. Interv Neuroradiol. 2016; 22(5):524-8. doi: 10.1177/1591019916653247.Walkoff L, Brinjikji W, Rouchaud A, Caroff J, Kallmes DF. Comparing magnetic resonance angiography (MRA) and computed tomography angiography (CTA) with conventional angiography in the detection of distal territory cerebral mycotic and oncotic aneurysms. Interv Neuroradiol. 2016; 22(5):524-8. doi: 10.1177/1591019916653247.Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F et al; ESC Scientific Document Group. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015; 36(44):3075-3128. doi: 10.1093/eurheartj/ehv319.Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F et al; ESC Scientific Document Group. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015; 36(44):3075-3128. doi: 10.1093/eurheartj/ehv319.Chapot R, Houdart E, Saint-Maurice JP, Aymard A, Mounayer C, Lot G et al. Endovascular treatment of cerebral mycotic aneurysms. Radiology. 2002; 222(2):389-96. doi: 10.1148/radiol.2222010432. PMID: 11818604.Chapot R, Houdart E, Saint-Maurice JP, Aymard A, Mounayer C, Lot G et al. Endovascular treatment of cerebral mycotic aneurysms. Radiology. 2002; 222(2):389-96. doi: 10.1148/radiol.2222010432. PMID: 11818604.Ragulojan R, Grupke S, Fraser JF. Systematic Review of Endovascular, Surgical, and Conservative Options for Infectious Intracranial Aneurysms and Cardiac Considerations. J Stroke Cerebrovasc Dis. 2019; 28(3):838-844. doi: 10.1016/j.jstrokecerebrovasdis.2018.11.035.Ragulojan R, Grupke S, Fraser JF. Systematic Review of Endovascular, Surgical, and Conservative Options for Infectious Intracranial Aneurysms and Cardiac Considerations. J Stroke Cerebrovasc Dis. 2019; 28(3):838-844. doi: 10.1016/j.jstrokecerebrovasdis.2018.11.035.Brust JC, Dickinson PC, Hughes JE, Holtzman RN. The diagnosis and treatment of cerebral mycotic aneurysms. Ann Neurol. 1990; 27(3):238-46. doi: 10.1002/ana.410270305. Erratum in: Ann Neurol 1990 Sep;28(3):364.Brust JC, Dickinson PC, Hughes JE, Holtzman RN. The diagnosis and treatment of cerebral mycotic aneurysms. Ann Neurol. 1990; 27(3):238-46. doi: 10.1002/ana.410270305. Erratum in: Ann Neurol 1990 Sep;28(3):364.Corr P, Wright M, Handler LC. Endocarditis-related cerebral aneurysms: radiologic changes with treatment. AJNR Am J Neuroradiol. 1995;16(4):745-8.Corr P, Wright M, Handler LC. Endocarditis-related cerebral aneurysms: radiologic changes with treatment. AJNR Am J Neuroradiol. 1995;16(4):745-8.Park W, Ahn JS, Park JC, Kwun BD, Lee DH. Treatment Strategy Based on Experience of Treating Intracranial Infectious Aneurysms. World Neurosurg. 2017; 97:351-359. doi: 10.1016/j.wneu.2016.09.119.Park W, Ahn JS, Park JC, Kwun BD, Lee DH. Treatment Strategy Based on Experience of Treating Intracranial Infectious Aneurysms. World Neurosurg. 2017; 97:351-359. doi: 10.1016/j.wneu.2016.09.119.Рожченко Л.В., Иванов А.Ю., Дрягина Н.В., Петров А.Е., Горощенко С.А., Раджабов С.Д., и др. Коррекция тромбоэмболических осложнений при эндоваскулярных эмболизациях. Трансляционная медицина. 2016;3(1):98-105. https://doi.org/10.18705/2311-4495-2016-3-1-98-105.Рожченко Л.В., Иванов А.Ю., Дрягина Н.В., Петров А.Е., Горощенко С.А., Раджабов С.Д., и др. Коррекция тромбоэмболических осложнений при эндоваскулярных эмболизациях. Трансляционная медицина. 2016;3(1):98-105. https://doi.org/10.18705/2311-4495-2016-3-1-98-105.Singla A, Fargen K, Blackburn S, Neal D, Martin TD, Hess PJ et al. National treatment practices in the management of infectious intracranial aneurysms and infective endocarditis. J Neurointerv Surg. 2016; 8(7):741-46. doi: 10.1136/neurintsurg-2015-011834.Singla A, Fargen K, Blackburn S, Neal D, Martin TD, Hess PJ et al. National treatment practices in the management of infectious intracranial aneurysms and infective endocarditis. J Neurointerv Surg. 2016; 8(7):741-46. doi: 10.1136/neurintsurg-2015-011834.Appelboom G, Kadri K, Hassan F, Leclerc X. Infectious aneurysm of the cavernous carotid artery in a child treated with a new-generation of flow-diverting stent graft: case report. Neurosurgery. 2010; 66(3):623-24; discussion E624. doi: 10.1227/01.NEU.0000365370.82554.08.Appelboom G, Kadri K, Hassan F, Leclerc X. Infectious aneurysm of the cavernous carotid artery in a child treated with a new-generation of flow-diverting stent graft: case report. Neurosurgery. 2010; 66(3):623-24; discussion E624. doi: 10.1227/01.NEU.0000365370.82554.08.Hartmann A, Hoffmann K-T, Sander C, Sander C, Quäschling U, Schob S. Superior cerebellar artery aneurysm: spontaneous subarachnoid hemorrhage and stent-assisted coil occlusion of a ruptured aneurysm at the superior cerebellar artery origin and of an unruptured small basilar artery bifurcation aneurysm, bacterial endocarditis, early major aneurysm recurrence with oculomotor palsy, and treatment of the “mycotic” aneurysm by flow diverter implantation, with resolution of the aneurysm and good clinical recovery. In: Henkes H, Lylyk P, Ganslandt O. editors. The aneurysm casebook: a guide to treatment selection and technique. Cham: Springer International Publishing, 2018. 1-10 DOI: 10.1007/978-3-319-70267-4_56-1Hartmann A, Hoffmann K-T, Sander C, Sander C, Quäschling U, Schob S. Superior cerebellar artery aneurysm: spontaneous subarachnoid hemorrhage and stent-assisted coil occlusion of a ruptured aneurysm at the superior cerebellar artery origin and of an unruptured small basilar artery bifurcation aneurysm, bacterial endocarditis, early major aneurysm recurrence with oculomotor palsy, and treatment of the “mycotic” aneurysm by flow diverter implantation, with resolution of the aneurysm and good clinical recovery. In: Henkes H, Lylyk P, Ganslandt O. editors. The aneurysm casebook: a guide to treatment selection and technique. Cham: Springer International Publishing, 2018. 1-10 DOI: 10.1007/978-3-319-70267-4_56-1Imamura H, Sakai N, Alexander MJ. Flow-Diverter Stenting of Intracavernous Internal Carotid Artery Mycotic Aneurysm. J Stroke Cerebrovasc Dis. 2019;28(7):81-82. doi: 10.1016/j.jstrokecerebrovasdis.2019.04.026.Imamura H, Sakai N, Alexander MJ. Flow-Diverter Stenting of Intracavernous Internal Carotid Artery Mycotic Aneurysm. J Stroke Cerebrovasc Dis. 2019;28(7):81-82. doi: 10.1016/j.jstrokecerebrovasdis.2019.04.026.Kobets AJ, Scoco A, Nakhla J, Brook AL, Kinon MD, Baxi N et al. Flow-Diverting Stents for the Obliteration of Symptomatic, Infectious Cavernous Carotid Artery Aneurysms. Oper Neurosurg (Hagerstown). 2018; 14(6):681-685. doi: 10.1093/ons/opx166Kobets AJ, Scoco A, Nakhla J, Brook AL, Kinon MD, Baxi N et al. Flow-Diverting Stents for the Obliteration of Symptomatic, Infectious Cavernous Carotid Artery Aneurysms. Oper Neurosurg (Hagerstown). 2018; 14(6):681-685. doi: 10.1093/ons/opx166Samples DC, Ravindra VM, Thoms DJ, Tarasiewicz I, Grandhi R. Successful flow diversion treatment of ruptured infectious middle cerebral artery aneurysms with the use of Pipeline Flex with Shield technology. Interv Neuroradiol. 2021; 27(2):225-29. doi: 10.1177/1591019921990506.Samples DC, Ravindra VM, Thoms DJ, Tarasiewicz I, Grandhi R. Successful flow diversion treatment of ruptured infectious middle cerebral artery aneurysms with the use of Pipeline Flex with Shield technology. Interv Neuroradiol. 2021; 27(2):225-29. doi: 10.1177/1591019921990506.

The authors declare that there are no conflicts of interest present.