Risk factors of infection in neuroendovascular procedure

Abstract

Background

With the advent of neuroendovascular procedures, there has been a revolution in the management of neurovascular diseases. One of the major advantages for this minimally invasive procedure is low rate of infections, as compared to craniotomy for treatment of the diseases. However, the risk of infection in these procedures has not been reported widely in the literature. We studied the risk of infection in neuroendovascular procedures in our experience.

Materials and Methods

We studied 256 procedures in 220 prospective patients who underwent neuroendovascular treatment from September 2006 to May 2008 at our institution. Sepsis was defined following the criteria of systemic inflammatory response syndrome plus a documented source of infection with blood cultures.

Results

Sepsis occurred in 22 (8.6%) of the 256 procedures. Almost all of these cases were treated with antibiotics without complicating their intravascular devices infection. However, two sepsis cases of methicillin-resistant Staphylococcus aureus were intractable and took more than a month to resolve.

Conclusion

This study emphasizes the risk of infections in endovascular procedures, and the importance of sterility in these procedures.

Key words

Infections - neuroendovascular - sepsis

• References

• 1 Meyer P, Reizine D, Aymard A. Septic complications in interventional radiography: Evaluation of risk and preventive measures: Preliminary studies. J Interv Radiol 1988; 3: 73-75
• 2 Ryan JM, Ryan BM, Smith TP. Antibiotic prophylaxis in interventional radiology. J Vasc Interv Radiol 2004; 15: 547-556
• 3 Antonios VS, Baddour LM. Intra-arterial device infections. Curr Infect Dis Rep 2004; 6: 263-269
• 4 Ducasse E, Calisti A, Speziale F, Rizzo L, Misuraca M, Fiorani P. Aortoiliac stent graft infection: Current problems and management. Ann Vasc Surg 2004; 18: 521-526
• 5 Samore MH, Wessolossky MA, Lewis SM, Shubrooks Jr SJ, Karchmer AW. Frequency, risk factors, and outcome for bacteremia after percutaneous transluminal coronary angioplasty. Am J Cardiol 1997; 79: 873-877
• 6 Deiparine MK, Ballard JL, Taylor FC, Chase DR. Endovascular stent infection. J Vasc Surg 1996; 23: 529-533
• 7 Al-Okaili R, Patel SJ. Brain abscess after endovascular coiling of a saccular aneurysm: Case Report. AJNR Am J Neuroradiol 2002; 23: 697-699
• 8 Jenkinson MD, Javadpour M, Nixon T, Warnke P. Intracerebral abscess formation following embolisation of an internal carotid artery aneurysm using Guglielmi detachable coils. Acta Neurochirurgica 2003; 145: 703-706
• 9 Kaviani A, Ouriel K, Kashyap VS. Infected carotid pseudoaneurysm and carotid-cutaneous fistula as a late complication of carotid artery stenting. J Vasc Surg 2006; 43: 379-381