Pyogenic parenchymatous and nidus infection after embolization of an arteriovenous malformation

Abstract

Infectious complications of cerebral angiography and of therapeutic angiographic procedures are very seldom reported. The case of an infected embolized arteriovenous malformation (AVM) by staphylococcus aureus is reported. Abscess formation became manifest seven months after the endovascular procedures. Antibiotherapy was initially started after puncturing the abscess, but finally the cure of the lesion could only be obtained by radical excision of the infected and embolized AVM, as if the persisting embolization material was promoting the infection. The modalities of infection after cerebral endovascular procedures are discussed.

Cerebral abscesses after endovascular coiling of a paraophthalmic aneurysm: Case report and review of the literature

“…The following search terms were used in combination: “cerebral,” “abscess,” “endovascular,” and “embolization.” Review of literature found 12 patients (13 including our case) satisfying these criteria. [13467111315171820] The patients who developed intracranial abscess had endovascular procedures to treat their aneurysm[14671115] or AVM. [313171820]…”

“…In seven patients,[14671115] this was to treat a cerebral aneurysm, and in six cases, this was to treat an AVM. [313171820]…”

“…Three males[31820] and 3 females[131720] had therapeutic endovascular treatment of AVM (female: male ratio 1). Mean age of 27 years (range 21–38 years).…”

“…On admission, 50% of patients had alobar hemorrhage secondary to cerebral AVMs. [171820] Complete embolization with N-butyl cyanoacrylate glue was performed in three cases, while in two cases residual filling persisted. The result of embolization was not specified in one case.…”

“…In 3 out of 13 patients (2 aneurysms, 1 AVM), Staphyloccous aureus was present in blood culture. [71117] Staphyloccous is a skin saprophyte and frequently penetrates the bloodstream through the femoral puncture site leading to bacteremia and maybe a source of the contamination for intravascular devices. [9] Salmonella group D species was identified in the report by Kirollos et al .…”