Ruptured Multiple Mycotic Aneurysms Following Infective Endocarditis: Effectiveness of Catheter-based Techniques Using N-butyl Cyanoacrylate in a Hemorrhage-induced Coagulopathy

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.