Intracranial mycotic or infectious aneurysms result from the infection of arterial walls, most commonly caused by bacterial or fungal organisms. These infections can weaken the arterial wall, leading to the formation of an aneurysm, a localized dilation, or a bulge [1], [2]. Mycotic aneurysms predominantly affect large arteries, such as the aorta or intracranial vessels [3]. Common risk factors include underlying infections such as endocarditis, septicemia, or intravenous drug abuse [2], [4], [5]. Given their association with infection, mycotic aneurysms demand prompt intervention to prevent catastrophic complications [5].

In addition to previous conservative treatment, mainly based on antibiotics, more invasive procedures such as direct aneurysm clipping or endovascular treatment are selected. Endovascular treatment has gained increasing recognition as a valuable approach for managing mycotic aneurysms. Unlike open surgical repair, which involves major incisions and extensive dissection, endovascular techniques offer a minimally invasive alternative [6]. The procedure typically involves the use of catheters, guide wires, and specialized devices to access the affected blood vessel through small incisions in the groin or wrist. Once inside the blood vessel, the physician can navigate the catheter to the site of the aneurysm and deploy various endovascular tools, such as stents or embolic agents, to reinforce the arterial wall or occlude the aneurysm. These techniques can effectively seal off the aneurysm, preventing rupture and restoring normal blood flow [7].

Endovascular treatment of intracranial aneurysms offers several benefits over open surgery [7], [8]. Firstly, it reduces the risk of complications associated with large surgical incisions, such as wound infections or prolonged hospital stays. The minimally invasive nature of the procedure also results in shorter recovery times and allows for earlier mobilization of patients [9]. Additionally, endovascular techniques are particularly advantageous in patients who are considered high-risk surgical candidates due to comorbidities or frailty [10].

In this paper, we performed a systematic review and meta-analysis of the current literature on endovascular treatment of mycotic aneurysms, analyzing the safety and efficacy associated with this procedure.