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Related Experiment Videos

Unruptured intracranial aneurysms.

P M White1, J M Wardlaw

  • 1Department of Clinical Neuroscience, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK.

Journal of Neuroradiology = Journal De Neuroradiologie
|January 31, 2004
PubMed
Summary
This summary is machine-generated.

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Unruptured intracranial aneurysms pose a rupture risk influenced by size and location. Endovascular coiling shows promise for ruptured and unruptured aneurysms, offering better outcomes than surgical clipping in some cases.

Area of Science:

  • Neurosurgery
  • Neuroradiology
  • Vascular Neurology

Background:

  • Unruptured intracranial aneurysms (UIAs) affect 3.6-6% of the population.
  • Rupture risk is stratified by aneurysm location, size, and patient history of subarachnoid hemorrhage (SAH).
  • Diagnostic imaging modalities include MRA, CTA, and IADSA, with limitations in detecting smaller aneurysms.

Purpose of the Study:

  • To analyze rupture rates of intracranial aneurysms based on size, location, and patient history.
  • To compare the efficacy and safety of endovascular coiling versus surgical clipping for ruptured and unruptured aneurysms.
  • To evaluate the cost-effectiveness of mass screening for aneurysms.

Main Methods:

  • Analysis of rupture rates from the ISUIA 2 study for unruptured aneurysms.

Related Experiment Videos

  • Review of the ISAT trial data comparing coiling and clipping for ruptured aneurysms.
  • Assessment of diagnostic accuracy for MRA and CTA in aneurysm detection.

    • Main Results:

    • Rupture rates increase with aneurysm size and posterior circulation location; giant aneurysms have the highest risk.
    • Endovascular coiling demonstrated a significant reduction in death or dependency for ruptured aneurysms compared to surgical clipping.
    • For unruptured aneurysms, coiling showed lower morbidity and mortality than clipping, though long-term durability remains a concern.

    Conclusions:

    • Aneurysm management decisions should consider individual risk factors, including size, location, and patient history.
    • Endovascular coiling is a viable alternative to surgical clipping, particularly for ruptured aneurysms.
    • Mass screening for aneurysms is not cost-effective, but targeted screening in high-risk subgroups may be warranted.