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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Aneurysm IV: Nursing Management01:22

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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Aneurysm I: Introduction01:30

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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Related Experiment Video

Updated: Oct 1, 2025

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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A Meta-Analysis of Rupture Risk for Intracranial Aneurysms 10 mm or Less in Size Selected for Conservative Management

Ronil V Chandra1,2, Julian Maingard1, Lee-Anne Slater1,2

  • 1NeuroInterventional Radiology, Monash Medical Centre, Monash Health, Melbourne, VIC, Australia.

Frontiers in Neurology
|March 7, 2022
PubMed
Summary

Small unruptured intracranial aneurysms (UIAs) ≤10 mm have a low rupture risk, with 8-15 events per 1,000 over 3.7 years when managed conservatively. These findings are consistent for aneurysms ≤5 mm.

Keywords:
Systematic Reviews and Meta-Analysescerebral aneurysmevidence based medicine (EBM)intracranial aneurysmsubarachnoid hemorrhage

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Area of Science:

  • Neurosurgery
  • Vascular Neurology
  • Epidemiology

Background:

  • Small unruptured intracranial aneurysms (UIAs) are generally considered low risk.
  • The rupture rate of UIAs ≤10 mm managed conservatively is not well-established.
  • This study quantifies UIA rupture risk by size and explores heterogeneity.

Approach:

  • Systematic review and random-effects meta-analysis of 31 studies (13,800 UIAs).
  • Searched multiple databases (MEDLINE, EMBASE, Web of Science, Cochrane) from inception to August 2020.
  • Analyzed rupture outcomes for UIAs ≤10 mm, stratified to ≤5 mm and ≤3 mm, exploring heterogeneity via meta-regression.

Key Points:

  • Pooled rupture proportion for UIAs ≤10 mm managed conservatively was 1.1% over 3.7 years (95% CI 0.8-1.5).
  • Rupture rates were 1.0% for ≤5 mm (95% CI 0.8-1.3) and 0.8% for ≤3 mm (95% CI 0.4-1.5), with no heterogeneity.
  • Higher quality studies reported a 1.8% rupture rate (95% CI 1.5-2.0) over 3.9 years.

Conclusions:

  • Conservative management of UIAs ≤10 mm results in an estimated 8-15 ruptures per 1,000 over 3.7 years.
  • Rupture risk estimates are consistent and clinically applicable for UIAs ≤5 mm managed conservatively.
  • Aneurysm size, shape, location, and prior subarachnoid hemorrhage were not significant sources of heterogeneity.