Long-term Follow-up after Treatment for Cerebrovascular Disease. Late Follow-up Review of Clipped Cerebral Aneurysms.

Assessment of long-term results of intracranial aneurysm clipping by means of computed tomography angiography

“…Kakinuma et al reported 7 rehaemorrhages (including 5 from 'de novo' and 2 from regrowth of clipped aneurysms) in 482 pa -tients, at a mean interval of 7.3 years after clipping. Annual risk of subsequent SAH from both 'de novo' aneurysms and regrowths was 0.2% [15]. In our series, the overall and annual risk of aneurysm re-rupture were 0.7% and 0.1% respectively.…”

“…Despite the low risk of subsequent haemorrhage, it is emphasised that this is still higher than in the gene ral population. Some authors postulate closer surveillance of those patients including periodic performance of CTA or MRA, and DSA in cases where residual neck is known [15]. However, the benefit of routine long-term screening in every patient after clipping is questionable, in the light of possible complications from preventive DSA and re-treatment [17].…”

“…Our series contains only 58% of the patients invited to the study. Unfortunately, most long-term follow-up analyses encompass only a proportion of treated patients [2,10,11,15,21]. The unexplored groups include patients who died of various causes (possibly also due to rebleeding), severely disabled patients at discharge, and those who were not interested in invasive screening tests.…”