Long-term Outcome of Unruptured Giant Cerebral Aneurysms

Nakase, Hiroyuki; Shin, Yasushi; Kanemoto, Yukihide; Ohnishi, Hideyuki; Morimoto, Tetsuya; Sakaki, Toshisuke

doi:10.2176/nmc.46.379

Cited by 44 publications

(32 citation statements)

References 21 publications

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“…August 2015 patients 224 and for all patients with regard to mortality, but at a cost in terms of morbidity: In a series of 39 patients with giant UIAs, Nakase et al 225 noted that mortality was markedly reduced by surgical intervention (4% versus 31%), but morbidity affected 19% compared with 8% of untreated patients.…”

Section: Strokementioning

confidence: 99%

Guidelines for the Management of Patients With Unruptured Intracranial Aneurysms

Thompson¹,

Brown²,

Amin‐Hanjani³

et al. 2015

Stroke

833

352

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Purpose— The aim of this updated statement is to provide comprehensive and evidence-based recommendations for management of patients with unruptured intracranial aneurysms. Methods— Writing group members used systematic literature reviews from January 1977 up to June 2014. They also reviewed contemporary published evidence-based guidelines, personal files, and published expert opinion to summarize existing evidence, indicate gaps in current knowledge, and when appropriate, formulated recommendations using standard American Heart Association criteria. The guideline underwent extensive peer review, including review by the Stroke Council Leadership and Stroke Scientific Statement Oversight Committees, before consideration and approval by the American Heart Association Science Advisory and Coordinating Committee. Results— Evidence-based guidelines are presented for the care of patients presenting with unruptured intracranial aneurysms. The guidelines address presentation, natural history, epidemiology, risk factors, screening, diagnosis, imaging and outcomes from surgical and endovascular treatment.

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Section: Strokementioning

confidence: 99%

Guidelines for the Management of Patients With Unruptured Intracranial Aneurysms

Thompson¹,

Brown²,

Amin‐Hanjani³

et al. 2015

Stroke

833

352

View full text Add to dashboard Cite

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“…Twenty-one studies reported risk factors for aneurysm growth, including 3954 patients with 4990 aneurysms with 11,000 patient-years and 13,294 aneurysm-years of follow-up. 9,12,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Eleven of these studies reported the rupture rate of growing aneurysms. Mean patient follow-up was 4.9 years, and median was 3.2 years.…”

Section: Literature Reviewmentioning

confidence: 99%

Risk Factors for Growth of Intracranial Aneurysms: A Systematic Review and Meta-Analysis

Brinjikji¹,

Zhang²,

Lanzino³

et al. 2015

AJNR Am J Neuroradiol

171

101

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“…1 ) [1, . Patient data description was aggregate in 15 study populations (854 GIA) [1,[15][16][17][18][19][20][21][22][23][24][25][26] and individual in 49 study populations (415 GIA) . Table 1 [67] 2002 R E 7 100 50.6 Yes Yes P = Prospective; R = retrospective; S = surgical; E = endovascular; C = combined; N/A = not available.…”

Section: Resultsmentioning

confidence: 99%

Outcome of Surgical or Endovascular Treatment of Giant Intracranial Aneurysms, with Emphasis on Age, Aneurysm Location, and Unruptured Aneuryms - A Systematic Review and Meta-Analysis

et al. 2016

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BACKGROUND Designing treatment strategies for unruptured giant intracranial aneurysms (GIA) is difficult as evidence of large clinical trials is lacking. We examined the outcome following surgical or endovascular GIA treatment focusing on patient age, GIA location and unruptured GIA. METHODS Medline and Embase were searched for studies reporting on GIA treatment outcome published after January 2000. We calculated the proportion of good outcome (PGO) for all included GIA and for unruptured GIA by meta-analysis using a random effects model. RESULTS We included 54 studies containing 64 study populations with 1,269 GIA at a median follow-up time (FU-T) of 26.4 months (95% CI 10.8-42.0). PGO was 80.9% (77.4-84.4) in the analysis of all GIA compared to 81.2% (75.3-86.1) in the separate analysis of unruptured GIA. For each year added to patient age, PGO decreased by 0.8%, both for all GIA and unruptured GIA. For all GIA, surgical treatment resulted in a PGO of 80.3% (95% CI 76.0-84.6) compared to 84.2% (78.5-89.8, p = 0.27) after endovascular treatment. In unruptured GIA, PGO was 79.7% (95% CI 71.5-87.8) after surgical treatment and 84.9% (79.1-90.7, p = 0.54) after endovascular treatment. PGO was lower in high quality studies and in studies presenting aggregate instead of individual patient data. In unruptured GIA, the OR for good treatment outcome was 5.2 (95% CI 2.0-13.0) at the internal carotid artery compared to 0.1 (0.1-0.3, p < 0.1) in the posterior circulation. Patient sex, FU-T and prevalence of ruptured GIA were not associated with PGO. CONCLUSIONS We found that the chances of good outcome after surgical or endovascular GIA treatment mainly depend on patient age and aneurysm location rather than on the type of treatment conducted. Our analysis may inform future research on GIA. .7, p = 0.54) after endovascular treatment. PGO was lower in high quality studies and in studies presenting aggregate instead of individual patient data. In unruptured GIA, the OR for good treatment outcome was 5.2 (95% CI 2.0-13.0) at the internal carotid artery compared to 0.1 (0.1-0.3, p < 0.1) in the posterior circulation. Patient sex, FU-T and prevalence of ruptured GIA were not associated with PGO. Conclusions:We found that the chances of good outcome after surgical or endovascular GIA treatment mainly depend on patient age and aneurysm location rather than on the type of treatment conducted. Our analysis may inform future research on GIA.© 2016 S. Karger AG, Basel Key WordsGiant intracranial aneurysm · Endovascular treatment · Surgical aneurysm treatment Abstract Background: Designing treatment strategies for unruptured giant intracranial aneurysms (GIA) is difficult as evidence of large clinical trials is lacking. We examined the outcome following surgical or endovascular GIA treatment focusing on patient age, GIA location and unruptured GIA. Methods: Medline and Embase were searched for studies reporting on GIA treatment outcome published after January 2000. We calculated the proportion of good outcome (PGO) for all...

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Long-term Outcome of Unruptured Giant Cerebral Aneurysms

Cited by 44 publications

References 21 publications

Guidelines for the Management of Patients With Unruptured Intracranial Aneurysms

Guidelines for the Management of Patients With Unruptured Intracranial Aneurysms

Risk Factors for Growth of Intracranial Aneurysms: A Systematic Review and Meta-Analysis

Outcome of Surgical or Endovascular Treatment of Giant Intracranial Aneurysms, with Emphasis on Age, Aneurysm Location, and Unruptured Aneuryms - A Systematic Review and Meta-Analysis

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