Abstract
Background and purpose
The rate of de novo aneurysm formation in patients with unruptured aneurysm without history of subarachnoid hemorrhage is scarcely defined in literature. We report the incidence of de novo aneurysm formation in a large contemporary series of patients with unruptured intracranial aneurysm (UIA) undergoing serial neurovascular imaging.
Methods
Neurovascular imaging studies of 321 consecutive UIA patients with no prior history of subarachnoid hemorrhage, with at least 3 years of follow-up imaging, were reviewed by a neuroradiologist and a neurosurgeon. Rate of de novo aneurysm formation was reported on a per-patient and per-patient-year basis.
Results
Of the 321 included patients, three patients (0.9%) developed a de novo aneurysm over a mean follow-up period of 5.2 years, for an incidence rate of 0.18% per patient-year. No de novo aneurysms ruptured and all three were 2 mm in size.
Conclusions
The rate of de novo aneurysm formation in patients with unruptured aneurysms and no history of subarachnoid hemorrhage is very low. These data are useful to advice patients with unruptured aneurysms from another aneurysm and to plan imaging follow-ups in these patients.
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Dr. Giordan, Dr. Brinjikji and Mrs. Vine report no disclosures. Dr. Lanzino reports that he is a consultant with Medtronic.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Giordan, E., Brinjikji, W., Vine, R.L. et al. Risk of de novo aneurysm formation in patients with unruptured intracranial aneurysms. Acta Neurochir 160, 747–751 (2018). https://doi.org/10.1007/s00701-018-3472-5
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DOI: https://doi.org/10.1007/s00701-018-3472-5