scholarly journals Long-Term Rupture Risk in Patients with Unruptured Intracranial Aneurysms Treated with Endovascular Therapy: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 41 (6) ◽  
pp. 1043-1048
Author(s):  
A. Rizvi ◽  
S.M. Seyedsaadat ◽  
M. Alzuabi ◽  
M.H. Murad ◽  
R. Kadirvel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Endovascular Therapy ◽  
Intracranial Aneurysms ◽  
Meta Analysis ◽  
Rupture Risk ◽  
Unruptured Intracranial Aneurysms

Long-Term Efficacy of Clipping Versus Coiling of Intracranial Aneurysms: A Systematic Review and Meta-Analysis

2018 ◽  
Author(s):  
Alexander F. Hulsbergen ◽  
Lida Mirzaei ◽  
Arthur T. Van der Boog ◽  
Timothy R. Smith ◽  
Ivo S. Muskens ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intracranial Aneurysms ◽  
Meta Analysis ◽  
Term Efficacy

Abstract WP130: Long Term Outcome of Large and Giant Unruptured Intracranial Aneurysms

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Issei Kan ◽  
Toshihiro Ishibashi ◽  
Ichiro Yuki ◽  
Masayuki Ebara ◽  
Hideki Arakawa ◽  
...  
Keyword(s):  
Endovascular Therapy ◽  
Intracranial Aneurysms ◽  
Long Term Results ◽  
Final Visit ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Unruptured Intracranial Aneurysms ◽  
Retreatment Rate

Objectives: Long term outcome of large / giant unruptured intracranial aneurysms (LG-UIAs) after endovascular therapy is still unknown. We retrospectively analyzed long-term results of patients with LG-UIAs who were followed up more than 5 years after endovascular therapy. Methods: We included patients from our complete database with UIAs greater than 10mm and treated at our hospital from January 2003 to December 2013. Retreatment rate of targeted aneurysms, rupture rate, and the modified Rankin scale (mRS) at last visit were evaluated till December 2018. Results: From 142 patients treated during the period were excluded 3 patients with perioperative rupture and 38 patients with less than 5 years follow-up period, finally analyzing 101 patients. The median aneurysm size was 12.0 mm (IQR 10.8-15). The median follow-up period was 9.4 years (IQR: 7-11), the longest being 13.3 years. Retreatment was performed on 36 patients (35.6%). Comparing cumulative re-treatment rates in groups with aneurysm sizes <15 mm and> 20 mm, it was predominantly higher for aneurysms> 20 mm (P = 0.02, Figure1 ). Rupture of targeted aneurysms was observed in 2 cases (1.98%, Figure2 ), and the longest period from last treatment was up to 12 years. The mRS 0-1 at the first treatment and the final visit were 98% and 93%, respectively, and mRS deterioration remained at 5%. Conclusion: The retreatment rate tended to increase in proportion to the size of the aneurysm, however the final neurological outcome was favorable when considering the natural history of these aneurysms. Since aneurysmal rupture could occur after 12 years of treatment, long-term follow-up should be considered for LG-UIAs.

scholarly journals P.114 Headache outcomes after treatment of unruptured intracranial aneurysms: systematic review and meta-analysis

2019 ◽  
Vol 46 (s1) ◽  
pp. S43-S44
Author(s):  
C Dandurand ◽  
H Parhar ◽  
F Naji ◽  
S Prakash ◽  
PA Gooderham
Keyword(s):  
Systematic Review ◽  
Intracranial Aneurysm ◽  
Intracranial Aneurysms ◽  
Rating Scale ◽  
Meta Analysis ◽  
Effect Estimate ◽  
Significant Heterogeneity ◽  
Unruptured Intracranial Aneurysm ◽  
Standard Mean Difference ◽  
Unruptured Intracranial Aneurysms

Background: Headaches are a major cause of disability and healthcare cost worldwide. When investigating headaches etiology, incidental unruptured intracranial aneurysms are often considered unrelated. We conducted a systematic review and meta-analysis to assess headaches outcomes (severity) after treatment of unruptured intracranial aneurysm. Methods: MEDLINE and EMBASE were systematically reviewed. Results: The data from eligible studies (n=7) was extracted and analyzed. 309 nonduplicated patients provided patient-level data for analysis. All studies used the 10-point numeric rating scale (NRS). 88% of patients were treated with endovascular technique. Overall, the observed effect estimate under a random effects model was found to be a standard mean difference in pre- and post-intervention headache severity of -0.448 (95% CI: -0.566 to -0.329). No significant heterogeneity was noted. No significant publication bias was demonstrated. Conclusions: This is the first and largest systematic review assessing postoperative headache outcomes after treatment of unruptured intracranial aneurysm. A significant reduction in headache intensity after treatment is observed in the current published literature. This study highlights an interesting clinical phenomenon that still warrants scientific effort before it can influence clinical practice. We encourage future study to stratify headache outcomes by aneurysm size, location and treatment modality.

PHASES score and treatment scoring with cigarette smoking in the long-term prediction of rupturing of unruptured intracranial aneurysms

2021 ◽  
pp. 1-7
Author(s):  
Seppo Juvela
Keyword(s):  
Intracranial Aneurysms ◽  
Area Under The Curve ◽  
Aneurysm Rupture ◽  
Rupture Risk ◽  
Optimal Cutoff ◽  
Unruptured Intracranial Aneurysms ◽  
Working Age ◽  
Optimal Cutoff Point ◽  
New Treatment

OBJECTIVE Treatment indications in unruptured intracranial aneurysms (UIAs) are challenging because of the lack of prospective natural history studies without treatment selection and the decreasing incidence of aneurysm rupture. The purpose of this study was to test whether the population, hypertension, age, size of aneurysm, earlier aneurysm rupture, site of aneurysm (PHASES) score obtained from an individual-based meta-analysis could predict the long-term rupture risk of UIAs. METHODS The series included 142 patients of working age with UIAs diagnosed before 1979, when these were not treated but were followed up until the first rupture, death, or the last contact. PHASES scores were recorded for all patients by using the baseline variables and compared with the new treatment score obtained from a recent cohort, consisting of age, smoking status, and aneurysm size and location. RESULTS Of the 142 patients, 34 had an aneurysm rupture during a total follow-up of 3064 person-years. The median time between diagnosis and an aneurysm rupture was 10.6 years. The PHASES score at baseline was higher in those with an aneurysm rupture than in the others (5.3 ± 2.3 vs 4.2 ± 2.2, p = 0.012), and the difference relative to the new treatment score was 5.3 ± 2.4 versus 3.0 ± 2.2 (p < 0.001). The receiver operating characteristic curve of the PHASES score for predicting rupture showed a fair area under the curve (0.674, 95% CI 0.558–0.790) where the optimal cutoff point was obtained at ≥ 6 versus < 6 points for sensitivity (0.500) and specificity (0.811). The area under the curve of the new score was 0.755 (95% CI 0.657–0.853), with the optimal cutoff point at ≥ 5 versus < 5 points for sensitivity (0.607) and specificity (0.789). CONCLUSIONS The PHASES and the new scores predicted the long-term aneurysm rupture risk moderately well, with the latter, which also included smoking, being slightly better and easier in clinical practice. The findings suggest that treatment decisions about UIAs in patients of working age can be done with an improved cost-effectiveness.

Long-Term Durability of Open Surgical versus Endovascular Repair of Intracranial Aneurysms: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 132 ◽  
pp. e820-e833 ◽  
Author(s):  
Alexander F.C. Hulsbergen ◽  
Lida Mirzaei ◽  
Arthur T.J. van der Boog ◽  
Timothy R. Smith ◽  
Ivo S. Muskens ◽  
...  
Keyword(s):  
Systematic Review ◽  
Endovascular Repair ◽  
Intracranial Aneurysms ◽  
Meta Analysis
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