No treatment or imaging follow-up most effective for tiny UIAs

November 21, 2017

(HealthDay)—For patients with unruptured intracranial aneurysms (UIAs) that are 3 mm or smaller, no preventive treatment or imaging follow-up is the most effective management strategy, according to a study published online Nov. 20 in JAMA Neurology.

Ajay Malhotra, M.D., from the Yale School of Medicine in New Haven, Conn., and colleagues used inputs from the medical literature to conduct a decision-analytic model-based comparative effectiveness analysis. Five management strategies were assessed: annual (MRA) screening, biennial MRA screening, MRA screening every five years, aneurysm coiling and follow-up, and no treatment or preventive follow-up.

In an analysis of 10,000 iterations simulating adult patients, the researchers found that the highest health benefit was seen for the strategy of no treatment or preventive follow-up (mean quality-adjusted life-years, 19.40). MRA every five years was the best of the that incorporate follow-up imaging, with the next highest effectiveness (mean quality-adjusted life-years, 18.05). When the annual growth rate and risk of rupture of growing aneurysms are varied, no routine follow-up remains the optimal strategy. No follow-up is the optimal when the annual risk of rupture of nongrowing UIAs is less than 1.7 percent; coiling should be performed directly if the annual risk of rupture is >1.7 percent.

"Given these findings, it is important to critically evaluate the appropriateness of current clinical practices," the authors write.

Explore further: Small unruptured intracranial aneurysms grow slowly

More information: Abstract/Full Text
Editorial

Related Stories

Small unruptured intracranial aneurysms grow slowly

June 6, 2017
(HealthDay)—Small unruptured intracranial aneurysms (UIAs) have low growth and rupture rates, according to a review published online June 6 in the Annals of Internal Medicine.

Risk of rupture increases with size of cerebral aneurysm

June 28, 2012
(HealthDay) -- The natural course of unruptured cerebral aneurysms varies according to their size, location, and shape, according to a study published in the June 28 issue of the New England Journal of Medicine.

Growth in cerebral aneurysms increases risk of rupture

July 2, 2013
Cerebral aneurysms of all sizes—even small ones below seven millimeters—are 12 times more likely to rupture if they are growing in size, according to a new study published online in the journal Radiology.

No increase in brain aneurysm rupture risk during pregnancy and delivery

February 7, 2013
For women with aneurysms involving the brain blood vessels, pregnancy and delivery don't appear to increase the risk of aneurysm rupture, reports a paper in the February issue of Neurosurgery, official journal of the Congress ...

Bone strength + bone mineral density screening cost-effective

October 29, 2017
(HealthDay)—Combined assessment of bone strength and bone mineral density is a cost-effective strategy for osteoporosis screening in postmenopausal women, according to a study published in the November issue of Radiology.

New guideline for screening for abdominal aortic aneurysms

September 11, 2017
A new screening guideline from the Canadian Task Force on Preventive Health Care (CTFPHC) for abdominal aortic aneurysms (AAAs), which cause approximately 1244 deaths every year in Canada, recommends one-time ultrasonography ...

Recommended for you

Cell study reveals how head injuries lead to serious brain diseases

November 16, 2018
UCLA biologists have discovered how head injuries adversely affect individual cells and genes that can lead to serious brain disorders. The life scientists provide the first cell "atlas" of the hippocampus—the part of the ...

Newborn babies' brain responses to being touched on the face measured for the first time

November 16, 2018
A newborn baby's brain responds to being touched on the face, according to new research co-led by UCL.

Precision neuroengineering enables reproduction of complex brain-like functions in vitro

November 14, 2018
One of the most important and surprising traits of the brain is its ability to dynamically reconfigure the connections to process and respond properly to stimuli. Researchers from Tohoku University (Sendai, Japan) and the ...

New brain imaging research shows that when we expect something to hurt it does, even if the stimulus isn't so painful

November 14, 2018
Expect a shot to hurt and it probably will, even if the needle poke isn't really so painful. Brace for a second shot and you'll likely flinch again, even though—second time around—you should know better.

A 15-minute scan could help diagnose brain damage in newborns

November 14, 2018
A 15-minute scan could help diagnose brain damage in babies up to two years earlier than current methods.

New clues to the origin and progression of multiple sclerosis

November 13, 2018
Mapping of a certain group of cells, known as oligodendrocytes, in the central nervous system of a mouse model of multiple sclerosis (MS), shows that they might have a significant role in the development of the disease. The ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.