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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleNeurointervention

Management of Small Unruptured Intracranial Aneurysms: A Survey of Neuroradiologists

A. Malhotra, X. Wu, B. Geng, D. Hersey, D. Gandhi and P. Sanelli
American Journal of Neuroradiology April 2018, DOI: https://doi.org/10.3174/ajnr.A5631
A. Malhotra
aFrom the Department of Radiology and Biomedical Imaging (A.M.), Yale School of Medicine, New Haven, Connecticut
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X. Wu
bYale School of Medicine (X.W., B.G.), New Haven, Connecticut
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B. Geng
bYale School of Medicine (X.W., B.G.), New Haven, Connecticut
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D. Hersey
cClinical Information Services (D.H.), Cushing/Whitney Medical Library, Yale University, New Haven, Connecticut
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D. Gandhi
dDepartment of Interventional Neuroradiology (D.G.), University of Maryland School of Medicine, Baltimore, Maryland
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P. Sanelli
eDepartment of Radiology (P.S.), Northwell Health, New York, New York.
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References

  1. 1.↵
    1. Vlak MH,
    2. Algra A,
    3. Brandenburg R, et al
    . Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis. Lancet Neurol 2011;10:626–36 doi:10.1016/S1474-4422(11)70109-0 pmid:21641282
    CrossRefPubMedWeb of Science
  2. 2.↵
    1. Qureshi AI,
    2. Suri MF,
    3. Nasar A, et al
    . Trends in hospitalization and mortality for subarachnoid hemorrhage and unruptured aneurysms in the United States. Neurosurgery 2005;57:1–8; discussion 1–8 pmid:15987534
    PubMedWeb of Science
  3. 3.↵
    1. Malhotra A,
    2. Wu X,
    3. Forman HP, et al
    . Growth and rupture risk of small unruptured intracranial aneurysms: a systematic review. Ann Intern Med 2017;167:26–33 doi:10.7326/M17-0246 pmid:28586893
    CrossRefPubMed
  4. 4.↵
    1. Steiner T,
    2. Juvela S,
    3. Unterberg A, et al
    ; European Stroke Organization. European Stroke Organization guidelines for the management of intracranial aneurysms and subarachnoid haemorrhage. Cerebrovasc Dis (Basel, Switzerland) 2013;35:93–112 doi:10.1159/000346087 pmid:23406828
    CrossRefPubMed
  5. 5.↵
    1. Go AS,
    2. Mozaffarian D,
    3. Roger VL, et al
    ; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics: 2014 update—a report from the American Heart Association. Circulation 2014;129:e28–92 doi:10.1161/01.cir.0000441139.02102.80 pmid:24352519
    FREE Full Text
  6. 6.↵
    1. Wiebers DO,
    2. Whisnant JP,
    3. Huston J 3rd., et al
    ; International Study of Unruptured Intracranial Aneurysms Investigators. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet 2003;362:103–10 doi:10.1016/S0140-6736(03)13860-3 pmid:12867109
    CrossRefPubMedWeb of Science
  7. 7.↵
    1. Morita A,
    2. Kirino T,
    3. Hashi K, et al
    ; UCAS Japan Investigators. The natural course of unruptured cerebral aneurysms in a Japanese cohort. N Engl J Med 2012;366:2474–82 doi:10.1056/NEJMoa1113260 pmid:22738097
    CrossRefPubMedWeb of Science
  8. 8.↵
    1. Thompson BG,
    2. Brown RD Jr.,
    3. Amin-Hanjani S, et al
    ; American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, and Council on Epidemiology and Prevention, American Heart Association, American Stroke Association. Guidelines for the management of patients with unruptured intracranial aneurysms: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2015;46:2368–400 doi:10.1161/STR.0000000000000070 pmid:26089327
    Abstract/FREE Full Text
  9. 9.↵
    1. Murayama Y,
    2. Takao H,
    3. Ishibashi T, et al
    . Risk analysis of unruptured intracranial aneurysms: prospective 10-year cohort study. Stroke 2016;47:365–71 doi:10.1161/STROKEAHA.115.010698 pmid:26742803
    Abstract/FREE Full Text
  10. 10.↵
    1. Wardlaw JM,
    2. White PM
    . The detection and management of unruptured intracranial aneurysms. Brain 2000;123(Pt 2):205–21 doi:10.1093/brain/123.2.205 pmid:10648430
    CrossRefPubMedWeb of Science
  11. 11.↵
    1. Wong GK,
    2. Teoh J,
    3. Chan EK, et al
    . Intracranial aneurysm size responsible for spontaneous subarachnoid haemorrhage. Br J Neurosurg 2013;27:34–39 doi:10.3109/02688697.2012.709559 pmid:22905889
    CrossRefPubMed
  12. 12.↵
    1. Alshafai N,
    2. Falenchuk O,
    3. Cusimano MD
    . Practices and controversies in the management of asymptomatic aneurysms: results of an international survey. Br J Neurosurg 2015;29:758–64 doi:10.3109/02688697.2015.1096906 pmid:26540183
    CrossRefPubMed
  13. 13.↵
    1. Fargen KM,
    2. Soriano-Baron HE,
    3. Rushing JT, et al
    . A survey of intracranial aneurysm treatment practices among United States physicians. J Neurointerv Surg 2018;10:44–49 doi:10.1136/neurintsurg-2016-012808 pmid:28184003
    Abstract/FREE Full Text
  14. 14.↵
    1. Wermer MJ,
    2. van der Schaaf IC,
    3. Algra A, et al
    . Risk of rupture of unruptured intracranial aneurysms in relation to patient and aneurysm characteristics: an updated meta-analysis. Stroke 2007;38:1404–10 doi:10.1161/01.STR.0000260955.51401.cd pmid:17332442
    Abstract/FREE Full Text
  15. 15.↵
    1. Güresir E,
    2. Vatter H,
    3. Schuss P, et al
    . Natural history of small unruptured anterior circulation aneurysms: a prospective cohort study. Stroke 2013;44:3027–31 doi:10.1161/STROKEAHA.113.001107 pmid:24003049
    Abstract/FREE Full Text
  16. 16.↵
    1. Villablanca JP,
    2. Duckwiler GR,
    3. Jahan R, et al
    . Natural history of asymptomatic unruptured cerebral aneurysms evaluated at CT angiography: growth and rupture incidence and correlation with epidemiologic risk factors. Radiology 2013;269:258–65 doi:10.1148/radiol.13121188 pmid:23821755
    CrossRefPubMedWeb of Science
  17. 17.↵
    1. Backes D,
    2. Rinkel GJ,
    3. Laban KG, et al
    . Patient- and aneurysm-specific risk factors for intracranial aneurysm growth: a systematic review and meta-analysis. Stroke 2016;47:951–57 doi:10.1161/STROKEAHA.115.012162 pmid:26906920
    Abstract/FREE Full Text
  18. 18.↵
    1. Connolly ES Jr.,
    2. Rabinstein AA,
    3. Carhuapoma JR, et al
    ; American Heart Association Stroke Council, Council on Cardiovascular Radiology and Intervention, Council on Cardiovascular Nursing, Council on Cardiovascular Surgery and Anesthesia, Council on Clinical Cardiology. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2012;43:1711–37 doi:10.1161/STR.0b013e3182587839 pmid:22556195
    Abstract/FREE Full Text
  19. 19.↵
    1. Chmayssani M,
    2. Rebeiz JG,
    3. Rebeiz TJ, et al
    . Relationship of growth to aneurysm rupture in asymptomatic aneurysms ≤7 mm: a systematic analysis of the literature. Neurosurgery 2011;68:1164–71; discussion 1171 doi:10.1227/NEU.0b013e31820edbd3 pmid:21307791
    CrossRefPubMedWeb of Science
  20. 20.↵
    1. Li MH,
    2. Chen SW,
    3. Li YD, et al
    . Prevalence of unruptured cerebral aneurysms in Chinese adults aged 35 to 75 years: a cross-sectional study. Ann Intern Med 2013;159:514–21 doi:10.7326/0003-4819-159-8-201310150-00004 pmid:24126645
    CrossRefPubMed
  21. 21.↵
    1. Juvela S,
    2. Poussa K,
    3. Lehto H, et al
    . Natural history of unruptured intracranial aneurysms: a long-term follow-up study. Stroke 2013;44:2414–21 doi:10.1161/STROKEAHA.113.001838 pmid:23868274
    Abstract/FREE Full Text
  22. 22.↵
    1. Ishibashi T,
    2. Murayama Y,
    3. Urashima M, et al
    . Unruptured intracranial aneurysms: incidence of rupture and risk factors. Stroke 2009;40:313–16 doi:10.1161/STROKEAHA.108.521674 pmid:18845802
    Abstract/FREE Full Text
  23. 23.↵
    1. Sonobe M,
    2. Yamazaki T,
    3. Yonekura M, et al
    . Small unruptured intracranial aneurysm verification study: SUAVe study, Japan. Stroke 2010;41:1969–77 doi:10.1161/STROKEAHA.110.585059 pmid:20671254
    Abstract/FREE Full Text
  24. 24.↵
    1. Bor AS,
    2. Tiel Groenestege AT,
    3. terBrugge KG, et al
    . Clinical, radiological, and flow-related risk factors for growth of untreated, unruptured intracranial aneurysms. Stroke 2015;46:42–48 doi:10.1161/STROKEAHA.114.005963 pmid:25395411
    Abstract/FREE Full Text
  25. 25.↵
    1. Burns JD,
    2. Huston J 3rd.,
    3. Layton KF, et al
    . Intracranial aneurysm enlargement on serial magnetic resonance angiography: frequency and risk factors. Stroke 2009;40:406–11 doi:10.1161/STROKEAHA.108.519165 pmid:19023101
    Abstract/FREE Full Text
  26. 26.↵
    1. Ferns SP,
    2. Sprengers ME,
    3. van Rooij WJ, et al
    . De novo aneurysm formation and growth of untreated aneurysms: a 5-year MRA follow-up in a large cohort of patients with coiled aneurysms and review of the literature. Stroke 2011;42:313–18 doi:10.1161/STROKEAHA.110.591594 pmid:21164110
    Abstract/FREE Full Text
  27. 27.↵
    1. Mehan WA Jr.,
    2. Romero JM,
    3. Hirsch JA, et al
    . Unruptured intracranial aneurysms conservatively followed with serial CT angiography: could morphology and growth predict rupture? J Neurointerv Surg 2014;6:761–66 doi:10.1136/neurintsurg-2013-010944 pmid:24275611
    Abstract/FREE Full Text
  28. 28.↵
    1. Nader-Sepahi A,
    2. Casimiro M,
    3. Sen J, et al
    . Is aspect ratio a reliable predictor of intracranial aneurysm rupture? Neurosurgery 2004;54:1343–47; discussion 1347–48 doi:10.1227/01.NEU.0000124482.03676.8B pmid:15157290
    CrossRefPubMedWeb of Science
  29. 29.↵
    1. Hoh BL,
    2. Sistrom CL,
    3. Firment CS, et al
    . Bottleneck factor and height-width ratio: association with ruptured aneurysms in patients with multiple cerebral aneurysms. Neurosurgery 2007;61:716–22; discussion 722–23 doi:10.1227/01.NEU.0000298899.77097.BF pmid:17986932
    CrossRefPubMed
  30. 30.↵
    1. Yasuda R,
    2. Strother CM,
    3. Taki W, et al
    . Aneurysm volume-to-ostium area ratio: a parameter useful for discriminating the rupture status of intracranial aneurysms. Neurosurgery 2011;68:310–17; discussion 317–18 doi:10.1227/NEU.0b013e3182010ed0 pmid:21135739
    CrossRefPubMed
  31. 31.↵
    1. Dhar S,
    2. Tremmel M,
    3. Mocco J, et al
    . Morphology parameters for intracranial aneurysm rupture risk assessment. Neurosurgery 2008;63:185–96; discussion 196–97 doi:10.1227/01.NEU.0000316847.64140.81 pmid:18797347
    CrossRefPubMedWeb of Science
  32. 32.↵
    1. Lauric A,
    2. Baharoglu MI,
    3. Malek AM
    . Ruptured status discrimination performance of aspect ratio, height/width, and bottleneck factor is highly dependent on aneurysm sizing methodology. Neurosurgery 2012;71:38–45 doi:10.1227/NEU.0b013e3182503bf9 pmid:22353797
    CrossRefPubMed
  33. 33.↵
    1. Lauric A,
    2. Baharoglu MI,
    3. Gao BL, et al
    . Incremental contribution of size ratio as a discriminant for rupture status in cerebral aneurysms: comparison with size, height, and vessel diameter. Neurosurgery 2012;70:944–51; discussion 951–52 doi:10.1227/NEU.0b013e31823bcda7 pmid:21997542
    CrossRefPubMedWeb of Science
  34. 34.↵
    1. Juvela S,
    2. Korja M
    . Intracranial aneurysm parameters for predicting a future subarachnoid hemorrhage: a long-term follow-up study. Neurosurgery 2017;81:432–40 doi:10.1093/neuros/nyw049 pmid:28327974
    CrossRefPubMed
  35. 35.↵
    1. Suh SH,
    2. Cloft HJ,
    3. Huston J 3rd., et al
    . Interobserver variability of aneurysm morphology: discrimination of the daughter sac. J Neurointerv Surg 2016;8:38–41 doi:10.1136/neurintsurg-2014-011471 pmid:25385747
    Abstract/FREE Full Text
  36. 36.↵
    1. Malhotra A,
    2. Wu X,
    3. Forman HP, et al
    . Management of tiny unruptured intracranial aneurysms: a comparative effectiveness analysis. JAMA Neurol 2018;75:27–34 doi:10.1001/jamaneurol.2017.3232 pmid:29159405
    CrossRefPubMed
  37. 37.↵
    1. Sato K,
    2. Yoshimoto Y
    . Risk profile of intracranial aneurysms: rupture rate is not constant after formation. Stroke 2011;42:3376–81 doi:10.1161/STROKEAHA.111.625871 pmid:21980206
    Abstract/FREE Full Text
  38. 38.↵
    1. Gupta R,
    2. Griessenauer CJ,
    3. Adeeb N, et al
    . Evaluating imaging follow-up strategies and costs of unruptured intracranial aneurysms treated with endovascular techniques: a survey of academic neurovascular centers in the United States. World Neurosurg 2016;94:360–67 doi:10.1016/j.wneu.2016.07.030 pmid:27436215
    CrossRefPubMed
  39. 39.↵
    1. Koffijberg H,
    2. Buskens E,
    3. Algra A, et al
    . Growth rates of intracranial aneurysms: exploring constancy. J Neurosurg 2008;109:176–85 doi:10.3171/JNS/2008/109/8/0176 pmid:18671627
    CrossRefPubMedWeb of Science
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A. Malhotra, X. Wu, B. Geng, D. Hersey, D. Gandhi, P. Sanelli
Management of Small Unruptured Intracranial Aneurysms: A Survey of Neuroradiologists
American Journal of Neuroradiology Apr 2018, DOI: 10.3174/ajnr.A5631

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Management of Small Unruptured Intracranial Aneurysms: A Survey of Neuroradiologists
A. Malhotra, X. Wu, B. Geng, D. Hersey, D. Gandhi, P. Sanelli
American Journal of Neuroradiology Apr 2018, DOI: 10.3174/ajnr.A5631
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