Aneurysm growth and de novo aneurysms during aneurysm surveillance

This study investigates the rate of aneurysm growth of UIAs and de novo aneurysm formation during aneurysm surveillance.   The study includes surveillance of 234 aneurysms in 192 patients.  Over the 793 years of aneurysm follow up the annual UIA growth was approximately 3.5% and the risk of de novo aneurysm formation was found to be nearly 1%.   Interestingly, the only aneurysm variable predictive of aneurysm growth was initial aneurysm size at the time of diagnosis.  Modifiable risk factors such as hypertension, tobacco use, alcohol abuse and an individuals family history of SAH were not predictive of growth. The incidence of growth for UIAs was higher for aneurysm > 5 mm.  Additionally, during the surveillance interval, 4.3% of UIAs in the study grew at the 6 month examination. 

            While the study does have limitations due to the retrospective nature of the analysis, the unexpected early growth encountered may have implications for current practice and may support more frequent early surveillance and possibly even earlier treatment of UIA’s, especially when UIA size is 5 mm or greater. 

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American Association of Neurological Surgeons

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