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Thread: Article:Long-term Follow-up of clipped aneurysms find 30% of patients have new ones

  1. #1

    Default Article:Long-term Follow-up of clipped aneurysms find 30% of patients have new ones

    For those of you who were told that clipping was permanent, and didn't need follow-up, please ask for follow-up. 30% develop new aneurysms.
    JulieNH

    Long-term follow-up survey reveals a high yield, up to 30% of patients presenting newly detected aneurysms more than 10 years after ruptured intracranial aneurysms clipping.

    Neurosurg Rev. 2011; 34(4):485-96 (ISSN: 1437-2320)

    Bruneau M; Rynkowski M; Smida-Rynkowska K; Brotchi J; De Witte O; Lubicz B
    Department of Neurosurgery, H˘pital Erasme, UniversitÚ Libre de Bruxelles, Brussels, Belgium. mbruneau@ulb.ac.be

    The need to pursue long-term follow-up in patients treated for a ruptured aneurysm remains debated. New aneurysms development is a crucial element to consider but remains scarcely analyzed especially after a mean follow-up longer than 10 years. Our study was designed to provide rates of newly developed aneurysms in patients who have undergone prior clipping who were not followed with serial imaging. Patients were included if they were (1) treated more than 10 years ago by clipping of a ruptured aneurysm, (2) independent at time of discharge, (3) presently younger than 65 years, and if (4) they agreed to undergo a late digital subtraction angiography (DSA) control or to transmit results of a recent one performed elsewhere. Twenty patients were included with a mean delay between aneurysm treatment and late DSA of 18.0 years (10-26.5 years). Out of these patients, six (30%) harbored new aneurysms. Of these six individuals, four (66.6%) presented multiple aneurysms with a total of 15 newly discovered aneurysms. Aneurysm sizes ranged from 1 to 10 mm. One patient suffered from a de novo aneurysm rupture. Multiple aneurysms at the time of the first hemorrhage were a risk factor in developing de novo aneurysm (p=0.0175). In conclusion, based on a 30% rate of new aneurysm formation in patients clipped more than a decade ago, close screening on a very long-term perspective is encouraged. This study suggests aneurysm formation to be a continuous process.

    http://reference.medscape.com/medline/abstract/21643681

  2. #2
    Distinguished Community Member Ging's Avatar
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    Wow Julie, I will pass this along to my sister in law, she was clipped and told she did not need any follow up testing , she was done ! As always , thanks for your continued valuable research. I like to know and feel better when I have enough knowledge to ask the right questions ! :) GING

  3. #3
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    Default That's a bit scary!!!

    I have my 2 year check up in March- and I'm worried that they will find another....
    Though here in Australia my neuro said I will have to be monitored for the rest of my life. I had a rupture which was clipped (at 42) and then 2 small unruptured that were clipped (at 43) . I guess I just have to hope for the best.
    Trace

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    Thanks for posting this! I have never felt comfortable that I was "okay". I was so glad that I pushed for a one year follow up MRA and found my daughter annie that way. It feels me with dread knowing that this a lifelong concern again! I was in a position that I had options and chose clipping since I was so young. I have been told that I was "fixed" and it makes me mad that they tell people this. I was only 34 with my first, so I guess I will continue insisting on being checked.

    Thanks again...I think this is something we should all be aware of. Rupture or not!
    Candice-37 years old
    7 mm ophthalmic annie clipped Nov 14, 2007
    4 mm daughter annie clipped March 11, 2009
    September 2009 diagnosed with Trigeminal Neuralgia

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