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DETECTION AND FOLLOW‐UP OF ANEURYSMS BY CTA
Author(s) -
Dorsch N. W. C.,
Young N.,
Kang A.,
Ly S.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04124_9.x
Subject(s) - medicine , aneurysm , family history , radiology , natural history , circle of willis , surgery
Purpose To analyse usefulness of CTA in detecting aneurysms in subjects with a family history, and in follow‐up of patients with known aneurysms. Methodology From 1997 to 2004, 286 adults with a family history of cerebral aneurysms were investigated by a spiral CT angiogram of the Circle of Willis. Their age range was 20–76, and 192 were female. Over a similar period 119 patients with 138 known aneurysms, described as Group 1, and another 84 with a past history of SAH and aneurysm treatment (Group 2), were followed by serial CTAs for up to 97 months, median 36 months. Results Of those with a family history, 193 had one CTA and the other 93 averaged 2.8 studies. Aneurysms were found in 15.4%, with 56 detected in 44 patients. There were multiple aneurysms in 12 of the 44 (27%); 80% of the aneurysms were under 7mm in diameter and 93% less than 13mm; 39% were on the MCA – all findings similar to other literature. In the 119 group 1 patients there were initially 120 aneurysms. During follow‐up 18 more developed, a rate of 5% per year. Of these 138, 99 remained stable, 29 enlarged (21%), and nine became smaller. One aneurysm ruptured, a rupture rate of 0.28% per year. In group 2 patients, 75 aneurysms were found on the initial CTA in the 84 patients. Subsequent studies showed 19 new aneurysms for a total of 94 – annual development rate 7.5%. Four aneurysms ruptured in the study period, equivalent to 1.7% annually. Conclusions CTA is useful for relatives of aneurysm patients, for subjects with unruptured aneurysms, and for patients with past aneurysmal SAH. As others have shown, in this last group new aneurysms develop more often, they grow faster, they rupture more often, and they rupture at smaller size.