gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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The risk of rupture of small anterior circulation aneurysms – Results of the Central European Register

Meeting Abstract

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  • D. Hänggi - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf
  • N. Etminan - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf
  • H.J. Steiger - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf
  • A. Raabe - Neurochirurgische Klinik, Inselspital, UniversitätsSpital Bern, Schweiz

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocSA.06.04

doi: 10.3205/12dgnc335, urn:nbn:de:0183-12dgnc3355

Published: June 4, 2012

© 2012 Hänggi et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: According to the results of the International Study of Unruptured Intracranial Aneurysms (ISUIA), the rate of rupture for aneurysms smaller than 7 mm in the anterior circulation (except posterior communicating artery, PCOM) in patients without a previous bleeding or familial history is 0.0%. The goal of the present retrospective register is to challenge a 0.0% rupture rate for these aneurysms.

Methods: A Central European Survey was performed in March 2011. 109 German, 8 Swiss and 11 Austrian Neurosurgical Departments participating in neurosurgical treatment of cerebral aneurysms were contacted by the register coordinators to report the incidence of aneurysm as such: 1) Incidental aneurysm of the anterior circulation (except PCOM) 2) Largest diameter lesser than 7 mm 3) Negative history for previous (subarachnoid hemorrhage) SAH 4) Negative familial history for SAH 5) No intention to treat 6) Subsequent subarachnoid hemorrhage from the previously diagnosed and untreated aneurysm.

Results: The overall response rate was 21.8%. The number of aneurysms meeting the inclusion criteria was 21, of which 13 were aneurysms of the anterior communicating artery and 8 of the middle cerebral artery. The documentation in all cases was provided by either CT or MRI and DSA studies of each individual as well as the patient history.

Conclusions: The retrospectively obtained data from the Central European Survey demonstrated that incidental and conservatively treated aneurysms of the anterior circulation with a diameter smaller than 7 mm do have a subsequent risk of rupture greater than 0.0%, despite the absence of risk factors. Therefore, additional and yet unknown variables influencing the threshold for aneurysm rupture remain to be investigated in a prospective, observational study.