De novo aneurysms in long-term follow-up computed tomographic angiography of patients with clipped intracranial aneurysms

Abstract

Objective: This study was undertaken to evaluate de novo aneurysm formation in the long-term follow-up of patients with clipped aneurysms.

Methods: Of 459 patients who underwent clipping of ruptured cerebral aneurysms at our institution between 1997 and 2008, 119 patients were available in good condition and agreed to undergo 64-detector row computed tomographic (CT) angiography. In addition, eight patients underwent CT angiography for new subarachnoid hemorrhage.

Results: The mean ± standard deviation interval from surgery was 7.2 ± 2.3 years for CT angiography controlled patients. De novo aneurysms were detected in 5 of 119 (4.5%) patients and 4 of 8 patients with new subarachnoid hemorrhage. A history of multiple aneurysms was associated with de novo aneurysm formation (P < 0.001).

Conclusion: The risk of de novo aneurysm formation in patients with clipped aneurysms is significant in long-term follow-up. CT angiography can be used as a noninvasive method for detection of de novo aneurysms in these patients.

Keywords: CT angiography; Cerebral aneurysm; De novo aneurysm; Surgical clipping.