No Treatment or Imaging Follow-Up Most Effective for Tiny UIAs

Share this content:
No Treatment or Imaging Follow-Up Most Effective for Tiny UIAs
No Treatment or Imaging Follow-Up Most Effective for Tiny UIAs

TUESDAY, Nov. 21, 2017 (HealthDay News) -- For patients with unruptured intracranial aneurysms (UIAs) that are 3 mm or smaller, no preventive treatment or imaging follow-up is the most effective management strategy, according to a study published online Nov. 20 in JAMA Neurology.

Ajay Malhotra, M.D., from the Yale School of Medicine in New Haven, Conn., and colleagues used inputs from the medical literature to conduct a decision-analytic model-based comparative effectiveness analysis. Five management strategies were assessed: annual magnetic resonance angiography (MRA) screening, biennial MRA screening, MRA screening every five years, aneurysm coiling and follow-up, and no treatment or preventive follow-up.

In an analysis of 10,000 iterations simulating adult patients, the researchers found that the highest health benefit was seen for the management strategy of no treatment or preventive follow-up (mean quality-adjusted life-years, 19.40). MRA every five years was the best of the management strategies that incorporate follow-up imaging, with the next highest effectiveness (mean quality-adjusted life-years, 18.05). When the annual growth rate and risk of rupture of growing aneurysms are varied, no routine follow-up remains the optimal strategy. No follow-up is the optimal strategy when the annual risk of rupture of nongrowing UIAs is less than 1.7 percent; coiling should be performed directly if the annual risk of rupture is >1.7 percent.

"Given these findings, it is important to critically evaluate the appropriateness of current clinical practices," the authors write.

Abstract/Full Text
Editorial

Share this content:

is free, fast, and customized just for you!

Already a member?

Sign In Now »

Drug Lookup

Browse drugs by: BrandGenericDisease

Trending Activities

All Professions


Sign up for myCME e-newsletters


More in Home

ASH: Anti-CD19 CAR T-Cell Tx Beneficial in B-Cell Lymphomas

ASH: Anti-CD19 CAR T-Cell Tx Beneficial in B-Cell ...

Second study shows benefit in relapsed or refractory B-cell lymphoma, follicular lymphoma

ASH: AAVD Beats ABVD for Advanced Hodgkin's Lymphoma

ASH: A+AVD Beats ABVD for Advanced Hodgkin's Lymphoma

Lower combined risk of progression, death, or noncomplete response with A+AVD

ASH: High-Dose Gene Transfer Beneficial in Severe Hemophilia A

ASH: High-Dose Gene Transfer Beneficial in Severe Hemophilia ...

Factor VIII gene transfer tied to sustained normalization of factor VIII activity levels

is free, fast, and customized just for you!

Already a member?

Sign In Now »