| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
|
|
|
|
|||||||||||||
|
|
|||||||||||||||
Department of
Neurosurgery, Royal Hallamshire Hospital, Sheffield S10 2JF, UK
Correspondence to: Dr P Mitchell P.Mitchell{at}sheffield.ac.uk
Received 7 September
1999 and in revised form 16 November 1999;
Accepted 2
December 1999
OBJECTIVES
To
calculate the expected number of life-years saved by surgical treatment
of unruptured intracranial aneurysms at ages over 20 years.
METHODSAn
actuarial risk analysis of the treatment of unruptured intracranial
aneurysms based on data from the International Study of Unruptured
Intracranial Aneurysms (ISUIA). The benefits of operative treatment are
calculated in terms of average life-years saved.
RESULTSResults are
presented as graphs of life-years saved or lost against age at the time
of operative treatment for three groups of aneurysms: those under 10 mm
in diameter with no history of subarachnoid haemorrhage (SAH) from
another aneurysm, those under 10 mm in diameter and a history of
previous SAH from a different aneurysm, and those over 10 mm in
diameter. Life-years are lost at all ages in the group under 10 mm with
no history of SAH. For the group under 10 mm with a history of SAH
about 4 years are saved at age 20 declining to 0 at around age 50. For
aneurysms 10 mm or more in diameter about 8 life-years are saved at age 20 declining to 0 at around 50.
CONCLUSIONSClipping
of unruptured aneurysms under 10 mm in diameter with no history of
subarachnoid haemorrhage is not justified on actuarial grounds.
Intervention in other unruptured aneurysms produces benefits in life
expectancy up to the age of 50. There may be subgroups of aneurysms in
which larger benefits exist.
This article has been cited by other articles:
|
|
 |
|
  R R Vindlacheruvu, A D Mendelow, and P Mitchell Risk-benefit analysis of the treatment of unruptured intracranial aneurysms J. Neurol. Neurosurg. Psychiatry, February 1, 2005; 76(2): 234 - 239. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Vogel, R. Verreault, J.-F. Turcotte, M. Kiesmann, and M. Berthel Review Article. Intracerebral Aneurysms: A Review With Special Attention to Geriatric Aspects J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2003; 58(6): M520 - 524. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
