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Hall S, Abouharb A, Anderson I, et al. A survey of the radiological follow-up of unruptured intracranial aneurysms in the United Kingdom. Br J Neurosurg. 2021;1-7doi: 10.1080/02688697.2021.1995587.
Hall, S., Abouharb, A., Anderson, I., Bacon, A., Bahl, A., Brydon, H., Dow, G., Fouyas, I., Galea, J., Ghosh, A., Gurusinghe, N., Kamel, M., Minhas, P., Mitchell, P., Mowle, D., Mukerji, N., Nair, R., Norris, J., Patel, H., Patel, J., Patel, K., St George, J., Teo, M., Toma, A., Trivedi, R., Uff, C., Visca, A., Walsh, D. C., White, E., Whitfield, P., & Bulters, D. (2021). A survey of the radiological follow-up of unruptured intracranial aneurysms in the United Kingdom. British journal of neurosurgery, 1-7. https://doi.org/10.1080/02688697.2021.1995587
Hall, Samuel, et al. "A survey of the radiological follow-up of unruptured intracranial aneurysms in the United Kingdom." British journal of neurosurgery vol. (2021): 1-7. doi: https://doi.org/10.1080/02688697.2021.1995587
Hall S, Abouharb A, Anderson I, Bacon A, Bahl A, Brydon H, Dow G, Fouyas I, Galea J, Ghosh A, Gurusinghe N, Kamel M, Minhas P, Mitchell P, Mowle D, Mukerji N, Nair R, Norris J, Patel H, Patel J, Patel K, St George J, Teo M, Toma A, Trivedi R, Uff C, Visca A, Walsh DC, White E, Whitfield P, Bulters D. A survey of the radiological follow-up of unruptured intracranial aneurysms in the United Kingdom. Br J Neurosurg. 2021 Nov 05;1-7. doi: 10.1080/02688697.2021.1995587. Epub 2021 Nov 05. PMID: 34738491.
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Br J Neurosurg. 2021 Nov 05;1-7. doi: 10.1080/02688697.2021.1995587. Epub 2021 Nov 05.

A survey of the radiological follow-up of unruptured intracranial aneurysms in the United Kingdom.

British journal of neurosurgery

Samuel Hall, Ashraf Abouharb, Ian Anderson, Andrew Bacon, Anuj Bahl, Howard Brydon, Graham Dow, Ioannis Fouyas, James Galea, Anthony Ghosh, Nihal Gurusinghe, Mahmoud Kamel, Pawan Minhas, Patrick Mitchell, David Mowle, Nitin Mukerji, Ramesh Nair, John Norris, Hiren Patel, Jash Patel, Krunal Patel, Jerome St George, Mario Teo, Ahmed Toma, Rikin Trivedi, Chris Uff, Anna Visca, Daniel C Walsh, Edward White, Peter Whitfield, Diederik Bulters

Affiliations

  1. Wessex Neurological Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK.
  2. Department of Neurosurgery, Belfast Health and Social Care Trust, Belfast, UK.
  3. Department of Neurosurgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
  4. Sheffield Centre for Neurosurgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  5. Department of Neurosurgery, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK.
  6. Department of Neurosurgery, University Hospital of North Midlands NHS Trust, Stoke on Trent, UK.
  7. Department of Neurosurgery, Queens Medical Centre, Nottingham, UK.
  8. Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, UK.
  9. Department of Neurosurgery, Cardiff and Vale University Health Board, Cardiff, UK.
  10. Department of Neurosurgery, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK.
  11. Department of Neurourgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.
  12. Neurosurgery Department, NHS Grampian, Aberdeen, UK.
  13. Department of Neurosurgery, St George's University Hospitals NHS Foundation Trust, London, UK.
  14. Department of Neurosurgery, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
  15. Department of Neurosurgery, Ninewells Hospital and Medical School, Dundee, UK.
  16. Department of Neurosurgery, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK.
  17. Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, UK.
  18. Hurstwood Park Neurosciences Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
  19. Department of Neurosurgery, Salford Royal NHS Foundation Trust, Salford, UK.
  20. Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  21. Department of Neurosurgery, University Hospitals Coventry and Warwickshire, Coventry, UK.
  22. Institute of Neurosciences, Glasgow, UK.
  23. Department of Neurosurgery, North Bristol NHS Trust, Bristol, UK.
  24. National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.
  25. Department of Neurosurgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  26. Department of Neurosurgery, Barts Health NHS Trust, London, UK.
  27. Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK.
  28. Department of Neurosurgery, King's College Hospital NHS Trust, London, UK.
  29. Department of Neurosurgery, Queen Elizabeth Hospital, Birmingham, UK.
  30. Department of Neurosurgery, University Hospitals Plymouth NHS Trust, Plymouth, UK.

PMID: 34738491 DOI: 10.1080/02688697.2021.1995587

Abstract

OBJECTIVE: Unruptured intracranial aneurysms (UIA) are common. For many the treatment risks outweigh their risk of subarachnoid haemorrhage and patients undergo surveillance imaging. There is little data to inform if and how to monitor UIAs resulting in widely varying practices. This study aimed to determine the current practice of unruptured UIA surveillance in the United Kingdom.

METHODS: A questionnaire was designed to address the themes of surveillance protocols for UIA including when surveillance is initiated, how frequently it is performed, and when it is terminated. Additionally, how aneurysm growth is managed and how clinically meaningful growth is defined were explored. The questionnaire was distributed to members of the British Neurovascular Group using probability-based cluster and non-probability purposive sampling methods.

RESULTS: Responses were received from 30 of the 30 (100.0%) adult neurosurgical units in the United Kingdom of which 27 (90.0%) routinely perform surveillance for aneurysm growth. Only four units had a unit policy. The mean patient age up to which a unit would initiate follow-up of a low-risk UIA was 65.4 ± 9.0 years. The time points at which imaging is performed varied widely. There was an even split between whether units use a fixed duration of follow-up or an age threshold for terminating surveillance. Forty percent of units will follow-up patients more than 5 years from diagnosis. The magnitude in the change in size that was felt to constitute growth ranged from 1 to 3mm. No units routinely used vessel wall imaging although 27 had access to 3T MRI capable of performing it.

CONCLUSIONS: There is marked heterogeneity in surveillance practices between units in the United Kingdom. This study will help units better understand their practice relative to their peers and provide a framework forplanning further research on aneurysm growth.

Keywords: MRI; Unruptured intracranial aneurysm; aneurysm growth; surveillance protocol

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