Effectiveness of preventive surgery for asymptomatic unruptured intracranial aneurysms.
Recently in Japan, physicians used MRI angiography (MRA) for the detection of asymptomatic intracranial diseases. Asymptomatic unruptured intracranial aneurysms (UIAs) are one of the most common abnormalities; usually the patients are advised to undergo preventive surgery. We evaluated the effectiveness of preventive surgery for asymptomatic UIAs, using published data in the literature with decision analysis on a Markov model. The baseline analysis showed that preventive surgery is superior to follow-up in a wide range of patient ages, but only by small QALY margin. Sensitivity analyses showed that the rate of rupture and the clinical outcome of surgery will influence the choice.
Inomiya
K
K
Hospital Computer Center, University of Tokyo Hospital, 7-3-I Hongo, Bunkyo Tokyo I 13, Japan.
Sakurai
T
T
Kaihara
S
S
D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000453:epidemiology / Q000517:prevention & control*; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000517:prevention & control; D003661:Decision Support Techniques; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D008017:Life Expectancy; D018810:Magnetic Resonance Angiography; D008297:Male; D008390:Markov Chains; D008959:Models, Neurological; D019057:Quality-Adjusted Life Years; D011859:Radiography; D012008:Recurrence; D012307:Risk Factors; D012422:Rupture, Spontaneous; D012680:Sensitivity and Specificity; D015996:Survival Rate; D016896:Treatment Outcome