title: Effectiveness of preventive surgery for asymptomatic unruptured intracranial aneurysms.
abstract: 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.
authors.affiliation: Hospital Computer Center, University of Tokyo Hospital, 7-3-I Hongo, Bunkyo Tokyo I 13, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Inomiya
authors.forename: T
authors.initials: T
authors.lastname: Sakurai
authors.forename: S
authors.initials: S
authors.lastname: Kaihara
mesh_terms: 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