What is the treatment for unruptured aneurysms?
The management of asymptomatic aneurysms discovered incidentally remains controversial. A recent study followed 142 patients with unruptured aneurysms for a period of 14 years and found an average annual rupture incidence of 1.4%. The cumulative rate of bleeding from the aneurysms was 10% at 10 years, 26% at 20 years, and 32% at 30 years after the diagnosis. The surgical clipping of an intact and accessible aneurysm is usually a procedure of low risks without the future development of postoperative ischemia or vasospasm, which are often encountered with the clipping of ruptured aneurysms (leading to risk of death or disability). Surgery is usually recommended for large accessible aneurysms; but with small ones (with a proportionally lower chance of rupture) you should discuss the ratio of risk to benefit with your physicians.
