Short summary

The study will investigate the treatment indications, complications and outcome in all patients treated for non-ruptured cerebral aneurysms in the period 2014- 2016 in Denmark. The treatment indications will be evaluated across all four neurosurgical departments in the country, and complications will be evaluated for both surgical and coil treatment. 

Rationale

Non-ruptured aneurysms generate a large visitation burden across the neurosurgical departments in Denmark. Often, these aneurysms are not associated with clinical symptoms, and are regularly an incidental finding during a CT or MRI scan in the course of examinations of other diseases.

There are multiple factors involved in determining treatment strategies of non-ruptured aneurysms. Among these are the anatomical placement and the orientation of the aneurysm on the artery, and the neck of the aneurysm. As of today these aneurysms can be treated with surgical clips, or endovascular coiling, or stenting in combination with coiling. 

At present time, there is little knowledge on complications to both the endovascular and the surgical treatment of non-ruptured aneurysms. As there are an increasing number of patients beeing treated for non-ruptured aneurysms, it is of much importance to highlight current indications for treatment, complications and outcome.

As a part of the study, the amount of aneurysmal closure, and whether additional attempts to close the aneurysm were beeing made if the first attempt of closure were insufficient, will also be a part of this research. 

As of today it is standard procedure with a post-operative control with arteriography, CTC or MRI with angio sequence after first treatment. With regards to this, it will be investigated if MRI with angio sequence could be used as a sole control in all patients, as this procedure is non-invasive, without the use of contrast that potentially damage the kidneys.

Description of the cohort

Adult men and woman diagnosed with non ruptured aneurysm.

Data and biological material

Data from electronic health record including: 

• Age
• Gender
• Alcohol consumption 
• Tobacco consumption
• Blood pressure
• Medication
• Familial predisposition
• Neurological symptoms 
• Ethnicity
• Malignant disease
• Coagulation disturbancies
• Size, placement and orientation of the aneurysm
• Degree of closure, post operative
• Description of MRI, CTC and arteriography 
• Complications of treatment
• If applicable, further treatment 

Collaborating researchers and departments

Department of Neurosurgery, Odense University Hospital

• Sune Munthe, MD PhD
• Professor Frantz R. Poulsen, PhD
• Andreas Sveaass

Department of Neurosurgery, Aarhus University Hospital

• Niels Sunde, MD
• Tom Sehested, MD

Department of Neurosurgery, Aalborg University Hospital

• Peter Birkeland, MD
• Helga Gulisano, MD

Department of Neurosurgery, Rigshospitalet

• John Hauerberg, MD
• Per Rochat, MD