Document Detail

Extended follow-up of unruptured intracranial aneurysms detected by presymptomatic screening in patients with autosomal dominant polycystic kidney disease.
MedLine Citation:
PMID:  21551026     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVES: Autosomal dominant polycystic kidney disease (ADPKD) patients have an increased risk for intracranial aneurysms (IAs). The importance of screening for unruptured IAs (UIAs) depends on their risks for growth and rupture.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: ADPKD patients with UIAs found by presymptomatic screening with magnetic resonance angiography (MRA) during 1989 to 2009 were followed initially at 6 months and annually, and less frequently after demonstration of stability.
RESULTS: Forty-five saccular aneurysms were detected in 38 patients from 36 families. Most were small (median diameter 3.5 mm) and in the anterior circulation (84%). Median age at diagnosis was 49 years. During cumulative imaging follow-up of 243 years, one de novo UIA was detected and increased in size from 2 to 4.4 mm over 144 months and two UIAs grew from 4.5 to 5.9 mm and 4.7 to 6.2 mm after 69 and 184 months, respectively. Seven patients did not have imaging follow-up. No change was detected in the remaining 28 patients. During cumulative clinical follow-up of 316 years, no aneurysm ruptured. Five patients died from unrelated causes and two were lost to follow-up after 8 and 120 months. Three patients underwent surgical clipping.
CONCLUSIONS: Most UIAs detected by presymptomatic screening in ADPKD patients are small and in the anterior circulation. Growth and rupture risks are not higher than those of UIAs in the general population. These data support very selective screening for UIAs in ADPKD patients, and widespread screening is not indicated.
Maria V Irazabal; John Huston; Vickie Kubly; Sandro Rossetti; Jamie L Sundsbak; Marie C Hogan; Peter C Harris; Robert D Brown; Vicente E Torres
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-05-05
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  6     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-09     Completed Date:  2011-09-30     Revised Date:  2014-09-14    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1274-85     Citation Subset:  IM    
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MeSH Terms
Aneurysm, Ruptured / diagnosis,  etiology,  prevention & control
Asymptomatic Diseases
Cerebral Angiography / methods*
DNA Mutational Analysis
Disease Progression
Follow-Up Studies
Intracranial Aneurysm / diagnosis*,  etiology,  surgery
Magnetic Resonance Angiography*
Middle Aged
Polycystic Kidney, Autosomal Dominant / complications*,  genetics
Predictive Value of Tests
Risk Assessment
Risk Factors
Time Factors
Young Adult
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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