J Neurosurg: Should a lifetime follow-up aneurysm recur after aneurysm clamping?

High blood pressure, smoking, female and multiple aneurysms were found to be risk factors after new cystic intracranial aneurysms (IAs) were first reported in 1970Other conditions also increase the risk of new cystic IAs, including autosomal dominant inherited polycystic nephropathy, therapeutically closed cervical arteries, cerebral artery bypass, radiation therapy, gliomas, hemangiosis, and the use of chemotherapy drugs near cerebrovascular vessels during surgeryHowever, the exact incidence of new aneurysms remains a matter of debate, with the reported annual incidence averaging 0.37-4.15 per centTherefore, it is not clear whether a routine follow-up cystic aneurysm may help detect new aneurysmsthe recurrence of fully enclosed aneurysms was first reported in 1964, although the permanent blocking rate of microsurgical clamping cystic aneurysm was significantly higher than intravascular blockingAs with new cystic aneurysms, the recurrence rate of clamped aneurysms remains controversial; In addition, follow-up problems in these patients remain unknownFollow-up is very complex because of the large development time span of newborn aneurysms and recurrent aneurysms, ranging from 27 to 30 yearsIn February 2020, Alexander Spiesberger of Switzerland and others published their systematic review and meta analysis results at JNS to explore the annual summary of the probability of new aneurysms and the recurrence rate of post-clamping aneurysms, as well as the relationship between patient characteristics and the timing of the recurrence of new aneurysms and aneurysmsscreened a total of 7,606 articles, including 92 articlesThe reported cases of 101 patients with recurrence of aneurysm and 132 cases of new aneurysm were analyzedThe study on long-term follow-up of new aneurysms included 13,723 patients and 101378 patients- years, and the study on the recurrence of aneurysms included 5,922 patients and 31055 patients followed upThe average recurrence time was 12.9 plus -6.6 years, and the average time for the formation of new aneurysms was 9.3 plus-6.1 yearsNo link was found to be sex, the site of the aneurysm, and the initial ruptureMultiple aneurysms (HR 0.63, P - 0.03) and older people (HR per 10yr 0.88, P s 0.06) develop new aneurysms laterThe annual aggregate incidence of new aneurysms was 0.35% and the recurrence of aneurysms was 0.13%the final authors concluded that despite the low annual incidence reported, the cumulative risk of aneurysm recurrence or new aneurysm after 20 years of aneurysm was 9.6-22%, and that lifetime follow-up was needed Over five years, 10- and 20-year screening will detect 30.8 percent, 64.2 percent and 95.9 percent of newborn aneurysms Over 10 years, 15 and 20 years of screening will detect 36.6%, 65.3% and 95.1% recurrence of aneurysms