Should Surveillance of Unruptured Brain Aneurysms Be Selective?

Unruptured brain aneurysms are present in about 3% of the general population. With the increased use of cranial imaging, incidental aneurysms can be detected. For small aneurysms, the optimal strategy for surveillance of aneurysm growth is uncertain. These authors developed a model to evaluate different imaging strategies for a hypothetical 55-year-old woman with a brain aneurysm. They developed models for three different countries (United States, United Kingdom, and the Netherlands) that considered the willingness to pay for a quality-adjusted life-year (QALY) in the three countries. Imaging strategies included no follow-up; MRI in the first and fifth year after aneurysm detection, annually, every 2 years, or every 5 years; or immediate in…