De Novo aneurysms in long–term follow-up CT-angiography of patients with clipped intracranial aneurysms

BACKGROUND: This study was conducted to evaluate the de Novo aneurysm formation in the long-term follow-up of patients with clipped intracranial aneurysms. METHODS: A total of 459 patients underwent the clipping of ruptured cerebral aneurysms in our institution during 1997 -2008. Of them, 119 patients were available in good condition and agreed to undergo 64 detector row computed tomography (CT) angiography. In addition, 8 patients with subarachnoid hemorrhage (SAH) underwent CT angiography. RESULTS: The mean ± SD interval from surgery was 7.2±2.3 years for CT-angiography controlled patents. De novo aneurysms were detected in 5 of 119 (4.5%) patients and 4 of 8 patients with new subarachnoid hemorrhage. A history of multiple aneurysms was associated with the de novo aneurysm formation (p less than 0.001). CONCLUSIONS: The risk of the de novo aneurysm formation in patients with clipped aneurysm is significant in long term follow-up. CT-angiography can be used as a non-invasive method for detection of de novo aneurysms in these patients. KEYWORDS: Cerebral aneurysm, Ct-angiography, De Novo aneurysm, Surgical clipping