International Stroke Conference
Kaustubh Limaye, MD
Management of unruptured aneurysms continues to be a clinical conundrum. This session at ISC 2018 was geared toward identifying better strategies for identifying patients at higher risk of rupture and selecting appropriate management modalities.
The session started with a talk by Dr. Mervyn Vergouwen, who discussed risk factors for aneurysm growth and rupture. He discussed the prevalence of aneurysm to be 3% of the world population. “Growth predicts rupture,” he said. What to do: treat or wait and scan? Weigh risk of rupture and risk of treatment. He discussed the PHACES and ELAPSS studies, highlighting the important features and also the important predictors of aneurysm rupture that were excluded from these studies, like data on smoking, familial history and aneurysm morphology. “Risk predicting scores are the beginning and not the end,” he said. Multiple factors, rather than just diameter or location, should be included in deciding treatment.