Screening programs for asymptomatic unruptured intracranial aneurysms: review of clinical effectiveness, cost-effectiveness, and evidence-based guidelines
Canadian Agency for Drugs and Technologies in Health
Record ID 32011001180
English
Authors' recommendations:
Some studies have indicated that among family members over the age of 30 years with two or more affected first-degree relatives, certain risk factors such as female gender and a history of smoking or hypertension further increase the risk of harboring unruptured intracranial aneurysms. Although there is evidence that rupture of intracranial aneurysms does not appear to occur at a younger age in subsequent generations, the optimal age in which to initiate screening in family members is not known. An economic evaluation indicated that MRA screening is cost-effective for family members under the age of 50 years with two or more affected first-degree relatives. It is not clear whether screening for unruptured intracranial aneurysms is cost-effective in a Canadian setting.The optimal imaging technique for screening has not been established. MRA may be preferred over CTA due to the allergic reactions to contrast and the radiation exposure associated with CTA use. The frequency and duration of follow-up imaging for family members receiving both positive and negative screening results is not yet evident. There is evidence that individuals with two or more affected first-degree relatives who are negative for intracranial aneurysms with MRA screening have a 7% risk of developing an intracranial aneurysm within 5years of screening. Based on the limited amount of available evidence, current guidelines state that screening for unruptured intracranial aneurysms should be considered on an individual basis as the benefits of screening are uncertain at this time.
Details
Project Status:
Completed
URL for project:
http://www.cadth.ca/media/pdf/20100503-090753_l0173_screening_asymptomatic_aneurysms_final.pdf
Year Published:
2010
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Cerebral Angiography
- Intracranial Aneurysm
- Magnetic Resonance Angiography
- Mass Screening
- Treatment Outcome
Contact
Organisation Name:
Canadian Agency for Drugs and Technologies in Health
Contact Address:
600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;
Contact Name:
requests@cadth.ca
Contact Email:
requests@cadth.ca
Copyright:
Canadian Agency for Drugs and Technologies in Health (CADTH)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.