Endovascular treatment of brain aneurysms—is under 5mm a ‘go’ or ‘no-go’ area?
neuronewsinternational.com
Jan. 24, 2025, 4:48 p.m.
The question of whether aneurysms under 5mm should undergo treatment at all, and whether it is safe to do it, has been lingering in the minds of researchers and clinicians for at least the past two decades. The COAST study has made an important step towards a better understanding of the consequences of such a treatment. In order to better put these results in perspective, however, we should take into consideration the natural history of intracranial aneurysms, look at ruptured and unruptured aneurysms separately, and discuss blood blister-like aneurysms as well. One of the most often-heard arguments in favour of treatment when discussing small aneurysms is the discrepancy between natural history studies, showing a low longitudinal risk of haemorrhage from small aneurysms, on one hand, and retrospective analyses showing a preponderance of small aneurysms in large subarachnoid haemorrhage (SAH) series on the other.