Treatment of Unruptured Intracranial Aneurysms in Autosomal Dominant Polycystic Kidney Disease: Primum Non Nocere

Prevalence of Intracranial Aneurysms in Patients with Aortic Aneurysms

“…15,17 According to this relative risk, some have advised a systematic screening with MRA for IA in ADPKD. [21][22][23][24][25][26] However, to date, there is no proved benefit in morbidity, mortality, or reduction in subarachnoid hemorrhage among patients with ADPKD screened for IA, 27 potentially due to other factors such as a higher risk of IA treatment in patients with ADPKD, as recently suggested by Rozenfeld et al 28,29 In our study, the IA prevalence in patients with AAs was similar to the IA prevalence in the ADPKD population. Our results suggest that future prospective studies examining the role of IA screening in patients with AAs could be warranted, especially in female patients with TAAs.…”

“…Our results suggest that future prospective studies examining the role of IA screening in patients with AAs could be warranted, especially in female patients with TAAs. 28,29 Also, there is a high association of IA with AA in the perioperative care of AA. Indeed, the pressure on the cerebral arteries varies substantially due to cross-clamping and declamping of the aorta during aortic surgery.…”

Vascular complications in patients with Autosomal Dominant Polycystic Kidney Disease. A review of the literature and current clinical recommendations

“…On the other hand, it is necessary to take into account the increased surgery risk, frequent detection of small aneurysms (with low risk of rupture) in brain imaging. In addition, at the moment there is a lack of reliable radiological, biochemical or genetic markers that would help assess the risk of aneurysm rupture in an ADPKD patient, thus justifying a preventive procedure [22].…”