Etminan et al reported the Unruptured Intracranial Aneurysm Treatment Score (UIATS). One component identifies features favoring repair. The numerous authors are from multiple institutions from around the world.
Patient selection: unruptured intracranial aneurysm
Patient parameters:
(1) age in years
(2) risk factors (may be multiple)
(3) clinical symptoms from unruptured aneurysm (may be multiple)
(4) other
Aneurysm parameters:
(1) maximum diameter in mm
(2) morphology (may be multiple)
(3) location
(4) other (may be multiple)
|
Parameter |
Finding |
Points |
|
age of the patient |
< 40 years |
4 |
|
|
40 to 60 years |
3 |
|
|
61 to 70 years |
2 |
|
|
71 to 80 years |
1 |
|
|
> 80 years |
0 |
|
previous SAH from previous aneurysm |
no |
0 |
|
|
yes |
4 |
|
familial intracranial aneurysms or SAH |
no |
0 |
|
|
yes |
3 |
|
ethnicity |
Japanese, Finnish, Inuit |
2 |
|
|
other |
0 |
|
current cigarette smoking |
no |
0 |
|
|
yes |
3 |
|
systolic blood pressure |
<= 140 mm Hg |
0 |
|
|
> 140 mm Hg |
2 |
|
autosomal polycystic kidney disease |
no |
0 |
|
|
yes |
2 |
|
current cocaine or amphetamine abuse |
no |
0 |
|
|
yes |
2 |
|
current alcohol abuse |
no |
0 |
|
|
yes |
1 |
|
cranial nerve deficit |
no |
0 |
|
|
yes |
4 |
|
clinical or radiological mass effect |
no |
0 |
|
|
yes |
4 |
|
thromboembolic events from the aneurysm |
no |
0 |
|
|
yes |
3 |
|
epilepsy |
no |
0 |
|
|
yes |
1 |
|
reduced quality of life from fear of rupture |
no |
0 |
|
|
yes |
2 |
|
number of aneurysms |
1 |
0 |
|
|
>= 2 (mutiple) |
1 |
|
maximum diameter |
<= 3.9 mm |
0 |
|
|
4.0 to 6.9 mm |
1 |
|
|
7.0 to 12.9 mm |
2 |
|
|
13.0 to 24.9 mm |
3 |
|
|
>= 25 mm |
4 |
|
location |
BasA bifurcation |
5 |
|
|
vertebral/basilar artery |
4 |
|
|
AcomA or PcomA |
2 |
|
|
other |
0 |
|
aneurysm growth on serial imaging |
no |
0 |
|
|
yes |
4 |
|
aneurysm de novo formation on serial imaging |
no |
0 |
|
|
yes |
3 |
|
contralateral steno-occlusive vessel disease |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 55 (unless growth and de novo on serial imaging exclude the other, in which case it is 52)
• If the score favoring repair exceeds the score favoring conservative therapy, then repair should be considered.
Specialty: Neurology
