Occult Intracranial Aneurysms in Polycystic Kidney Disease

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Abstract
Patients with polycystic kidney disease are at increased risk of subarachnoid hemorrhage from rupture of intracranial aneurysms. We used decision analysis to assess whether or not patients with polycystic kidney disease should undergo routine cerebral arteriography for intracranial aneurysms and prophylactic surgery, if an aneurysm is detected. We incorporated published data on the prevalence of intracranial aneurysms in patients with polycystic kidney disease, the annual rate of aneurysmal rupture, the risk of grave complications of rupture, and the likelihood of grave complications of arteriography and prophylactic surgery. Outcomes were assessed as years of survival, and benefit was calculated as the gain in survival.