The protocol has many assets. A prospective nationwide recruitment allows for the inclusion of a large cohort of patients with UIA. It will combine accurate clinical phenotyping and comprehensive imaging with CAWE screening. Besides, it will enable to exploit metadata and to explore new pathophysiological pathways of interest by crossing clinical, genetic, biological, and imaging information.
Management of small (\<7mm) unruptured intracranial aneurysms (UIA) remains controversial. Previous retrospective studies have suggested that post gadolinium arterial wall enhancement (AWE) of unruptured intracranial aneurysms on MR imaging may reflect aneurysm wall instability, and hence may highlight a higher risk of UIA growth over time. This multicentric prospective cohort aims at exploring vessel wall imaging findings of UIAs with consecutive follow-up to substantiate these assumptions.The objective is to develop diagnostic and predictive tools for the risk of IA evolution. The aim is to demonstrate in clinical practice the predictive value of (AWE) for UIA growth. The growth will be determined by any modification of the UIA measurement. Both UIA growth and the UIA wall enhancement will be assessed in consensus by two expert neuroradiologists.The French prospective UCAN project is a non-interventional international wide and multicentric prospective cohort. UIA of bifurcation between 3 and 7 mm for whom a clinical and imaging follow-up without occlusion treatment was scheduled by local multidisciplinary staff will be included. Extensive clinical, biological and imaging data will be recorded during a 3 years follow-up (visits at 1 and 3 years after inclusion).
Study Type
OBSERVATIONAL
Enrollment
1,000
UIA of bifurcation between 3 and 7 mm for whom a clinical and imaging follow-up without occlusion treatment was scheduled by local multidisciplinary staff will be included. Extensive clinical, biological and imaging data will be recorded during a 3 years follow-up (visits at 1 and 3 years after inclusion).
Clairval's Hospital
Marseille, Bouches-du-Rhône, France
The aim is to evaluate in clinical practice the predictive value of UIA wall enhancement for UIA growth. It will allow to set up a secure, efficient and personalized follow-up.
In order to evaluate the informative value of AWE for UIA growth, investigators will consider as primary endpoint the growth of the UIA after the complete follow-up at 3 years.
Time frame: 5 years
Predictive value of UIA wall enhancement for UIA growth
This event could occur at any time during the follow-up if an UIA becomes symptomatic but will be systematically assessed by MRI. UIA growth will be assessed blindly and independently by two expert neuroradiologists, routinely involved in UIA management and disagreement will be solved by consensus with involvement of a third expert. UIA wall enhancement status will be defined independently by two different expert neuroradiologists, with \> 5yrs experience in intracranial vessel wall imaging. Disagreement will be solved by consensus with involvement of a third expert.
Time frame: at 1 year
Predictive value of UIA wall enhancement for UIA growth
This event could occur at any time during the follow-up if an UIA becomes symptomatic but will be systematically assessed by MRI. UIA growth will be assessed blindly and independently by two expert neuroradiologists, routinely involved in UIA management and disagreement will be solved by consensus with involvement of a third expert. UIA wall enhancement status will be defined independently by two different expert neuroradiologists, with \> 5yrs experience in intracranial vessel wall imaging. Disagreement will be solved by consensus with involvement of a third expert.
Time frame: at 3 years
Quality of life related to the growth of UIA.
Evaluation of the quality of life (QOL) of untreated patients with UIA during the follow-up.
Time frame: 5 years
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Brest University Hospital
Brest, Finistère, France
NOT_YET_RECRUITINGBordeaux University Hospital
Bordeaux, Gironde, France
NOT_YET_RECRUITINGToulouse University Hospital
Toulouse, Haute-Garonne, France
NOT_YET_RECRUITINGLimoges University Hospital
Limoges, Haute-Vienne, France
NOT_YET_RECRUITINGRennes University Hospital
Rennes, Ille-et-Vilaine, France
NOT_YET_RECRUITINGTours University Hospital
Tours, Indre-et-Loire, France
NOT_YET_RECRUITINGNantes University Hospital
Nantes, Loire-Atlantique, France
RECRUITINGAngers University Hospital
Angers, Maine Et Loire, France
NOT_YET_RECRUITINGReims University Hospital
Reims, Marne, France
NOT_YET_RECRUITING...and 10 more locations
AWE variation patterns related to the growth of UIA.
Detection of other AWE variation patterns related to growth during the follow-up in order to improve the follow-up of UIA patients
Time frame: 5 years
Clinical, genetics or biological factors related to the growth of UIA.
Clinical, genetic (blood serum level of circulating ANGPTL6) and biological (plasma factors as circulating ANGPTL6 levels, metalloproteinase…) features recorded.
Time frame: 5 years
Incidence of growth of UIA.
Incidence of growth, stratified by clinical, genetics or biological features.
Time frame: 5 years
Incidence of IA rupture
Incidence of IA rupture, stratified by clinical, genetics or biological features.
Time frame: 5 years
quality of life patients related to the growth of UIA.
Completion of standardized EQ5D questionnaire to measure quality of life patients
Time frame: 5 years
Construction of an automatized tool of AWE pattern
Construction and evaluation of an automatized tool of AWE patterns, as compared to the visual analysis of experts, in the form of a decision-making tool.
Time frame: 5 years