Objective: There is a relative lack of literature on long-term aneurysm recurrence and de novo aneurysm formation following surgical treatment of unruptured intracranial aneurysms. This retrospective single-center cohort study, therefore, analyzes the incidence of aneurysm recurrence, and the incidence of de novo aneurysms formation in patients with at least 10yrs of radiological follow-up. The data are put into the context of a systematic review of the literature.Methods: Patients that underwent surgical treatment of an unruptured intracranial aneurysm at the Basel University Hospital were retrospectively identified. The rate of recurrent or de novo aneurysm formation was assessed for all patients with imaging follow-up ≥10yrs. A systematic review including studies with a mean follow-up period of ≥10yrs was then performed.Results: A total of 95 patients had undergone surgical treatment of an unruptured intracranial aneurysm between 1994 and 2008. Twenty-one patients (22.1%) had available imaging follow-up ≥10yrs (mean: 13.1yrs). In these patients, aneurysm recurrence and de novo aneurysm formation were equally found in 23.8% (n = 5; 1.8%/yr). There was no case of aneurysm rupture from a recurrent or a de novo aneurysm. The systematic literature review covered a combined cohort of 1778 patients over a mean follow-up period of 14.0yrs. In this cohort, the aneurysm recurrence rate was 16.4% (0.7%/yr), and the rate of de novo aneurysm formation was 6.2% (0.4%/yr).Discussion: Despite some discrepancy regarding the incidence, both cohorts show a non-negligible long-term risk of aneurysm recurrence and de novo aneurysm formation, which warrants life-long imaging follow-up.Abbreviations: SD: standard deviation; DSA: digital subtraction angiography; CTA: computed tomography angiography; MRA: magnetic resonance angiography; MCA: middle cerebral artery; ACA: anterior cerebral artery; ACommA: anterior communicating artery; ICA: internal carotid artery; ADPKD: autosomal dominant polycystic kidney disease; MeSH: Medical Subject Headings.

中文翻译：

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颅内动脉瘤破裂手术治疗后的长期动脉瘤复发和新生动脉瘤形成：一项队列研究和系统评价。

目的：目前尚无有关颅内动脉瘤破裂手术治疗后长期动脉瘤复发和从头形成的文献。因此，这项回顾性单中心队列研究分析了至少10年的放射学随访患者的动脉瘤复发率和新生动脉瘤形成率。方法：回顾性鉴定在巴塞尔大学医院接受手术治疗的颅内动脉瘤破裂的患者。对所有影像学检查≥10年的患者评估复发或新生动脉瘤的发生率。然后进行了系统评价，包括平均随访期≥10年的研究。在1994年至2008年之间，共有95例患者接受了手术治疗，其中颅内动脉瘤未破裂。21例患者（占22.1％）的影像学随访≥10年（平均：13.1年）。在这些患者中，平均23.8％（n = 5； 1.8％/年）发现动脉瘤复发和新生动脉瘤形成。没有发生因复发或新生动脉瘤而破裂的情况。系统的文献综述涵盖了1778名患者，平均随访期为14.0年。在这个队列中，动脉瘤复发率为16.4％（0.7％/年），从头动脉瘤形成率为6.2％（0.4％/年）。讨论：尽管发病率存在差异，但两个队列均未发现-动脉瘤复发和新生动脉瘤形成的长期风险可忽略不计，因此需要终身进行影像学随访。缩写：SD：标准偏差；DSA：数字减影血管造影；CTA：计算机断层扫描血管造影；MRA：磁共振血管造影；MCA：大脑中动脉；ACA：大脑前动脉；ACommA：前交通动脉；ICA：颈内动脉；ADPKD：常染色体显性遗传性多囊肾；MeSH：医学主题词。