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Unruptured ICA aneurysms – surveillance or treatment?

Posted by Unruptured C6 Aneurysms @dmetzy, Jun 22 11:17am

Hello.

I’m a 61-year-old woman who recently learned that I have two incidental, unruptured bilateral C6 ICA aneurysms measuring 7 mm and 8 mm. They were found on a CTA and are not causing any symptoms.

The vascular neurosurgeon described them as broad-necked/“basket-shaped.” If treated endovascularly, they would likely require stent-assisted coiling. Clipping is also an option.

He estimated the treatment risk at approximately 3–5% and the rupture risk at about 1% per year, so after discussing it with my family doctor, I chose monitoring for now.

I would love to hear from others with similar aneurysms. If you were given a choice between surveillance, clipping, or stent-assisted coiling, how did you decide? For those who chose surveillance, how have you managed the uncertainty over time?

Thank you for sharing your experiences.

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Profile picture for Maryann
Maryann | @mkoch | 13 hours ago
In reply to @shamb52 "My 4x8 ICA (brain aneurysm) was discovered in 2021. After monitoring, it has not grown as..." + (show)
Profile picture for shamb52 @shamb52

My 4x8 ICA (brain aneurysm) was discovered in 2021. After monitoring, it has not grown as of late last year (2025). Monitoring was every six months, then every year, now every two years. I have had two friends in the last year lose their adult children from undetected burst brain aneurysms. I lost 3 friends in the last 50 years from the same. In a sense, I am glad I found out and in another sense, terrified. I am lucky though. Never smoked, always had pretty low/normal blood pressure. Retired so not a lot of stress. I had asked about an angiogram so we can see what is going on there. When I told my primary care physician I had thought about an angiogram, she said "so you VOLUNTEERED for that huh?" like what is the matter with you. I would like to hear other experiences with angiograms. I am 74 years old, a little overweight but very healthy on only one med for reflux. My risk of burst is low but hey, I want to get every chance I have to outlive my dogs! lol Experiences with angiograms? Let me know.

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@shamb52: Just ignore your P.C.P.'s snarky remark. I've had two angiograms. The first after I was diagnosed with an aneurysm about 2 years ago that was found incidentally when I had an MRI to monitor a meningioma. The neurosurgeon wanted a more complete picture than the MRI/MRA could show. There are different types of aneurysms and that can influence next steps to be taken. Then, I had my aneurysm coiled and had a follow up angiogram about 3 or 6 months afterwards (can't remember) to make sure the coiling procedure worked. That being said, I found the angiogram to be a nothing-burger. It was, as I remember, an hour to hour and a half of the actual procedure. (I'm not factoring in the prep beforehand: getting in the gown, vitals taken, visit by anesthesiologist and neurosurgeon.) It was painless. It required no general anesthetic. (I only had to align with an anesthesiologist b/c I have sleep apnea. Don't know why that was of concern but that was the rule.) Going under a general is what is of concern for us older people. (I am 74 as well) Of course, had I been much younger, I would also be worried about all that radiation. But as my neurologist told me, the consequences from the radiation would be 20-30 years down the road and I piped in and finished his thought by saying, "And probably something else will get me by then." Current health care perspective has changed in the last 10 or so years and we, the patient, are allowed and encouraged to take part in the decision making regarding our health care. Don't be deterred by the remarks of your P.C.P. You are entitled to know more about the aneurysm in your brain if that is important to you. There is a post somewhere on this thread where a person writes that she was told the type of aneurysm she had was unlikely to bleed out. One can learn a lot more about their aneurysm from an angiogram. Actually, I am surprised that a follow up angiogram wasn't recommended given that you were only 69 or 70 when it was first discovered.

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