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Open research questions in Intracranial Aneurysms: Treatment and Complications

171 unresolved questions extracted from the limitations and future-work sections of 395 Intracranial Aneurysms: Treatment and Complications papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • further research is needed to understand the long-term psychological sequelae in CeAD patients, - studies should investigate the impact of baseline characteristics on the development of PTSD and anxiety in CeAD patients, - research should focus on developing strategies to improve QoL in CeAD patients

    Long-term mental health and quality of life in patients after cervical artery dissection · 2026 · DOI

  • Limited evidence on long-term psychological sequelae in CeAD patients. Lack of understanding of baseline variables that can identify patients at high risk of developing PTSD or anxiety.

    Long-term mental health and quality of life in patients after cervical artery dissection · 2026 · DOI

  • The current understanding of the relationship between thyroid dysfunction and intracranial aneurysm formation and rupture is limited. There is a need for further research into the association between free triiodothyronine and intracranial aneurysms.

    Free triiodothyronine in intracranial aneurysms: a sex-specific association with unruptured disease and a non-thyroidal illness signal after rupture · 2026 · DOI

  • However, little is known about whether CFRs vary by RIA location in population-based studies that include prehospital SAH deaths.

    Case Fatality of Subarachnoid Hemorrhage by Aneurysm Location · 2026 · DOI

  • Whether thyroid optimisation influences aneurysm development remains to be tested in prospective studies.

    Free triiodothyronine in intracranial aneurysms: a sex-specific association with unruptured disease and a non-thyroidal illness signal after rupture · 2026 · DOI

  • BACKGROUND AND OBJECTIVES: Cervical artery dissection (CeAD) is a common cause of acute ischemic stroke (AIS), especially in patients younger than 55 years, but data regarding trends and subsequent AIS risk after CeAD remain scarce.

    Incidence Trends and Risk of Recurrent Stroke of Cervical Artery Dissections in the United States Between 2005 and 2019 · 2025 · DOI

  • While inflammation is implicated in IA pathogenesis, the precise immune regulatory mechanisms underlying IA stability, growth, and rupture remain poorly defined.

    Immune Characterization of Intracranial Aneurysms Using Noninvasive Endoluminal Biopsy With High-Dimensional Single-Cell Phenotyping · 2025 · DOI

  • However, longitudinal outcomes in aneurysmal subarachnoid hemorrhage (aSAH) have not been well reported, which could provide insight into appropriate management and information for patients experiencing disability.

    Five-Year Functional Outcomes Among Patients Surviving Aneurysmal Subarachnoid Hemorrhage · 2025 · DOI

  • BACKGROUND: Although intravenous thrombolysis (IVT) is safe and effective in populations with general stroke, its impact on cervical artery dissection-related acute ischemic stroke (CeAD-AIS) remains unclear.

    Intravenous Thrombolysis in Cervical Artery Dissection–Related Stroke: A Nationwide Study · 2025 · DOI

  • However, it remains unclear whether this disparity is correlated with delayed cerebral ischemia (DCI) incidence and accompanying risk factors.

    Sex Differences in Incidence and Risk Factors for Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage: A Propensity Score‐Matched Analysis · 2025 · DOI

  • However, the association between the TyG index and the instability (growth or rupture) of unruptured intracranial aneurysms (UIAs) remains underexplored.

    Triglyceride–Glucose Index Predicts Instability in the Natural History of Intracranial Aneurysms: Insights From a Large‐Scale Chinese Multicenter Cohort · 2025 · DOI

  • Prospective multicenter validation is warranted to confirm its generalizability across diverse populations.

    Machine learning-based prediction of short-term outcomes in aneurysmal subarachnoid hemorrhage: a multicenter study integrating clinical and inflammatory indicators · 2025 · DOI

  • In this context, we also try to explain the methodological reasons behind some of the conflicting results and to discuss the primary strengths and limitations of different study designs used in the field of SAH epidemiology.

    Modifiable Risk Factors for Subarachnoid Hemorrhage · 2024 · DOI

  • We sought to determine the ability of VWI to identify the rarely reported spontaneous intracranial carotid dissection (sICD) guided by postmortem validation.

    Vessel Wall Imaging Features of Spontaneous Intracranial Carotid Artery Dissection · 2024 · DOI

  • in one-third infarction stent-assisted approximately Notably, a prior case series involving 26 branch vesselinvolving aneurysms (BVA) treated with coiling showed that only 31% achieved near-complete occlusion (whereas 50% had a residual neck), and 23% recurred at follow-up (4). Beyond complicating durability, BVAs also carry higher procedural risk, with prior studies reporting branch vesselterritory of BVA coiling cases, despite overall technical success (5). techniques have Although balloon- and expanded the utility of endovascular coiling, BVAs have been shown to limit optimal results (4, 6, 7). Thus, the existing studies and fails to account for the role of various confounders on aneurysm occlusion, specifically in the context of BVAs. Packing density (PD) is the percentage of the aneurysm volume that is occupied by implanted coils and can act as a quantitative measure of and treatment success (8). Furthermore, the presence of small from branch vessels originating the aneurysm, which cannot be protected with the use of double-catheter techniques (such as balloon- or stent-assisted coiling), are compromise feature a potentially notable coiling durability. aneurysm occlusion comparative that may literature larger lacks critical endovascular To this end, we collected a cohort of IAs with and without branch vessel involvement and conducted a propensity score-matched analysis to evaluate the impact on postprocedural PD, Raymond-Roy Occlusion Classification (RROC), recurrence, and retreatment. Our study offers novel insights into a critically understudied but important morphological feature and seeks to inform both procedural planning in aneurysm management.

    Presence of small and large branch vessels from intracranial aneurysms increases the risk of post-treatment recurrence and retreatment following endovascular coiling: insights from a propensity score-matched cohort · 2026 · DOI

  • There is a need for alternative methods to autologous bone cranioplasty due to its limitations. The effectiveness of 3D printed implants in cranioplasty for aSAH patients is not well established.

    Outcomes of cranioplasty with customized artificial bone flap made by 3D printing technique in patients with aneurysmal subarachnoid hemorrhage · 2026 · DOI

  • In the 3D group, titanium implants predominated, with only a few PEEK implants, and as these materials differ in biomechanical and complication-related properties, this heterogeneity is a study limitation.

    Outcomes of cranioplasty with customized artificial bone flap made by 3D printing technique in patients with aneurysmal subarachnoid hemorrhage · 2026 · DOI

  • Current preclinical animal models are costly and fail to reproduce aneurysm pathology. There is a need for a novel preclinical animal model that can validate various aspects required for an endovascular device.

    Establishment of the Rat Model of Intracranial Aneurysm Contributing to the Development of Endovascular Devices · 2026 · DOI

  • The majority of the included studies had a low risk of bias, but some studies had a high risk of bias due to a lack of clear demographic and clinical data. The review is limited to studies published between 2013 and 2025. The study did not include a control group for comparison.

    Safety and efficacy of flow diversion for blood blister aneurysms: A comprehensive systematic review and meta-analysis · 2026 · DOI

  • Our study has several limitations. The evidence is weakened by the heterogeneity between included studies and the rarity of the disease. Due to the rarity of the disease and complications following FD placement, meta-regression was limited, missing some correlated factors. Many of the included studies did not provide a clear or standardized definition of BBAs. Variations in occlusion criteria restricted our analysis to complete occlusion. Short follow-up periods may have affected observed clinical safety and efficacy. The time between symptom onset and treat- ment varied significantly, influencing occlusion and complica- tion rates. Most studies were small and monocentric, potentially causing a small study effect. Some studies had overlapping patients but were included due to incomplete overlap and addi- tional data provided for these patients.

    Safety and efficacy of flow diversion for blood blister aneurysms: A comprehensive systematic review and meta-analysis · 2026 · DOI

  • Author contributions First, despite a registry-based design, data were collected mainly from two centers, which may limit generalizability and introduce selection bias. Second, the model was only validated internally; external validation is needed to confirm clinical appli- cability. Third, TyG was measured only at postoperative day 3 and may be affected by perioperative stress, so it should be inter- preted as a prognostic marker rather than a causal factor. Fourth, detailed information regarding antiplatelet therapy timing and adherence was incomplete, representing a potential confounder. Fifth, as an observational study, residual confounding and treat- ment-selection bias could not be fully eliminated. Although ACS and cerebral infarction represent distinct clinical entities, the consistent directionality and robust predictive performance observed in component-specific analyses support the clinical validity of the composite ICCE endpoint for capturing overall post-treatment vascular vulnerability. YH: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Visualization, Writing – original draft, Writing – review & editing, Software. SC: Data curation, Investigation, Writing – review & editing. DL: Data curation, Investigation, Writing – review & editing. ZZ: Methodology, Validation, Writing – review & editing. YL: Methodology, Validation, Writing – review & editing. YW: Conceptualization, Funding acquisition, Project admin- istration, Supervision, Writing – review & editing.

    Machine learning-based prediction of ischemic cardio-cerebrovascular events after endovascular or microsurgical treatment of unruptured intracranial aneurysms and risk stratification by the early post-treatment triglyceride-glucose index · 2026 · DOI

  • SAH patients who present with coma can have poor prognosis. Early prognostication in SAH remains difficult due to potential secondary neurological injury. There is a need for a more direct pathophysiologic assessment of dynamic cerebral autoregulation in SAH patients.

    Multi-center pressure reactivity index temporal trajectories for predicting outcome in comatose subarachnoid hemorrhage patients · 2026 · DOI

  • There is a need for a more direct pathophysiologic assessment of dynamic cerebral autoregulation in SAH patients. Prior work has limitations in terms of prognosticating SAH outcome.

    Multi-center pressure reactivity index temporal trajectories for predicting outcome in comatose subarachnoid hemorrhage patients · 2026 · DOI

  • Limited data on direct comparison of flow diverter types. Need for evaluation of technical, angiographic, and clinical aspects of different flow diverters.

    Comparison Between Pipeline Embolization Device and Derivo Embolization Device for the Treatment of Unruptured Cerebral Aneurysms: A Single-Center Analysis · 2026 · DOI

  • The study is a post-hoc analysis of the ULTRA trial. The trial had a limited sample size of 955 patients. The study only evaluated QoL at three and six months.

    Quality of life after tranexamic acid in subarachnoid hemorrhage: post-hoc analysis of the ULTRA trial · 2026 · DOI

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171 open questions have been extracted from the limitations and future-work passages of 395 Intracranial Aneurysms: Treatment and Complications papers in our 4.5M-paper local library. Each one below links back to the study that raised it, so you can read the original claim in context.

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