643 A Review of the Screening Protocols Investigating Intracranial Aneurysms in Polycystic Kidney Disease

Abstract

Abstract Aim Intracranial aneurysms (ICA) are a common complication of polycystic kidney disease (PKD). Due to the lack of screening protocols that exist for PKD patients, without the appropriate preventative measures ICA rupture leads to significant morbidity and mortality. The aim is to analyse existing screening protocols by referencing the lead time between ICA diagnosis and rupture in PKD patients, the purpose and importance of screening, the types of imaging modalities used, and patient outcomes. We will also consider cost-effectiveness and its relation in establishing a screening protocol. Method A literature search was conducted in April 2022 for articles published between 1990-2022 with special interest in ICA, PKD, and screening protocols. Only exclusion criteria were patients who were diagnosed with PKD <30 years of age. An independent reviewer screened the relevant full papers prior to inclusion. Results Our findings suggest that if a PKD presents with either a positive family history of ICA and/or cerebrovascular events and/or is above 40 years of age, then they should have a magnetic resonance angiography (MRA) scan every 5 years to monitor ICA development with annual follow-ups. This will significantly decrease patient morbidity and mortality in PKD positive patients. Conclusions While there is significant evidence proving that screening protocols decrease the morbidity and mortality of PKD patients, none have been suggested. The screening protocol suggested in this review should be used as a guideline for future studies that will try and establish a national or international guidelines that can be used by nephrologists and neurosurgeons worldwide.