Unruptured Annie, treat or not?

I found out about a month ago that I have a 5.5 mm aneurysm on my ICA. The finding was incidental and I have not had any symptoms. I had decided on having it treated (my neuro says PED would be the method) but now that the time is getting close I am having second thoughts. Anyone out there have experiences they want to share? When given a choice did you decided to have your annie treated or not? What led you to your decision? How are things going since?

Thanks for your input.

Thanks Sue,

My Doc said based on the size and location of mine he could go either way (watch and wait or go ahead and treat). He said if it was him he would probably give it a year and then follow up and check for any growth. However, he went on to say that it wasn't him and he definitely understands there is a quality of life issue with living with an aneurysm and is wiling to do the treatment now if that is what I want.

I was really anxious at first but have been feeling better for the last couple of weeks. However, the little time bomb is still there. I am only 41 and I travel a lot with my job so I am thinking I will go ahead with the treatment but the thought of it makes me nervous. I would hate to make a bad situation worse with a bad result from the surgery.

Thanks Sue,

I have sent a request to join the PED group and have read over a bunch of the posts. There is some good info there.

As far as the waiting a year. He was basically saying I could take the "no treatment" approach and then have an MRI/MRA periodically to check it. If we see any growth treat it then if not just continue to watch it. My problem with that is that 5.5 mm aneurysms can rupture without any growth first. The odds are fairly low but it can and does happen as I'm sure you know.

Hi John - sorry to hear about your aneurysm. The direction to treat or not is such a personal one but I will share some of my story in hopes it helps. At least you know you are not alone in your struggle to decide! :slight_smile:

I am 33 and was diagnosed at Christmas. My aneurysm is relatively small, 4 mm, but I have a strong family history. My mom has had two aneurysms clipped and then on my dad’s side I had an aunt pass away from a rupture and two aunts living with multiple aneurysms. For me, knowing it is is there is always on my mind. I find myself thinking twice before I do things…go for a run, play soccer, being alone with my kids. I have a one year old daughter and a three year old son. All these things combined, have made me decide to go ahead with treatment. I am scheduled for clipping May 30.

Like you, I have no symptoms and feel great. One of biggest fears is having complications after. It is weird to think one morning I will wake up as I always do but instead of heading to work, I will be going to the hospital for major surgery. I am at peace with my decision though…I want to be around for my family and a rupture would be devastating.

These are just my own thoughts. Best of luck in your own decision making process. It is so tough! Sometimes I wish I never found put but then I am thankful I had been given the opportunity to fix it before a rupture.

Take care!

John, welcome..you will get a lot of input...we all vary; and, have so similar for symptoms to no symptoms, ruptures or not, to various treatments. My records note ICA, PComA region aneurysm that was 6mm in the diagnostic angio data...post-rupture...The size that is generally used to qualify the wait for treatment has been a concern to me. Some others have had ruptures of smaller than mine and/or in other artery locations.

Wishing you tons of feedback from so many here.


Hi John, my annie was discovered incidental in 2005 , and it was asyntomatic.
The doctor said it was too small, nothing should happened.
4 years later I had my rupture, first coiled and in january 2010 I received the PED.
I was very lucky, I fully recovered.
My suggestion is not to’ wait and get the PED.
here there is the PIPELINE EMBOLIZATION DEVICE GROUP, ask to join us.
Take care,

I had the PED and have had no regrets. The stress of the annies was too much for me. Also, anytime you get a bad headache you probably will need to have a CT and/or lumbar puncture to ensure that it isn't leaking. I would look into the amount of PED's your surgeon has placed. The surgery itself is not invasive, and generally goes ok-again-the surgeon MUST have experience! My husband and I differed a bit but this is what is came down to in my mind. As a 38 year old there is a very good chance that in my lifetime these annies would need treatment. I could do it planned, with my kids cared for, and with a surgeon of my choice....or I could stroke out at Target or on vacation and be airlifted to the closest hospital and have no say in the surgeon or circumstances. Also, I figured it was easier to treat an unruptered smallish vs. ruptured or giant annie.Again, different people/different personalities. It all comes down to what your bigger fear is....surgery or rupture. Mine was rupture, but many people's is surgery.

Wow, first let me say the support from you all is awesome! It really helps to hear from people who have "been there and done that".

My treatment is scheduled for next week. I was pretty much ready for it until I went in for my pre-admission testing and found out I was going to have a PED instead of just regular coiling. I guess just finding out my procedure was going to be different than I expected got me thinking about the whole process again. I feel comfortable with my doc, he had a fellowship at the Barrow Institute which seems to be top notch. He also has done ~20 PEDs here in Louisville and tons of coilings.

And I agree with Kim. Its weird to think about going in for brain surgery when I feel fine.

Hi John,

Treatment is not without risk whether it is a coiling or a clipping so you have to weigh your risks carefully and as mentioned by others, to treat or not to treat is a highly personal decision.

I've lived with at least one unruptured aneurysm for almost 43 years and with three for more than 35 years. I know about these because I had a rupture in 1969 and what can be characterized a miraculous recovery. I can honestly say that I don't live in constant fear of another rupture any more than I fear a car accident while on the roads in Houston. I am more concerned with preventing seizures which is the most serious side effect of my clipping and with other issues of "aging"!

I had an angiogram earlier this year. The largest of my three annies was measured at 5mm the other 2 are 2mm. My life, however, didn't change with these angiogram results. There were no new discoveries, no new fears. I only received more details re: what I already knew and what I'd lived with for a very long time. Except for the fact that I had a bleed 43 years ago, I have few risk factors for a rupture. So, my decision, with support of my doctors, was to continue to watch them but not to have treatment at this time. I plan to have a follow-up MRA next January 2013. In the meantime, I trust in God to keep me safe for nobody knows what tomorrow will bring.

I pray that God will guide you to make the decision that is right for you.


Welcome to BAF John

Just to say that mine has been treated and I'm happy about the results.

I shall keep you in my prayers

All my best


Hi John- everyone is right about the support you will find here but ultimately how it is a personal decision. I just wanted to say I had what sounds like the same size same location unruptured aneurysm coiled in Dec. 2011. For me this was the best decision because I was a nervous wreck and I think I had a warning headache. My recovery was great. One night in ICU and home the next day. No headaches, no problems since:) God bless you and your decisions!

Hi John I had my annie coiled because I had trust in my Doctors and I was having bad symptoms, also by that point the aneurysm was leaking...another small one behind my eye (watching and waiting)...I must tell you...this does happen...doubts...while I prepared for surgery I had so many...going back and forth...

Prayers your way ... on surgery and your decision ~ Colleen

Welcome, and sorry you have to be a part of our group. If you go to the PED group, you will find a ton of info...I had 2 PED's put in in November 2011. Mine was in my right ICA, cavernous segment....told it wasn't high risk for rupture by one doc..but when went for angiogram...showed it had grown out of the "protective" area and had a baby anuerysm on it, both making it more dangerous and likely to rupture. Mine was 12mm or 1 CM, considered to be large by most doctors standards. I waited 6 months to do something, most of it spent doing research, consulting with 5 docs...but in the end, I couldn't stand the wait and watch approach.. Everyone is different, and all annie's are different. You have to make the best informed decision you can. Research, ask questions, get different opinions...I had the surgery, and it was a breeze and am glad to be done with it. Have my follow up angio coming up next month. Will know then if the PED has worked. Good luck, and don't hesitate to ask questions..and if you don't like what you hear, go to another doctor and ask more! Things are going great since...am back to work, no deficits, no headaches whatsoever...but, again, it's a personal decision based on many different factors....


I have known about mine for almost 5 years now. I opted to not treat for a long time. Mine is in the cavernous sinus, a tricky area, but have since changed my mind. I am having PED surgery on May 15th. I am nervous, but living with this has been more difficult than I had anticipated. It is always in the back of mind? Will I wake up each day? Everytime I had an issue with my eye, either pink eye, allergies etc.....off the the doc i would go. I can't play sports, nosebleeds send me to the ER. I always have to be conscious that it may not just be headache, but a rupture instead. It has proven to be more emotionally difficult living with it. I am ready to say goodbye to the daily knowledge of it being there. That is how I came to my decision to have the surgery. it is hard emotionally either way you choose to deal with it, but this site has proven helpful to me :)

John, best of luck to you. I have a 5.16mm anny and I am having it clipped on 6/28. Decisions are very hard, but have faith in your Dr. He knows what he is doing.

Praise the Lord! I'm out of surgery and recovering in ICU. My doc said everything went great. I am the proud new owner of a PED.

When given the opportunity to change your course and fix somehing that you now know is broken is a lot better than waiting and wondering. I had a2.5 leak that almost killed me. Its all timing…not if but when. If i were you id rather be in control of the when

YAY Great to hear that.

Hi John,

What great news! Thanks be to God.

May you have a rapid and complete recovery.