Treatment strategies for unruptured intracranial aneurysms in the Chinese population: China Treatment Trial for Unruptured Intracranial Aneurysm (ChTUIA)

Abstract Background Intracranial aneurysm is a leading cause of subarachnoid hemorrhage and affects approximately 7% of the Chinese population, posing a significant public health concern. Due to the lack of a national cohort of unruptured intracranial aneurysms (UIAs) in China, optimal surgical management for UIAs remain insufficiently explored. Methods The China Treatment Trial for Unruptured Intracranial Aneurysm (ChTUIA) is a national, prospective, observational, multi-center registry study designed to identify optimal surgical management for UIAs in the Chinese population. Eligible patients were recruited from 83 regional neurological centers in China between December 2021 and December 2022. All patients will be followed up routinely for at least two years. Results A total of 25,438 patients with UIAs have been enrolled in the study, of whom 9794 (38.5%) were male, with a median age of 59 years (interquartile range: 52–67 years). The mean follow-up period was 4.28 years (interquartile range: 2.86–6.37 years). Among the patients, 6,712 (26.4%) patients underwent microsurgical clipping, and 18,726 (73.6%) patients underwent endovascular treatment, including 3,017 (16.1%) receiving coil alone or balloon-assisted coiling, 11,431 (61.1%) underwent stent-assisted coiling, and 4,278 (22.8%) treated with flow diverters. Comprehensive data collection encompassed 874,890 demographic and clinical records, 42,109 radiological records, 13,528 hemodynamic records, and 12,727 biological records, with a lost-to-follow-up rate of 5.4% and a data-missing rate of 8.3%. Conclusions The ChTUIA study represents the first national prospective investigation into surgical management protocols and treatment trends toward UIAs in the Chinese population. This study will provide critical evidence to guide the clinical management of UIA patients. Trial registration NCT05844163 ( https://clinicaltrials.gov/study/NCT05844163 ).