Francesco Diana, Michele Romoli, Eytan Raz, Ronit Agid, Felipe C Albuquerque, Adam S Arthur, Jürgen Beck, Jerome Berge, Hieronymus D Boogaarts, Jan-Karl Burkhardt, Marco Cenzato, René Chapot, Fady T Charbel, Hubert Desal, Giuseppe Esposito, Johanna T Fifi, Stefan Florian, Andreas Gruber, Ameer E Hassan, Pascal Jabbour, Ashutosh P Jadhav, Miikka Korja, Timo Krings, Giuseppe Lanzino, Torstein R Meling, Jaques Morcos, Pascal J Mosimann, Erez Nossek, Vitor Mendes Pereira, Andreas Raabe, Luca Regli, Veit Rohde, Adnan H Siddiqui, Rokuya Tanikawa, Stavropoula I Tjoumakaris, Alejandro Tomasello, Peter Vajkoczy, Luca Valvassori, Nikolay Velinov, Daniel Walsh, Henry Woo, Bin Xu, Shinichi Yoshimura, Wim H van Zwam, Simone Peschillo
{"title":"复杂性颅内动脉瘤:旨在确定相关特征的 DELPHI 研究。","authors":"Francesco Diana, Michele Romoli, Eytan Raz, Ronit Agid, Felipe C Albuquerque, Adam S Arthur, Jürgen Beck, Jerome Berge, Hieronymus D Boogaarts, Jan-Karl Burkhardt, Marco Cenzato, René Chapot, Fady T Charbel, Hubert Desal, Giuseppe Esposito, Johanna T Fifi, Stefan Florian, Andreas Gruber, Ameer E Hassan, Pascal Jabbour, Ashutosh P Jadhav, Miikka Korja, Timo Krings, Giuseppe Lanzino, Torstein R Meling, Jaques Morcos, Pascal J Mosimann, Erez Nossek, Vitor Mendes Pereira, Andreas Raabe, Luca Regli, Veit Rohde, Adnan H Siddiqui, Rokuya Tanikawa, Stavropoula I Tjoumakaris, Alejandro Tomasello, Peter Vajkoczy, Luca Valvassori, Nikolay Velinov, Daniel Walsh, Henry Woo, Bin Xu, Shinichi Yoshimura, Wim H van Zwam, Simone Peschillo","doi":"10.1007/s00701-024-06182-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Intracranial aneurysms present significant health risks, as their rupture leads to subarachnoid haemorrhage, which in turn has high morbidity and mortality rates. There are several elements affecting the complexity of an intracranial aneurysm. However, criteria for defining a complex intracranial aneurysm (CIA) in open surgery and endovascular treatment could differ, and actually there is no consensus on the definition of a \"complex\" aneurysm. This DELPHI study aims to assess consensus on variables defining a CIA.</p><p><strong>Methods: </strong>An international panel of 50 members, representing various specialties, was recruited to define CIAs through a three-round Delphi process. The panelists participated in surveys with Likert scale responses and open-ended questions. Consensus criteria were established to determine CIA variables, and statistical analysis evaluated consensus and stability.</p><p><strong>Results: </strong>In open surgery, CIAs were defined by fusiform or blister-like shape, dissecting aetiology, giant size (≥ 25 mm), broad neck encasing parent arteries, extensive neck surface, wall calcification, intraluminal thrombus, collateral branch from the sac, location (AICA, SCA, basilar), vasospasm context, and planned bypass (EC-IC or IC-IC). For endovascular treatment, CIAs included giant size, very wide neck (dome/neck ratio ≤ 1:1), and collateral branch from the sac.</p><p><strong>Conclusions: </strong>The definition of aneurysm complexity varies by treatment modality. Since elements related to complexity differ between open surgery and endovascular treatment, these consensus criteria of CIAs could even guide in selecting the best treatment approach.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Complex intracranial aneurysms: a DELPHI study to define associated characteristics.\",\"authors\":\"Francesco Diana, Michele Romoli, Eytan Raz, Ronit Agid, Felipe C Albuquerque, Adam S Arthur, Jürgen Beck, Jerome Berge, Hieronymus D Boogaarts, Jan-Karl Burkhardt, Marco Cenzato, René Chapot, Fady T Charbel, Hubert Desal, Giuseppe Esposito, Johanna T Fifi, Stefan Florian, Andreas Gruber, Ameer E Hassan, Pascal Jabbour, Ashutosh P Jadhav, Miikka Korja, Timo Krings, Giuseppe Lanzino, Torstein R Meling, Jaques Morcos, Pascal J Mosimann, Erez Nossek, Vitor Mendes Pereira, Andreas Raabe, Luca Regli, Veit Rohde, Adnan H Siddiqui, Rokuya Tanikawa, Stavropoula I Tjoumakaris, Alejandro Tomasello, Peter Vajkoczy, Luca Valvassori, Nikolay Velinov, Daniel Walsh, Henry Woo, Bin Xu, Shinichi Yoshimura, Wim H van Zwam, Simone Peschillo\",\"doi\":\"10.1007/s00701-024-06182-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Intracranial aneurysms present significant health risks, as their rupture leads to subarachnoid haemorrhage, which in turn has high morbidity and mortality rates. There are several elements affecting the complexity of an intracranial aneurysm. However, criteria for defining a complex intracranial aneurysm (CIA) in open surgery and endovascular treatment could differ, and actually there is no consensus on the definition of a \\\"complex\\\" aneurysm. This DELPHI study aims to assess consensus on variables defining a CIA.</p><p><strong>Methods: </strong>An international panel of 50 members, representing various specialties, was recruited to define CIAs through a three-round Delphi process. The panelists participated in surveys with Likert scale responses and open-ended questions. Consensus criteria were established to determine CIA variables, and statistical analysis evaluated consensus and stability.</p><p><strong>Results: </strong>In open surgery, CIAs were defined by fusiform or blister-like shape, dissecting aetiology, giant size (≥ 25 mm), broad neck encasing parent arteries, extensive neck surface, wall calcification, intraluminal thrombus, collateral branch from the sac, location (AICA, SCA, basilar), vasospasm context, and planned bypass (EC-IC or IC-IC). For endovascular treatment, CIAs included giant size, very wide neck (dome/neck ratio ≤ 1:1), and collateral branch from the sac.</p><p><strong>Conclusions: </strong>The definition of aneurysm complexity varies by treatment modality. Since elements related to complexity differ between open surgery and endovascular treatment, these consensus criteria of CIAs could even guide in selecting the best treatment approach.</p>\",\"PeriodicalId\":7370,\"journal\":{\"name\":\"Acta Neurochirurgica\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-07-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Neurochirurgica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00701-024-06182-z\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Neurochirurgica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00701-024-06182-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:颅内动脉瘤对健康构成重大威胁,因为动脉瘤破裂会导致蛛网膜下腔出血,进而造成高发病率和高死亡率。影响颅内动脉瘤复杂程度的因素有很多。然而,在开放手术和血管内治疗中,对复杂颅内动脉瘤(CIA)的定义标准可能会有所不同,而且实际上对 "复杂 "动脉瘤的定义还没有达成共识。这项 DELPHI 研究旨在评估关于 CIA 定义变量的共识:方法:我们招募了一个由 50 名成员组成的国际小组,他们代表不同的专科,通过三轮德尔菲过程来定义 CIA。小组成员参与了李克特量表回答和开放式问题的调查。通过建立共识标准来确定 CIA 变量,并通过统计分析评估共识和稳定性:在开放手术中,CIA的定义包括:纺锤形或水泡样形状、解剖病因、巨大尺寸(≥ 25 毫米)、宽颈部包裹母动脉、颈部表面广泛、管壁钙化、管腔内血栓、囊内侧枝、位置(AICA、SCA、基底动脉)、血管痉挛背景和计划分流(EC-IC 或 IC-IC)。对于血管内治疗,CIA包括巨型、颈部非常宽(穹顶/颈部比≤1:1)和囊内侧枝:动脉瘤复杂性的定义因治疗方式而异。结论:动脉瘤复杂性的定义因治疗方式而异,由于开放手术和血管内治疗的复杂性要素不同,这些CIA的共识标准甚至可以指导选择最佳治疗方法。
Complex intracranial aneurysms: a DELPHI study to define associated characteristics.
Purpose: Intracranial aneurysms present significant health risks, as their rupture leads to subarachnoid haemorrhage, which in turn has high morbidity and mortality rates. There are several elements affecting the complexity of an intracranial aneurysm. However, criteria for defining a complex intracranial aneurysm (CIA) in open surgery and endovascular treatment could differ, and actually there is no consensus on the definition of a "complex" aneurysm. This DELPHI study aims to assess consensus on variables defining a CIA.
Methods: An international panel of 50 members, representing various specialties, was recruited to define CIAs through a three-round Delphi process. The panelists participated in surveys with Likert scale responses and open-ended questions. Consensus criteria were established to determine CIA variables, and statistical analysis evaluated consensus and stability.
Results: In open surgery, CIAs were defined by fusiform or blister-like shape, dissecting aetiology, giant size (≥ 25 mm), broad neck encasing parent arteries, extensive neck surface, wall calcification, intraluminal thrombus, collateral branch from the sac, location (AICA, SCA, basilar), vasospasm context, and planned bypass (EC-IC or IC-IC). For endovascular treatment, CIAs included giant size, very wide neck (dome/neck ratio ≤ 1:1), and collateral branch from the sac.
Conclusions: The definition of aneurysm complexity varies by treatment modality. Since elements related to complexity differ between open surgery and endovascular treatment, these consensus criteria of CIAs could even guide in selecting the best treatment approach.
期刊介绍:
The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.