Journal article
Multidisciplinary consensus on assessment of unruptured intracranial aneurysms: proposal of an international research group
Stroke (1970), Vol.45(5), pp.1523-1530
05/2014
DOI: 10.1161/STROKEAHA.114.004519
PMID: 24668202
Abstract
To address the increasing need to counsel patients about treatment indications for unruptured intracranial aneurysms (UIA), we endeavored to develop a consensus on assessment of UIAs among a group of specialists from diverse fields involved in research and treatment of UIAs.
After composition of the research group, a Delphi consensus was initiated to identify and rate all features, which may be relevant to assess UIAs and their treatment by using ranking scales and analysis of inter-rater agreement (IRA) for each factor. IRA was categorized as very high, high, moderate, or low.
Ultimately, 39 specialists from 4 specialties agreed (high or very high IRAs) on the following key factors for or against UIA treatment decisions: (1) patient age, life expectancy, and comorbid diseases; (2) previous subarachnoid hemorrhage from a different aneurysm, family history for UIA or subarachnoid hemorrhage, nicotine use; (3) UIA size, location, and lobulation; (4) UIA growth or de novo formation on serial imaging; (5) clinical symptoms (cranial nerve deficit, mass effect, and thromboembolic events from UIAs); and (6) risk factors for UIA treatment (patient age and life expectancy, UIA size, and estimated risk of treatment). However, IRAs for features rated with low relevance were also generally low, which underlined the existing controversy about the natural history of UIAs.
Our results highlight that neurovascular specialists currently consider many features as important when evaluating UIAs but also highlight that the appreciation of natural history of UIAs remains uncertain, even within a group of highly informed individuals.
Details
- Title: Subtitle
- Multidisciplinary consensus on assessment of unruptured intracranial aneurysms: proposal of an international research group
- Creators
- Andrew MolyneuxNima Etminan - Heinrich Heine University DüsseldorfKerim Beseoglu - Heinrich Heine University DüsseldorfMichael K MorganDaniel L BarrowKentaro MoriJoshua BedersonAkio MoritaRobert D Brown JrYuichi MurayamaE Sander Connolly JrShinji NagahiroColin P Derdeyn - University of Iowa, RadiologyAlberto PasqualinDaniel Hänggi - Heinrich Heine University DüsseldorfAndreas RaabeJean RaymondSeppo JuvelaHidetoshi KasuyaGabriel J E RinkelDavid Hasan - University of Iowa, Roy J. Carver Department of Biomedical EngineeringDaniel RüfenachtVolker SeifertPeter J KirkpatrickNeville KnuckeyJulian SpearsTimo KoivistoHans-Jakob Steiger - Heinrich Heine University DüsseldorfHelmuth SteinmetzGiuseppe LanzinoMichael T LawtonJames C TornerPeter VajkoczyPeter LeRouxCameron G McDougallIsabel WankeGeorge K C WongEdward MeeJohn H WongJ MoccoR Loch Macdonald
- Resource Type
- Journal article
- Publication Details
- Stroke (1970), Vol.45(5), pp.1523-1530
- DOI
- 10.1161/STROKEAHA.114.004519
- PMID
- 24668202
- NLM abbreviation
- Stroke
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Publisher
- United States
- Language
- English
- Date published
- 05/2014
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Epidemiology; Iowa Neuroscience Institute; Surgery; Injury Prevention Research Center; Neurosurgery; Otolaryngology
- Record Identifier
- 9983996067902771
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