Residual Cerebral Aneurysms After Microsurgical Clipping: A New Scale, an Agreement Study, and a Systematic Review of the Literature.

Détails

ID Serval
serval:BIB_57A0DDDD4116
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Residual Cerebral Aneurysms After Microsurgical Clipping: A New Scale, an Agreement Study, and a Systematic Review of the Literature.
Périodique
World neurosurgery
Auteur(s)
Kotowski M., Farzin B., Fahed R., Guilbert F., Chagnon M., Darsaut T.E., Daniel R.T., Raymond J.
ISSN
1878-8769 (Electronic)
ISSN-L
1878-8750
Statut éditorial
Publié
Date de publication
01/2019
Peer-reviewed
Oui
Volume
121
Pages
e302-e321
Langue
anglais
Notes
Publication types: Journal Article ; Systematic Review
Publication Status: ppublish
Résumé
The surgical repair of a cerebral aneurysm does not always lead to complete occlusion. A standardized repeatable method of reporting results of surgical clipping is desirable. Our purpose was to systematically review methods of classifying aneurysm remnants, provide a new scale with precise definitions of categories, and perform an agreement study to assess the variability in adjudicating remnants after aneurysm clipping.
A systematic review was performed to identify ways to report angiographic results of surgical clipping between 1963 and 2017. Postclipping angiographic results of 43 patients were also independently evaluated by 10 raters of various experience and backgrounds using a new 4-category scale. Agreement between responses were analyzed using κ statistics.
The systematic review yielded 63 articles with 37 different nomenclatures using 2-6 categories. The reliability of judging the presence of an aneurysm remnant on catheter angiography was studied only twice, with only 2 raters each time, with contradictory results. Interobserver agreement using the new 4-category scale was moderate (κ = 0.52; 95% confidence interval, 0.43-0.62) for all observers, but improved to substantial (κ = 0.62; 95% confidence interval, 0.47-0.76) when results were dichotomized (grade 0/1 vs. 2/3).
Various classification schemes to evaluate angiographic results after surgical clipping exist in the literature, but they lack standardization. Adjudication using fewer, better defined categories may yield more reliable agreement.
Mots-clé
Aneurysm, Ruptured/surgery, Cerebral Angiography, Female, Humans, Intracranial Aneurysm/surgery, Male, Microsurgery/instrumentation, Microsurgery/methods, Middle Aged, Neurosurgical Procedures/instrumentation, Neurosurgical Procedures/methods, Observer Variation, Surgical Instruments, Agreement, Classification, Reliability, Residual aneurysm, Surgical clipping
Pubmed
Web of science
Création de la notice
04/11/2018 16:25
Dernière modification de la notice
20/08/2019 14:11
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