An outcomes-based grading scale for the evaluation of cerebral aneurysms treated with flow diversion

Min S. Park, Marcus D. Mazur, Karam Moon, Michael J. Nanaszko, John R.W. Kestle, Lubdha M. Shah, Blair Winegar, Felipe C. Albuquerque, Philipp Taussky, Cameron McDougall

Research output: Contribution to journalArticle

Abstract

Object Despite the popularity of flow-diverting stents for the treatment of cerebral aneurysms, there is no widely accepted scale for the characterization of results. We present an outcomes-based grading scale that considers factors related to failure of flow diversion. Methods The grading scale was developed using the results from consecutive patients at two institutions who were treated with flow diversion for a cerebral aneurysm. The initial treatment results were graded on patient, aneurysm, and treatment characteristics. A 6-point grading scale was developed based on these data. Results One hundred and seventy-one patients were included in the patient cohort. When compared by multivariate analysis with patients without residuals, patients with aneurysm residuals were found to be older (age ≥60 €...years, p=0.01, OR 1.17, 95% CI 1.03 to 1.33), to have larger aneurysms (size ≥15 €...mm, p<0.01, OR 1.38, 95% CI 1.17 to 1.62), to have aneurysms with associated side branches (p=0.02, OR 1.17, 95% CI 1.03 to 1.33), and to have a post-treatment Raymond score of 2 or 3 (p=0.01, OR 1.28, 95% CI 1.06 to 1.56). Using the Raymond score (1-3) as the foundation for the grading scale, additional points (0 or 1) were given for the other three identified factors, creating a 6-point scale. We found that patients with residual aneurysms had statistically higher final tabulated scores (p<0.01). Conclusions We propose a novel straightforward outcomes-based scale to characterize results after flow diversion treatment of cerebral aneurysms. This scale may provide the basis for the common reporting of results in future studies.

Original languageEnglish (US)
Pages (from-to)1060-1063
Number of pages4
JournalJournal of NeuroInterventional Surgery
Volume9
Issue number11
DOIs
StatePublished - Nov 1 2017
Externally publishedYes

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Intracranial Aneurysm
Aneurysm
Therapeutics
Stents
Multivariate Analysis

Keywords

  • Aneurysm
  • Flow Diverter

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

An outcomes-based grading scale for the evaluation of cerebral aneurysms treated with flow diversion. / Park, Min S.; Mazur, Marcus D.; Moon, Karam; Nanaszko, Michael J.; Kestle, John R.W.; Shah, Lubdha M.; Winegar, Blair; Albuquerque, Felipe C.; Taussky, Philipp; McDougall, Cameron.

In: Journal of NeuroInterventional Surgery, Vol. 9, No. 11, 01.11.2017, p. 1060-1063.

Research output: Contribution to journalArticle

Park, MS, Mazur, MD, Moon, K, Nanaszko, MJ, Kestle, JRW, Shah, LM, Winegar, B, Albuquerque, FC, Taussky, P & McDougall, C 2017, 'An outcomes-based grading scale for the evaluation of cerebral aneurysms treated with flow diversion', Journal of NeuroInterventional Surgery, vol. 9, no. 11, pp. 1060-1063. https://doi.org/10.1136/neurintsurg-2016-012688
Park, Min S. ; Mazur, Marcus D. ; Moon, Karam ; Nanaszko, Michael J. ; Kestle, John R.W. ; Shah, Lubdha M. ; Winegar, Blair ; Albuquerque, Felipe C. ; Taussky, Philipp ; McDougall, Cameron. / An outcomes-based grading scale for the evaluation of cerebral aneurysms treated with flow diversion. In: Journal of NeuroInterventional Surgery. 2017 ; Vol. 9, No. 11. pp. 1060-1063.
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abstract = "Object Despite the popularity of flow-diverting stents for the treatment of cerebral aneurysms, there is no widely accepted scale for the characterization of results. We present an outcomes-based grading scale that considers factors related to failure of flow diversion. Methods The grading scale was developed using the results from consecutive patients at two institutions who were treated with flow diversion for a cerebral aneurysm. The initial treatment results were graded on patient, aneurysm, and treatment characteristics. A 6-point grading scale was developed based on these data. Results One hundred and seventy-one patients were included in the patient cohort. When compared by multivariate analysis with patients without residuals, patients with aneurysm residuals were found to be older (age ≥60 €...years, p=0.01, OR 1.17, 95{\%} CI 1.03 to 1.33), to have larger aneurysms (size ≥15 €...mm, p<0.01, OR 1.38, 95{\%} CI 1.17 to 1.62), to have aneurysms with associated side branches (p=0.02, OR 1.17, 95{\%} CI 1.03 to 1.33), and to have a post-treatment Raymond score of 2 or 3 (p=0.01, OR 1.28, 95{\%} CI 1.06 to 1.56). Using the Raymond score (1-3) as the foundation for the grading scale, additional points (0 or 1) were given for the other three identified factors, creating a 6-point scale. We found that patients with residual aneurysms had statistically higher final tabulated scores (p<0.01). Conclusions We propose a novel straightforward outcomes-based scale to characterize results after flow diversion treatment of cerebral aneurysms. This scale may provide the basis for the common reporting of results in future studies.",
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T1 - An outcomes-based grading scale for the evaluation of cerebral aneurysms treated with flow diversion

AU - Park, Min S.

AU - Mazur, Marcus D.

AU - Moon, Karam

AU - Nanaszko, Michael J.

AU - Kestle, John R.W.

AU - Shah, Lubdha M.

AU - Winegar, Blair

AU - Albuquerque, Felipe C.

AU - Taussky, Philipp

AU - McDougall, Cameron

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Object Despite the popularity of flow-diverting stents for the treatment of cerebral aneurysms, there is no widely accepted scale for the characterization of results. We present an outcomes-based grading scale that considers factors related to failure of flow diversion. Methods The grading scale was developed using the results from consecutive patients at two institutions who were treated with flow diversion for a cerebral aneurysm. The initial treatment results were graded on patient, aneurysm, and treatment characteristics. A 6-point grading scale was developed based on these data. Results One hundred and seventy-one patients were included in the patient cohort. When compared by multivariate analysis with patients without residuals, patients with aneurysm residuals were found to be older (age ≥60 €...years, p=0.01, OR 1.17, 95% CI 1.03 to 1.33), to have larger aneurysms (size ≥15 €...mm, p<0.01, OR 1.38, 95% CI 1.17 to 1.62), to have aneurysms with associated side branches (p=0.02, OR 1.17, 95% CI 1.03 to 1.33), and to have a post-treatment Raymond score of 2 or 3 (p=0.01, OR 1.28, 95% CI 1.06 to 1.56). Using the Raymond score (1-3) as the foundation for the grading scale, additional points (0 or 1) were given for the other three identified factors, creating a 6-point scale. We found that patients with residual aneurysms had statistically higher final tabulated scores (p<0.01). Conclusions We propose a novel straightforward outcomes-based scale to characterize results after flow diversion treatment of cerebral aneurysms. This scale may provide the basis for the common reporting of results in future studies.

AB - Object Despite the popularity of flow-diverting stents for the treatment of cerebral aneurysms, there is no widely accepted scale for the characterization of results. We present an outcomes-based grading scale that considers factors related to failure of flow diversion. Methods The grading scale was developed using the results from consecutive patients at two institutions who were treated with flow diversion for a cerebral aneurysm. The initial treatment results were graded on patient, aneurysm, and treatment characteristics. A 6-point grading scale was developed based on these data. Results One hundred and seventy-one patients were included in the patient cohort. When compared by multivariate analysis with patients without residuals, patients with aneurysm residuals were found to be older (age ≥60 €...years, p=0.01, OR 1.17, 95% CI 1.03 to 1.33), to have larger aneurysms (size ≥15 €...mm, p<0.01, OR 1.38, 95% CI 1.17 to 1.62), to have aneurysms with associated side branches (p=0.02, OR 1.17, 95% CI 1.03 to 1.33), and to have a post-treatment Raymond score of 2 or 3 (p=0.01, OR 1.28, 95% CI 1.06 to 1.56). Using the Raymond score (1-3) as the foundation for the grading scale, additional points (0 or 1) were given for the other three identified factors, creating a 6-point scale. We found that patients with residual aneurysms had statistically higher final tabulated scores (p<0.01). Conclusions We propose a novel straightforward outcomes-based scale to characterize results after flow diversion treatment of cerebral aneurysms. This scale may provide the basis for the common reporting of results in future studies.

KW - Aneurysm

KW - Flow Diverter

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