Multidisciplinary Consensus on Assessment of Unruptured Intracranial Aneurysms
| العنوان: | Multidisciplinary Consensus on Assessment of Unruptured Intracranial Aneurysms |
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| المؤلفون: | Seppo Juvela, Timo Koivisto, Julian Spears, Michael T. Lawton, J Mocco, Daniel Hänggi, David Hasan, Isabel Wanke, Peter D. LeRoux, Colin P. Derdeyn, John H. Wong, Nima Etminan, Yuichi Murayama, Daniel L. Barrow, Kentaro Mori, Shinji Nagahiro, Andreas Raabe, Gabriel J.E. Rinkel, Joshua B. Bederson, Hans Jakob Steiger, Daniel A. Rüfenacht, Edward W. Mee, Cameron G. McDougall, Peter J. Kirkpatrick, Alberto Pasqualin, Robert Brown, George K.C. Wong, Andrew J. Molyneux, Peter Vajkoczy, Giuseppe Lanzino, Volker Seifert, Jean Raymond, E. Sander Connolly, Kerim Beseoglu, Akio Morita, R. Loch Macdonald, Helmuth Steinmetz, James C. Torner, Neville W. Knuckey, Hidetoshi Kasuya, Michael Kerin Morgan |
| المساهمون: | Clinicum, Department of Neurosciences |
| المصدر: | Stroke. 45:1523-1530 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2014. |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, Subarachnoid hemorrhage, education, Population, Medizin, Delphi method, 3124 Neurology and psychiatry, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Aneurysm, RUPTURE, LESS-THAN-7 MM YES, Multidisciplinary approach, Delphi technique, therapeutics, Humans, Medicine, Family history, Psychiatry, SUBARACHNOID HEMORRHAGE, METAANALYSIS, POPULATION, Advanced and Specialized Nursing, education.field_of_study, business.industry, Intracranial Aneurysm, NATURAL-HISTORY, CEREBRAL ANEURYSMS, medicine.disease, 3. Good health, incidental aneurysm, Natural history, cerebral aneurysm, consensus, natural history, ENDOVASCULAR TREATMENT, Emergency medicine, Life expectancy, Neurology (clinical), TIME TRENDS, Cardiology and Cardiovascular Medicine, business, EMPHASIS, 030217 neurology & neurosurgery |
| الوصف: | Background and Purpose— 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. Methods— 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. Results— 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. Conclusions— 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. |
| تدمد: | 1524-4628 0039-2499 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::99604bf5858b8c24d4214bd10358d1d6Test https://doi.org/10.1161/strokeaha.114.004519Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....99604bf5858b8c24d4214bd10358d1d6 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15244628 00392499 |
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