Reappraisal of Anatomic Outcome Scales of Coiled Intracranial Aneurysms in the Prediction of Recanalization
Journal of Korean Neurosurgical Society
;
: 342-348, 2013.
Article
in English
| WPRIM
| ID: wpr-90163
ABSTRACT
OBJECTIVE:
Several scales are currently used to assess occlusion rates of coiled cerebral aneurysms. This study compared these scales as predictors of recanalization.METHODS:
Clinical data of 827 patients harboring 901 aneurysms treated by coiling were retrospectively reviewed. Occlusion rates were assessed using angiographic grading scale (AGS), two-dimensional percent occlusion (2DPO), and volumetric packing density (vPD). Every scale had 3 categories. Followed patients were dichotomized into either presence or absence of recanalization. Kaplan-Meier analysis was conducted, and Cox proportional hazards analysis was performed to identify surviving probabilities of recanalization. Lastly, the predictive accuracies of three different scales were measured via Harrell's C index.RESULTS:
The cumulative risk of recanalization was 7% at 12-month, 10% at 24-month, and 13% at 36-month of postembolization, and significantly higher for the second and third categories of every scale (p<0.001). Multivariate-adjusted hazard ratios (HRs) of the second and third categories as compared with the first category of AGS (HR 3.95 and 4.15, p=0.004 and 0.001) and 2DPO (HR 4.87 and 3.12, p<0.001 and 0.01) were similar. For vPD, there was no association between occlusion rates and recanalization. The validated and optimism-adjusted C-indices were 0.50 [confidence (CI) -1.09-2.09], 0.47 (CI -1.10-2.09) and 0.44 (CI -1.10-2.08) for AGS, 2DPO, and vPD, respectively.CONCLUSION:
Total occlusion should be reasonably tried in coiling to maximize the benefit of the treatment. AGS may be the best to predict recanalization, whereas vPD should not be used alone.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Weights and Measures
/
Intracranial Aneurysm
/
Retrospective Studies
/
Kaplan-Meier Estimate
/
Aneurysm
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Journal of Korean Neurosurgical Society
Year:
2013
Type:
Article
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