School of Medicine Publications and Presentations
Complex intracranial aneurysms: a DELPHI study to define associated characteristics
Document Type
Article
Publication Date
7-11-2024
Abstract
Purpose
Intracranial aneurysms present significant health risks, as their rupture leads to subarachnoid haemorrhage, which in turn has high morbidity and mortality rates. There are several elements affecting the complexity of an intracranial aneurysm. However, criteria for defining a complex intracranial aneurysm (CIA) in open surgery and endovascular treatment could differ, and actually there is no consensus on the definition of a "complex" aneurysm. This DELPHI study aims to assess consensus on variables defining a CIA.
Methods
An international panel of 50 members, representing various specialties, was recruited to define CIAs through a three-round Delphi process. The panelists participated in surveys with Likert scale responses and open-ended questions. Consensus criteria were established to determine CIA variables, and statistical analysis evaluated consensus and stability.
Results
In open surgery, CIAs were defined by fusiform or blister-like shape, dissecting aetiology, giant size (≥ 25 mm), broad neck encasing parent arteries, extensive neck surface, wall calcification, intraluminal thrombus, collateral branch from the sac, location (AICA, SCA, basilar), vasospasm context, and planned bypass (EC-IC or IC-IC). For endovascular treatment, CIAs included giant size, very wide neck (dome/neck ratio ≤ 1:1), and collateral branch from the sac.
Conclusions
The definition of aneurysm complexity varies by treatment modality. Since elements related to complexity differ between open surgery and endovascular treatment, these consensus criteria of CIAs could even guide in selecting the best treatment approach.
Recommended Citation
Diana, F., Romoli, M., Raz, E., Agid, R., Albuquerque, F. C., Arthur, A. S., Beck, J., Berge, J., Boogaarts, H. D., Burkhardt, J. K., Cenzato, M., Chapot, R., Charbel, F. T., Desal, H., Esposito, G., Fifi, J. T., Florian, S., Gruber, A., Hassan, A. E., Jabbour, P., … Peschillo, S. (2024). Complex intracranial aneurysms: a DELPHI study to define associated characteristics. Acta neurochirurgica, 166(1), 294. https://doi.org/10.1007/s00701-024-06182-z
Publication Title
Acta Neurochirurgica
DOI
https://doi.org/10.1007/s00701-024-06182-z
Academic Level
faculty
Mentor/PI Department
Neurology
Comments
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