[1]陈 力,邓 波,刘卫东,等.改良Raymond- Roy分类评估颅内分叉部动脉瘤血管内治疗效果的一致性[J].介入放射学杂志,2020,29(10):968-972.
 CHEN Li,DENG Bo,LIU Weidong,et al.Consistency of modified Raymond- Roy classification in evaluating the efficacy of endovascular therapy for intracranial bifurcation aneurysms[J].journal interventional radiology,2020,29(10):968-972.
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改良Raymond- Roy分类评估颅内分叉部动脉瘤血管内治疗效果的一致性()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
29
期数:
2020年10
页码:
968-972
栏目:
神经介入
出版日期:
2020-10-25

文章信息/Info

Title:
Consistency of modified Raymond- Roy classification in evaluating the efficacy of endovascular therapy for intracranial bifurcation aneurysms
作者:
陈 力 邓 波 刘卫东 顾文权 顾斌贤 顾 奕 孟令平 王 武
Author(s):
CHEN Li DENG Bo LIU Weidong GU Wenquan GU Binxian GU Yi MENG Lingping WANG Wu.
Department of Radiology, Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
关键词:
【关键词】 颅内分叉部动脉瘤 改良Raymond- Roy分类 Raymond分类观察者间一致性 血管内治疗
文献标志码:
A
摘要:
【摘要】 目的 评价改良Raymond- Roy分类(MRRC)和Raymond 4级分类评估的观察者间一致性,比较两种分类预测颅内分叉部动脉瘤早期复发的能力。方法 回顾性分析2012年1月至2018年12月127例经血管内治疗的颅内分叉部动脉瘤患者临床资料。根据MRRC和Raymond 4级分类,5名经验丰富的神经介入医师独立评估颅内分叉部动脉瘤栓塞术后即刻和随访时血管造影所示栓塞程度。组内相关系数(ICC)确定观察者间评估的一致性。采用受试者工作特征曲线(ROC)分析两种分类预测动脉瘤随访时显著复发的能力。结果 术后即刻和随访时血管造影评估显示,MRRC、Roymond 4级分类ICC值分别为0.78、0.80和0.91、0.89。ROC分析显示,MRRC、Roymond 4级分类曲线下面积(AUC)均为0.67。 结论 MRRC和Raymond 4级分类评估的观察者间一致性相仿且均较优越。两种分类在预测随访时动脉瘤显著复发方面均有良好能力。

参考文献/References:

[1] 陈 蓦,王 武. 颅内动脉瘤血管内治疗现状与进展[J]. 介入放射学杂志, 2018, 27:592-597.
[2] Molyneux AJ, Birks J, Clarke A, et al. The durability of endovascular coiling versus neurosurgical clipping of ruptured cerebral aneurysms: 18 year follow-up of the UK cohort of the international subarachnoid aneurysm trial(ISAT)[J]. Lancet, 2015, 385: 691-697.
[3] Lauric A, Hippelheuser JE, Malek AM. Induction of aneurys-mogenic high positive wall shear stress gradient by wide angle at cerebral bifurcations, independent of flow rate[J]. J Neurosurg, 2018, 131: 442- 452.
[4] Alfano JM, Kolega J, Natarajan SK, et al. Intracranial aneurysms occur more frequently at bifurcation sites that typically experience higher hemodynamic stresses[J]. Neurosurgery, 2013, 73: 497-505.
[5] Cloft HJ, Kaufmann T, Kallmes DF. Observer agreement in the assessment of endovascular aneurysm therapy and aneurysm recurrence[J]. AJNR Am J Neuroradiol, 2007, 28: 497-500.
[6] Rouchaud A, Brinjikji W, Gunderson T, et al. Validity of the meyer scale for assessment of coiled aneurysms and aneurysm recurrence[J]. AJNR Am J Neuroradiol, 2016, 37: 844-848.
[7] Raymond J, White PM, Molyneux AJ. Scales, agreement,outcome measures, and progress in aneurysm therapy[J]. AJNR Am J Neuroradiol, 2007, 28: 501-502.
[8] Raymond J, Roy D, Bojanowski M, et al. Endovascular treatment of acutely ruptured and unruptured aneurysms of the basilar bifurcation[J]. J Neurosurg, 1997, 86: 211-219.
[9] Roy D, Milot G, Raymond J. Endovascular treatment of unruptured aneurysms[J]. Stroke, 2001, 32: 1998-2004.
[10] Lecler A, Raymond J, Rodriguez-Regent C, et al. Intracranial aneurysms: recurrences more than 10 years after endovascular treatment:a prospective cohort study, systematic review, and meta- analysis[J]. Radiology, 2015, 277: 173-180.
[11] Mascitelli JR, Moyle H, Oermann EK, et al. An update to the Raymond-Roy Occlusion Classification of intracranial aneurysms treated with coil embolization[J]. J Neurointerv Surg, 2015, 7: 496-502.
[12] Raymond J, Guilbert F, Weill A, et al. Long-term angiographic recurrences after selective endovascular treatment of aneurysms with detachable coils[J]. Stroke, 2003, 34: 1398-1403.
[13] Brisman JL, Song JK, Newell DW. Cerebral aneurysms[J]. N Engl J Med, 2006, 355: 928-939.
[14] 郄福忠,马光涛,王玖飞,等. 大脑中动脉分叉部动脉瘤的血管内介入治疗[J]. 介入放射学杂志, 2014, 23:655-657.
[15] 徐浩文,李明华,管 生, 等. “Y”型支架技术辅助弹簧圈栓塞基底动脉尖部宽颈动脉瘤[J]. 介入放射学杂志, 2011, 20:352-356.
[16] Meng H, Wang Z, Hoi Y, et al. Complex hemodynamics at the apex of an arterial bifurcation induces vascular remodeling resembling cerebral aneurysm initiation[J]. Stroke, 2007, 38: 1924-1931.
[17] Ingebrigtsen T, Morgan MK, Faulder K, et al. Bifurcation geometry and the presence of cerebral artery aneurysms[J]. J Neurosurg, 2004, 101: 108-113.
[18] Hasan DM, Nadareyshvili AI, Hoppe AL, et al. Cerebral aneurysm sac growth as the etiology of recurrence after successful coil embolization[J]. Stroke, 2012, 43: 866-868.
[19] Abdihalim M, Watanabe M, Chaudhry S, et al. Are coil compaction and aneurysmal growth two distinct etiologies leading to recurrence following endovascular treatment of intracranial aneurysm?[J]. J Neuroimaging, 2014, 24: 171-175.
[20] Stapleton CJ, Torok CM, Rabinov JD, et al. Validation of the modified Raymond-Roy classification for intracranial aneurysms treated with coil embolization[J]. J Neurointerv Surg, 2016, 8: 927-933.
[21] Jy C, Vedantham S, Wakhloo AK, et al. Aneurysm permeability following coil embolization: packing density and coil distribution[J]. J Neurointerv Surg, 2015, 7: 676-681.
[22] Bradac GB, Bergui M, Stura G, et al. Periprocedural morbidity and mortality by endovascular treatment of cerebral aneurysms with GDC: a retrospective 12-year experience of a single center[J]. Neurosurg Rev, 2007, 30: 117-126.
[23] Choi HH, Cho YD, Yoo DH, et al. Stent-assisted coil embolization of anterior communicating artery aneurysms: safety, effectiveness, and risk factors for procedural complications or recanalization[J]. J Neurointerv Surg, 2019, 11: 49-56.
[24] Lawson MF, Newman WC, Chi YY, et al. Stent-associated flow remodeling causes further occlusion of incompletely coiled aneurysms[J]. Neurosurgery, 2011, 69: 598-603.
[25] Tosello RT, Batista UC, Pereira BJA, et al. Packing density necessary to reach a high complete occlusion rate in circum-ferential unruptured intracranial aneurysms treated with stent-assisted coil embolization[J]. AJNR Am J Neuroradiol, 2017, 38: 1973-1977.
[26] Darflinger R, Thompson LA, Zhang ZW, et al. Recurrence, retreatment, and rebleed rates of coiled aneurysms with respect to the Raymond-Roy scale: a meta-analysis[J]. J Neurointerv Surg, 2016, 8: 507-511.

备注/Memo

备注/Memo:
(收稿日期:2020- 06-24)
(本文编辑:边 佶)
更新日期/Last Update: 2020-10-19