Alexander Stebner, Petra Cimflova, Salome L Bosshart, Marie-Sophie Schüngel, Satoru Fujiwara, Genevieve Milot, David Volders, Kazutaka Uchida, Christine Hawkes, Manuel Moreu, Isabel Fragata, Alexandra Paul, Umberto Pensato, Christian Ulfert, Donald Frei, Pervinder Bhogal, Joanna Schaafsma, Sandor Nardai, Syed Zaidi, Mohammed Almekhlafi, Shahid Nimjee, Pascal Mosimann, James Kennedy, Jeremy Rempel, Violiza Inoa, Shinichi Yoshimura, Marc Ribo, Demetrius Lopes, John Wong, Johanna Ospel
{"title":"关于囊内装置对颅内动脉瘤的随访和再治疗的文献回顾和DELPHI共识。","authors":"Alexander Stebner, Petra Cimflova, Salome L Bosshart, Marie-Sophie Schüngel, Satoru Fujiwara, Genevieve Milot, David Volders, Kazutaka Uchida, Christine Hawkes, Manuel Moreu, Isabel Fragata, Alexandra Paul, Umberto Pensato, Christian Ulfert, Donald Frei, Pervinder Bhogal, Joanna Schaafsma, Sandor Nardai, Syed Zaidi, Mohammed Almekhlafi, Shahid Nimjee, Pascal Mosimann, James Kennedy, Jeremy Rempel, Violiza Inoa, Shinichi Yoshimura, Marc Ribo, Demetrius Lopes, John Wong, Johanna Ospel","doi":"10.1177/15910199251380361","DOIUrl":null,"url":null,"abstract":"<p><p>BackgroundIntracranial aneurysms are increasingly detected incidentally due to broader use of neuroimaging. Intrasaccular devices are frequently used to prevent rupture, yet standardized follow-up and retreatment strategies remain undefined. We performed a scoping literature review and DELPHI consensus to gauge current practice patterns and expert opinions on managing intracranial aneurysms that were previously treated with intrasaccular devices.MethodsA DELPHI consensus was conducted during an invite-only meeting of international neurointerventional experts. The process was informed by a scoping literature review and included three iterative rounds of structured questionnaires to establish consensus on follow-up imaging timing, modality, and retreatment decision-making.ResultsTwenty-four experts participated. The literature review identified 16 key studies, which were presented to the panel. For completely occluded aneurysms, MRA at 6 months was preferred by 58% of participants, with annual imaging favored thereafter. For incompletely occluded aneurysms, 6-month DSA followed by annual imaging was recommended. No consensus was reached on the imaging modality for annual follow-up. Retreatment decisions were primarily driven by aneurysm growth (>2 mm). Endovascular retreatment was preferred over open surgery, with risks such as ischemia and rupture identified as key concerns.ConclusionThis DELPHI consensus highlights current practice trends and open questions in the follow-up and retreatment of aneurysms treated with intrasaccular devices.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251380361"},"PeriodicalIF":2.1000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460278/pdf/","citationCount":"0","resultStr":"{\"title\":\"Literature review and DELPHI consensus on follow-up and retreatment of intracranial aneurysms with intrasaccular devices.\",\"authors\":\"Alexander Stebner, Petra Cimflova, Salome L Bosshart, Marie-Sophie Schüngel, Satoru Fujiwara, Genevieve Milot, David Volders, Kazutaka Uchida, Christine Hawkes, Manuel Moreu, Isabel Fragata, Alexandra Paul, Umberto Pensato, Christian Ulfert, Donald Frei, Pervinder Bhogal, Joanna Schaafsma, Sandor Nardai, Syed Zaidi, Mohammed Almekhlafi, Shahid Nimjee, Pascal Mosimann, James Kennedy, Jeremy Rempel, Violiza Inoa, Shinichi Yoshimura, Marc Ribo, Demetrius Lopes, John Wong, Johanna Ospel\",\"doi\":\"10.1177/15910199251380361\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>BackgroundIntracranial aneurysms are increasingly detected incidentally due to broader use of neuroimaging. Intrasaccular devices are frequently used to prevent rupture, yet standardized follow-up and retreatment strategies remain undefined. We performed a scoping literature review and DELPHI consensus to gauge current practice patterns and expert opinions on managing intracranial aneurysms that were previously treated with intrasaccular devices.MethodsA DELPHI consensus was conducted during an invite-only meeting of international neurointerventional experts. The process was informed by a scoping literature review and included three iterative rounds of structured questionnaires to establish consensus on follow-up imaging timing, modality, and retreatment decision-making.ResultsTwenty-four experts participated. The literature review identified 16 key studies, which were presented to the panel. For completely occluded aneurysms, MRA at 6 months was preferred by 58% of participants, with annual imaging favored thereafter. For incompletely occluded aneurysms, 6-month DSA followed by annual imaging was recommended. No consensus was reached on the imaging modality for annual follow-up. Retreatment decisions were primarily driven by aneurysm growth (>2 mm). Endovascular retreatment was preferred over open surgery, with risks such as ischemia and rupture identified as key concerns.ConclusionThis DELPHI consensus highlights current practice trends and open questions in the follow-up and retreatment of aneurysms treated with intrasaccular devices.</p>\",\"PeriodicalId\":14380,\"journal\":{\"name\":\"Interventional Neuroradiology\",\"volume\":\" \",\"pages\":\"15910199251380361\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-09-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460278/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Interventional Neuroradiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/15910199251380361\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Interventional Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/15910199251380361","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Literature review and DELPHI consensus on follow-up and retreatment of intracranial aneurysms with intrasaccular devices.
BackgroundIntracranial aneurysms are increasingly detected incidentally due to broader use of neuroimaging. Intrasaccular devices are frequently used to prevent rupture, yet standardized follow-up and retreatment strategies remain undefined. We performed a scoping literature review and DELPHI consensus to gauge current practice patterns and expert opinions on managing intracranial aneurysms that were previously treated with intrasaccular devices.MethodsA DELPHI consensus was conducted during an invite-only meeting of international neurointerventional experts. The process was informed by a scoping literature review and included three iterative rounds of structured questionnaires to establish consensus on follow-up imaging timing, modality, and retreatment decision-making.ResultsTwenty-four experts participated. The literature review identified 16 key studies, which were presented to the panel. For completely occluded aneurysms, MRA at 6 months was preferred by 58% of participants, with annual imaging favored thereafter. For incompletely occluded aneurysms, 6-month DSA followed by annual imaging was recommended. No consensus was reached on the imaging modality for annual follow-up. Retreatment decisions were primarily driven by aneurysm growth (>2 mm). Endovascular retreatment was preferred over open surgery, with risks such as ischemia and rupture identified as key concerns.ConclusionThis DELPHI consensus highlights current practice trends and open questions in the follow-up and retreatment of aneurysms treated with intrasaccular devices.
期刊介绍:
Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...