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。

IF 2.1 4区 医学 Q3 Medicine
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}
引用次数: 0

摘要

背景:由于神经影像学的广泛应用,颅动脉瘤越来越多地被偶然发现。囊内装置常用于防止破裂,但标准化的随访和再治疗策略仍不明确。我们进行了范围文献回顾和DELPHI共识,以评估目前的实践模式和专家意见,以管理颅内动脉瘤,以前用囊内装置治疗。方法在国际神经介入专家邀请会议上进行DELPHI共识。该过程通过范围文献综述进行,包括三轮反复的结构化问卷调查,以建立对随访成像时间、方式和再治疗决策的共识。结果共有24名专家参与。文献综述确定了16项关键研究,并将其提交给专家组。对于完全闭塞的动脉瘤,58%的参与者更倾向于在6个月时进行MRA,此后每年进行一次成像。对于未完全闭塞的动脉瘤,建议6个月DSA后每年进行影像学检查。对于每年随访的影像学方式尚未达成共识。再治疗决定主要由动脉瘤生长(bbb20 mm)驱动。血管内再治疗优于开放手术,其风险如缺血和破裂被认为是关键问题。结论德尔福共识突出了当前的实践趋势和囊内装置治疗动脉瘤的随访和再治疗的开放性问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
2.80
自引率
11.80%
发文量
192
审稿时长
6-12 weeks
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...
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信