by Belal Neyazi, Vanessa M. Swiatek, Martin Skalej, Oliver Beuing, Klaus-Peter Stein, Jörg Hattingen, Bernhard Preim, Philipp Berg, Sylvia Saalfeld, I. Erol Sandalcioglu
Abstract:
Introduction:A multitude of approaches have been postulated for assessing the risk of intracranial aneurysm rupture. However, the amount of potential predictive factors is not applicable in clinical practice and they are rejected in favor of the more practical PHASES score. For the subgroup of multiple intracranial aneurysms (MIAs), the PHASES score might severely underestimate the rupture risk, as only the aneurysm with the largest diameter is considered for risk evaluation.Methods:In this study, we investigated 38 patients harboring a total number of 87 MIAs with respect to their morphological and hemodynamical characteristics. For the determination of the best suited parameters regarding their predictive power for aneurysm rupture, we conducted three phases of statistical evaluation. The statistical analysis aimed to identify parameters that differ significantly between ruptured and unruptured aneurysms, show smallest possible correlations among each other and have a high impact on rupture risk prediction.Results:Significant differences between ruptured and unruptured aneurysms were found in 16 out of 49 parameters. The lowest correlation were found for gamma, aspect ratio (AR1), aneurysm maximal relative residence time (Aneurysm\_RRT\_max) and aneurysm mean relative residence time. The data-driven parameter selection yielded a significant correlation of only two parameters (AR1 and the Aneurysm\_RRT\_max) with rupture state (area under curve?=?0.75).Conclusion:A high number of established morphological and hemodynamical parameters seem to have no or only low effect on prediction of aneurysm rupture in patients with MIAs. For best possible rupture risk assessment of patients with MIAs, only the morphological parameter AR1 and the hemodynamical parameter Aneurysm\_RRT\_max need to be included in the prediction model.
Reference:
Rupture risk assessment for multiple intracranial aneurysms: why there is no need for dozens of clinical, morphological and hemodynamic parameters (Belal Neyazi, Vanessa M. Swiatek, Martin Skalej, Oliver Beuing, Klaus-Peter Stein, Jörg Hattingen, Bernhard Preim, Philipp Berg, Sylvia Saalfeld, I. Erol Sandalcioglu), In Therapeutic Advances in Neurological Disorders, volume 13, 2020.
Bibtex Entry:
@article{neyazi_rupture_2020,
	title = {Rupture risk assessment for multiple intracranial aneurysms: why there is no need for dozens of clinical, morphological and hemodynamic parameters},
	volume = {13},
	issn = {1756-2864},
	url = {https://doi.org/10.1177/1756286420966159},
	doi = {10.1177/1756286420966159},
	abstract = {Introduction:A multitude of approaches have been postulated for assessing the risk of intracranial aneurysm rupture. However, the amount of potential predictive factors is not applicable in clinical practice and they are rejected in favor of the more practical PHASES score. For the subgroup of multiple intracranial aneurysms (MIAs), the PHASES score might severely underestimate the rupture risk, as only the aneurysm with the largest diameter is considered for risk evaluation.Methods:In this study, we investigated 38 patients harboring a total number of 87 MIAs with respect to their morphological and hemodynamical characteristics. For the determination of the best suited parameters regarding their predictive power for aneurysm rupture, we conducted three phases of statistical evaluation. The statistical analysis aimed to identify parameters that differ significantly between ruptured and unruptured aneurysms, show smallest possible correlations among each other and have a high impact on rupture risk prediction.Results:Significant differences between ruptured and unruptured aneurysms were found in 16 out of 49 parameters. The lowest correlation were found for gamma, aspect ratio (AR1), aneurysm maximal relative residence time (Aneurysm\_RRT\_max) and aneurysm mean relative residence time. The data-driven parameter selection yielded a significant correlation of only two parameters (AR1 and the Aneurysm\_RRT\_max) with rupture state (area under curve?=?0.75).Conclusion:A high number of established morphological and hemodynamical parameters seem to have no or only low effect on prediction of aneurysm rupture in patients with MIAs. For best possible rupture risk assessment of patients with MIAs, only the morphological parameter AR1 and the hemodynamical parameter Aneurysm\_RRT\_max need to be included in the prediction model.},
	urldate = {2021-03-09},
	journal = {Therapeutic Advances in Neurological Disorders},
	author = {Neyazi, Belal and Swiatek, Vanessa M. and Skalej, Martin and Beuing, Oliver and Stein, Klaus-Peter and Hattingen, Jörg and Preim, Bernhard and Berg, Philipp and Saalfeld, Sylvia and Sandalcioglu, I. Erol},
	month = jan,
	year = {2020},
	pages = {1756286420966159}
}