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Reporting standards for endovascular repair of saccular intracranial cerebral aneurysms
  1. Philip M Meyers1,
  2. H Christian Schumacher2,
  3. Randall T Higashida3,
  4. Colin P Derdeyn4,
  5. Gary M Nesbit5,
  6. David Sacks6,
  7. Lawrence R Wechsler7,
  8. Joshua B Bederson8,
  9. Sean D Lavine1,
  10. Peter Rasmussen9
  1. 1Columbia University, College of Physicians and Surgeons, Neurological Institute of New York, New York, USA
  2. 2Saul R Korey, Department of Neurology, Division of Vascular Neurology and Neurocritical Care, Albert Einstein College of Medicine, Bronx, New York, USA
  3. 3University of California, San Francisco, California, USA
  4. 4Mallinckrodt Institute of Radiology, Washington University, School of Medicine, St Louis, Missouri, USA
  5. 5Oregon Health and Science University, Portland, Oregon, USA
  6. 6Advanced Interventional Radiology, Reading Hospital and Medical Center, Reading, Pennsylvania, USA
  7. 7University of Pittsburgh Medical Center, Pennsylvania, USA
  8. 8Department of Neurological Surgery, Mount Sinai Medical Center, New York, New York, USA
  9. 9Cleveland Clinic Foundation, Cleveland, Ohio, USA
  1. Correspondence to Dr P M Meyers, Columbia University, College of Physicians and Surgeons, and Neuroendovascular Service, New York Presbyterian-Columbia Neurological Institute, New York, NY 10032, USA; pmm2002{at}columbia.edu

Abstract

Background and purpose The goal of this article is to provide consensus recommendations for reporting standards, terminology, and written definitions when reporting on the radiological evaluation and endovascular treatment of intracranial, cerebral aneurysms. These criteria can be used to design clinical trials, to provide uniformity of definitions for appropriate selection and stratification of patients, and to allow analysis and meta-analysis of reported data.

Methods This article was written under the auspices of the Joint Writing Group of the Technology Assessment Committee, Society of Neurolnterventional Surgery, Society of Interventional Radiology; Joint Section on Cerebrovascular Neurosurgery of the American Association of Neurological Surgeons and Congress of Neurological Surgeons; and Section of Stroke and Interventional Neurology of the American Academy of Neurology. A computerized search of the National Library of Medicine database of literature (PubMed) from January 1991 to December 2007 was conducted with the goal to identify published endovascular cerebrovascular interventional data about the assessment and endovascular treatment of cerebral aneurysms useful as benchmarks for quality assessment. We sought to identify those risk adjustment variables that affect the likelihood of success and complications. This article offers the rationale for different clinical and technical considerations that may be important during the design of clinical trials for endovascular treatment of cerebral aneurysms. Included in this guidance article are suggestions for uniform reporting standards for such trials. These definitions and standards are primarily intended for research purposes; however, they should also be helpful in clinical practice and applicable to all publications.

Conclusions The evaluation and treatment of brain aneurysms often involve multiple medical specialties. Recent reviews by the American Heart Association have surveyed the medical literature to develop guidelines for the clinical management of ruptured and unruptured cerebral aneurysms. Despite efforts to synthesize existing knowledge on cerebral aneurysm evaluation and treatment, significant inconsistencies remain in nomenclature and definition for research and reporting purposes. These operational definitions were selected by consensus of a multidisciplinary writing group to provide consistency for reporting on imaging in clinical trials and observational studies involving cerebral aneurysms. These definitions should help different groups to publish results that are directly comparable.

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Footnotes

  • This article first appeared in Stroke: Meyers PM, Schumacher HC, Higashida RT, et al. Reporting standards for endovascular treatment of cerebral aneurysms. Stroke 2009;40:366–79. Reproduced with permission from Wolters Kluwer Health.

  • Competing interests RTH served as a consultant to Cordis Neurovascular. GMN received honoraria from Cordis Neurovascular and Genentech, has an ownership interest in Concentric Medical and served as a consultant to Concentric Medical. LRW served as a consultant to Nuevelo Inc and Abbott Vascular. SDL received honoraria from Cordis Neurovascular. PR received honoraria from the Universities of Minnesota and Pittsburgh, Microvention/Terumo, ev3, Possis Medical/Medrad and Micrus, has an ownership interest in Chestnut Medical and served as a consultant to Chestnut Medical.

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