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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
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Computerized Angiographic Occlusion Rating for Ruptured Clipped Aneurysms is Superior to Subjective Occlusion Rating
A R Al-Schameri1, G Baltsavias2, P Winkler3
1From the Departments of Neurosurgery (A.R.A.-S., P.W., M.L., M.K., S.E., B.R.) a.al-schameri@salk.at.
AJNR. American Journal of Neuroradiology
|August 1, 2015
Summary
Computerized occlusion rating is more accurate than subjective rating for assessing clipped aneurysms after subarachnoid hemorrhage. This method shows lower interobserver variation, suggesting its superiority for reliable aneurysm occlusion assessment.
Area of Science:
- Neurosurgery
- Radiology
- Medical Imaging Analysis
Background:
- Assessing the occlusion of embolized aneurysms is crucial after treatment.
- Subjective occlusion rating is commonly used but may lack precision.
- Computerized methods offer potential for more objective assessment.
Purpose of the Study:
- To compare subjective and computerized occlusion rating methods.
- To evaluate their accuracy in analyzing aneurysms clipped after subarachnoid hemorrhage.
Main Methods:
- Analysis of pre- and postoperative digital subtraction angiography (DSA) images from 95 patients.
- Stratification of aneurysms into 4 occlusion grades (0-III).
- Comparison of manual estimation (subjective) versus automated area calculation (computerized).
Main Results:
- Significant differences observed in occlusion grade distribution between methods.
- Computerized rating demonstrated significantly lower interobserver variation.
- Subjective rating overestimated occlusion in 31.6% of patients.
- Both methods showed high predictive value for retreatment, with computerized rating being slightly superior (P < .001).
Conclusions:
- Computerized occlusion rating offers a more reliable and objective assessment of clipped aneurysms.
- Lower interobserver variability supports the superiority of the computerized method.
- This technique may improve patient management and outcomes following aneurysm treatment.
