CIRSE Standards of Practice for the Classification of Complications: The Modified CIRSE Classification System

Area of Science:

• Interventional Radiology
• Medical Classification Systems

Background:

• The original CIRSE classification system (2017) aimed to standardize interventional radiology complication reporting.
• It utilized 6 grades but lacked granularity for certain complication severities.

Purpose of the Study:

• To modify and validate the CIRSE classification system for improved standardization and reporting of complications.
• To stratify Grades 1 and 3 based on procedural impact and hospitalization duration.

Main Methods:

• A validation process was conducted during the International Conference on Complications in Interventional Radiology (ICCIR 2023).
• The system was modified to subdivide Grade 1 (1a, 1b) and Grade 3 (3a, 3b).
• Modified system reliability and inter-observer agreement were assessed.

Main Results:

• Grade 1 was subdivided to differentiate procedural completion (1a vs. 1b).
• Grade 3 was subdivided based on hospitalization duration (3a: <2 weeks, 3b: >2 weeks).
• Initial testing demonstrated high reliability and strong inter-observer agreement for the modified system.

Conclusions:

• The modified CIRSE classification system effectively addresses shortcomings of the original system.
• It offers clear, objective parameters for describing clinical outcomes after complications.
• The enhanced system maintains ease of use while improving diagnostic accuracy and reporting standardization.