Diagnostic reliability of the Berlin classification for complex MCA aneurysms—usability in a series of only giant aneurysms

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Wessels , L , Fekonja , L S , Achberger , J , Dengler , J , Czabanka , M , Hecht , N , Schneider , U , Tkatschenko , D , Schebesch , K-M , Schmidt , N O , Mielke , D , Hosch , H , Ganslandt , O , Gräwe , A , Hong , B , Walter , J , Güresir , E , Bijlenga , P , Haemmerli , J , Maldaner , N , Marbacher , S , Nurminen , V , Zitek , H , Dammers , R , Kato , N , Linfante , I , Pedro , M-T , Wrede , K , Wang , W-T , Wostrack , M & Vajkoczy , P 2020 , ' Diagnostic reliability of the Berlin classification for complex MCA aneurysms—usability in a series of only giant aneurysms ' , Acta Neurochirurgica , vol. 162 , no. 11 , pp. 2753-2758 . https://doi.org/10.1007/s00701-020-04565-6

Title: Diagnostic reliability of the Berlin classification for complex MCA aneurysms—usability in a series of only giant aneurysms
Author: Wessels, Lars; Fekonja, Lucius Samo; Achberger, Johannes; Dengler, Julius; Czabanka, Marcus; Hecht, Nils; Schneider, Ulf; Tkatschenko, Dimitri; Schebesch, Karl-Michael; Schmidt, Nils Ole; Mielke, Dorothee; Hosch, Henning; Ganslandt, Oliver; Gräwe, Alexander; Hong, Bujung; Walter, Jan; Güresir, Erdem; Bijlenga, Philippe; Haemmerli, Julien; Maldaner, Nicolai; Marbacher, Serge; Nurminen, Ville; Zitek, Hynek; Dammers, Ruben; Kato, Naoki; Linfante, Italo; Pedro, Maria-Teresa; Wrede, Karsten; Wang, Wei-Te; Wostrack, Maria; Vajkoczy, Peter
Other contributor: University of Helsinki, Kantonsspital Aarau
University of Helsinki, HUS Neurocenter




Date: 2020-11
Language: eng
Number of pages: 6
Belongs to series: Acta Neurochirurgica
ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-020-04565-6
URI: http://hdl.handle.net/10138/320317
Abstract: Background and objective The main challenge of bypass surgery of complex MCA aneurysms is not the selection of the bypass type but the initial decision-making of how to exclude the affected vessel segment from circulation. To this end, we have previously proposed a classification for complex MCA aneurysms based on the preoperative angiography. The current study aimed to validate this new classification and assess its diagnostic reliability using the giant aneurysm registry as an independent data set. Methods We reviewed the pretreatment neuroimaging of 51 patients with giant (> 2.5 cm) MCA aneurysms from 18 centers, prospectively entered into the international giant aneurysm registry. We classified the aneurysms according to our previously proposed Berlin classification for complex MCA aneurysms. To test for interrater diagnostic reliability, the data set was reviewed by four independent observers. Results We were able to classify all 51 aneurysms according to the Berlin classification for complex MCA aneurysms. Eight percent of the aneurysm were classified as type 1a, 14% as type 1b, 14% as type 2a, 24% as type 2b, 33% as type 2c, and 8% as type 3. The interrater reliability was moderate with Fleiss's Kappa of 0.419. Conclusion The recently published Berlin classification for complex MCA aneurysms showed diagnostic reliability, independent of the observer when applied to the MCA aneurysms of the international giant aneurysm registry.
Subject: 3126 Surgery, anesthesiology, intensive care, radiology
Giant aneurysm
Cerebral bypass
MCA aneurysm
CEREBRAL ANEURYSMS
BYPASS-SURGERY
REVASCULARIZATION
3112 Neurosciences
3124 Neurology and psychiatry
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