TY  - JOUR
A1  - Merkel, Helena
A1  - Lindner, Dirk
A1  - Gaber, Khaled
A1  - Ziganshyna, Svitlana
A1  - Jentzsch, Jennifer
A1  - Mucha, Simone
A1  - Gerhards, Thilo
A1  - Sari, Sabine
A1  - Stock, Annika
A1  - Vothel, Felicitas
A1  - Falter, Lea
A1  - Quäschling, Ulf
A1  - Hoffmann, Karl-Titus
A1  - Meixensberger, Jürgen
A1  - Halama, Dirk
A1  - Richter, Cindy
T1  - Standardized classification of cerebral vasospasm after subarachnoid hemorrhage by digital subtraction angiography
T2  - Journal of Clinical Medicine
N2  - Background: During the last decade, cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) was a current research focus without a standardized classification in digital subtraction angiography (DSA). This study was performed to investigate a device-independent visual cerebral vasospasm classification for endovascular treatment. Methods: The analyses are DSA based rather than multimodal. Ten defined points of intracranial arteries were measured in 45 patients suffering from cerebral vasospasm after SAH at three time points (hospitalization, before spasmolysis, control after six months). Mathematical clustering of vessel diameters was performed to generate four objective grades for comparison. Six interventional neuroradiologists in two groups scored 237 DSAs after a new visual classification (grade 0–3) developed on a segmental pattern of vessel contraction. For the second group, a threshold-based criterion was amended. Results: The raters had a reproducibility of 68.4% in the first group and 75.2% in the second group. The complementary threshold-based criterion increased the reproducibility by about 6.8%, while the rating deviated more from the mathematical clustering in all grades. Conclusions: The proposed visual classification scheme of cerebral vasospasm is suitable as a standard grading procedure for endovascular treatment. There is no advantage of a threshold-based criterion that compensates for the effort involved. Automated vessel analysis is superior to compare inter-group results in research settings.
KW  - cerebral vasospasm
KW  - subarachnoid hemorrhage
KW  - classification
KW  - vessel diameter
Y1  - 2022
UR  - https://opus.bibliothek.uni-wuerzburg.de/frontdoor/index/index/docId/27063
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:20-opus-270638
SN  - 2077-0383
VL  - 11
IS  - 7
ER  -