Validity of the Meyer Scale for Assessment of Coiled Aneurysms and Aneurysm Recurrence

Rouchaud, Aymeric; Brinjikji, Waleed; Gunderson, Tina M.; Caroff, Jildaz; Gentric, Jean-Christophe; Lanzino, Giuseppe; Cloft, Harry J.; Kallmes, David F.

doi:10.3174/ajnr.a4616

Cited by 5 publications

(1 citation statement)

References 23 publications

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“…Parameters of stent stenosis adapted from NASCET criteria40 were: minimal 0-29%, mild 30-49%, moderate 50-69%, severe 70-94%, critical 95-99%, or occluded 100%. Coiling cases were evaluated using variables adapted from modified Raymond Roy classification 41 (class I: complete obliteration, class II: residual neck, class IIIa: residual aneurysm with contrast opacification within coil, class IIIb: contrast opacification outside coil) and Meyer scale 42 (grade 1 > or = 90%, grade 2 70-89%, grade 3 50-69%, grade 4 26-49%, or grade 5 < or = 25% occlusion; modifier I: coil opacification; modifier G: independent aneurysm growth). Clipping cases were evaluated using variables adapted from Raymond Roy occlusion classification 41…”

Section: Validated Grading Of Neurovascular Biomarkersmentioning

confidence: 99%

Virtual reality adds value to analysis of aneurysms post-flow diversion, coiling, and clipping

Fourcand¹,

Kulhari²,

Mehta³

et al. 2020

JNSK

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Purpose: The purpose of this study was to measure sensitivity of virtual reality (VR) in detecting biomarkers of neurovascular remodeling suboptimally evaluated in digital subtraction angiography (DSA) of treated unruptured, intracranial aneurysms. Methods: The sensitivity of virtual reality and digital subtraction angiography in detection of neurovascular biomarkers in aneurysms treated with flow diversion, coiling, and clipping were evaluated. Validated grading scales were integrated into a standardized rating platform. The respective novel and conceptual measures of minimal imaging important difference (MIID) and number needed to image (NNI) were calculated for each biomarker. Results: In flow diversion, coiling, and clipping, minimal imaging important difference and number needed to image were associated with virtual reality in detection of abnormal biomarkers, with the exception of stasis phase associated with digital subtraction angiography. Number needed to image was associated with flow diversion stent stenosis (RR: 7.00, 95% CI 0.37 to 131.97; OR: 7.46, 95% CI 0.38 to 148.49). Minimal imaging important difference was greatest in residual aneurysm filling (25%±66, 95% CI) in flow diversion and Meyer score in coiling (42.5%±17.69, 95% CI) and clipping (22.2%±13.58, 95% CI). Regression models demonstrated minimal imaging important difference and number needed to image shared a significant correlation (R20.99, 95% CI, p<0.001). Conclusion: Virtual reality adds value to digital subtraction angiography in evaluation of aneurysms treated with flow diversion, coiling, and clipping. Larger, prospective studies are warranted to increase statistical power and validate clinical significance.

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Section: Validated Grading Of Neurovascular Biomarkersmentioning

confidence: 99%