P Lognon1, F Gariel2, G Marnat2, J Darcourt3, P Constant Dit Beaufils4,5, J Burel6, E Shotar7, J F Hak8, C Fauché9, B Kerleroux10, A Guédon11, J Ognard12, G Forestier13, R Pop14, C Paya15, J B Veyrières15, P Sporns16,17, J B Girot18, R Zannoni19, F Zhu20, A Crespy1, V L'Allinec18, D Mihoc14, A Rouchaud13, J C Gentric12, W Ben Hassen10, N Raynaud9, B Testud8, F Clarençon7, B Kaczmarek6, R Bourcier4,5, G Bellanger3, G Boulouis1, Kevin Janot21. 1. University Hospital of Tours, Tours, France. 2. University Hospital of Bordeaux, Bordeaux, France. 3. University Hospital of Toulouse, Toulouse, France. 4. L'institut du Thorax, University of Nantes, INSERM, CNRS, Nantes, France. 5. University Hospital of Nantes, Nantes, France. 6. University Hospital of Rouen, Rouen, France. 7. Pitié Salpêtrière Hospital, Paris, France. 8. University Hospital of Marseille, Marseille, France. 9. University Hospital of Poitiers, Poitiers, France. 10. Sainte-Anne Hospital, Paris, France. 11. Lariboisière Hospital, Paris, France. 12. University Hospital of Brest, Brest, France. 13. University Hospital of Limoges, Limoges, France. 14. University Hospital of Strasbourg, Strasbourg, France. 15. University Hospital of Saint-Pierre, Saint-Pierre, La Réunion, France. 16. University Hospital of Basel, Basel, Switzerland. 17. University Medical Center of Hamburg-Eppendorf, Hamburg, Germany. 18. University Hospital of Angers, Angers, France. 19. University Hospital of Saint-Etienne, Saint-Etienne, France. 20. University Hospital of Nancy, Nancy, France. 21. University Hospital of Tours, Tours, France. kevin.janot@univ-tours.fr.
Abstract
PURPOSE: The natural evolution of unruptured intracranial aneurysms (UIA) is indeed difficult to predict at the individual level. OBJECTIVE: In a large prospective multicentric European cohort, we aimed to evaluate whether the PHASES, UCAS, and ELPASS scores in patients with aneurysmal subarachnoid hemorrhage would have predicted a high risk of aneurysmal rupture or growth. METHODS: Academic centers treating patients with intracranial aneurysms were invited to prospectively collect de-identified data from all patients admitted at their institution for a subarachnoid hemorrhage-related to intracranial aneurysmal rupture between January 1 and March 31, 2021 through a trainee-led research collaborative network. Each responding center was provided with an electronic case record form (CRF) which collected all the elements of the PHASES, ELAPSS, and UCAS scores. RESULTS: A total of 319 patients with aneurysmal subarachnoid hemorrhage were included at 17 centers during a 3-month period. One hundred eighty-three aneurysms (57%) were less than 7 mm. The majority of aneurysms were located on the anterior communicating artery (n = 131, 41%). One hundred eighty-four patients (57%), 103 patients (32%), and 58 (18%) were classified as having a low risk of rupture or growth, according to the PHASES, UCAS, and ELAPSS scores, respectively. CONCLUSION: In a prospective study of European patients with aneurysmal subarachnoid hemorrhage, we showed that 3 common risk-assessment tools designed for patients with unruptured intracranial aneurysms would have not identified most patients to be at high or intermediate risk for rupture, questioning their use for decision-making in the setting of unruptured aneurysms.
PURPOSE: The natural evolution of unruptured intracranial aneurysms (UIA) is indeed difficult to predict at the individual level. OBJECTIVE: In a large prospective multicentric European cohort, we aimed to evaluate whether the PHASES, UCAS, and ELPASS scores in patients with aneurysmal subarachnoid hemorrhage would have predicted a high risk of aneurysmal rupture or growth. METHODS: Academic centers treating patients with intracranial aneurysms were invited to prospectively collect de-identified data from all patients admitted at their institution for a subarachnoid hemorrhage-related to intracranial aneurysmal rupture between January 1 and March 31, 2021 through a trainee-led research collaborative network. Each responding center was provided with an electronic case record form (CRF) which collected all the elements of the PHASES, ELAPSS, and UCAS scores. RESULTS: A total of 319 patients with aneurysmal subarachnoid hemorrhage were included at 17 centers during a 3-month period. One hundred eighty-three aneurysms (57%) were less than 7 mm. The majority of aneurysms were located on the anterior communicating artery (n = 131, 41%). One hundred eighty-four patients (57%), 103 patients (32%), and 58 (18%) were classified as having a low risk of rupture or growth, according to the PHASES, UCAS, and ELAPSS scores, respectively. CONCLUSION: In a prospective study of European patients with aneurysmal subarachnoid hemorrhage, we showed that 3 common risk-assessment tools designed for patients with unruptured intracranial aneurysms would have not identified most patients to be at high or intermediate risk for rupture, questioning their use for decision-making in the setting of unruptured aneurysms.
Authors: Olivier N Naggara; Phil M White; François Guilbert; Daniel Roy; Alain Weill; Jean Raymond Journal: Radiology Date: 2010-07-15 Impact factor: 11.105
Authors: Nima Etminan; Bruce A Buchholz; Rita Dreier; Peter Bruckner; James C Torner; Hans-Jakob Steiger; Daniel Hänggi; R Loch Macdonald Journal: Transl Stroke Res Date: 2013-10-30 Impact factor: 6.829
Authors: Jacoba P Greving; Marieke J H Wermer; Robert D Brown; Akio Morita; Seppo Juvela; Masahiro Yonekura; Toshihiro Ishibashi; James C Torner; Takeo Nakayama; Gabriël J E Rinkel; Ale Algra Journal: Lancet Neurol Date: 2013-11-27 Impact factor: 44.182