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

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. 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. 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. 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.

Citation

Lars Wessels, Lucius Samo Fekonja, Johannes Achberger, Julius Dengler, Marcus Czabanka, Nils Hecht, Ulf Schneider, Dimitri Tkatschenko, Karl-Michael Schebesch, Nils Ole Schmidt, Dorothee Mielke, Henning Hosch, Oliver Ganslandt, Alexander Gräwe, Bujung Hong, Jan Walter, Erdem Güresir, Philippe Bijlenga, Julien Haemmerli, Nicolai Maldaner, Serge Marbacher, Ville Nurminen, Hynek Zitek, Ruben Dammers, Naoki Kato, Italo Linfante, Maria-Teresa Pedro, Karsten Wrede, Wei-Te Wang, Maria Wostrack, Peter Vajkoczy. Diagnostic reliability of the Berlin classification for complex MCA aneurysms-usability in a series of only giant aneurysms. Acta neurochirurgica. 2020 Nov;162(11):2753-2758

Mesh Tags

PMID: 32929543

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