Recurrence, retreatment, and rebleed rates of coiled aneurysms with respect to the Raymond-Roy scale: a meta-analysis.

Abstract:

BACKGROUND AND PURPOSE:The Raymond-Roy grading scale is used for aneurysm coiling with only limited data on its validity. The scale was developed based on the extent of initial aneurysm occlusion from 1 to 3. However, the model usefulness in evaluating recurrence, retreatment, and rebleeding is unknown. Our goal was to perform a meta-analysis to evaluate the predictiveness of the Raymond scale. METHODS:We performed a systematic review of the English literature for aneurysm coiling which reported the initial embolization results, based on the Raymond-Roy grading scale, and the respective recurrence rates, retreatment rates, and rebleed rates. This yielded data for 4587 aneurysms. We conducted a Bayesian random effects meta-analysis to evaluate the outcomes with respect to the reported initial embolization results. RESULTS:We found the Raymond scale to be predictive of retreatment, with statistically higher rates of retreatment with higher initial Raymond grade. Furthermore, we found a higher probability of rebleeding for initial grades 2 or 3 versus grade 1, which approached significance. The rebleed rates were probably affected by monitoring and treatment of recurrence. However, although there was a trend towards higher recurrence rates with initial grade, this was not statistically significant. CONCLUSIONS:The modified Raymond-Roy scale appears to provide reasonable predictive value for treated aneurysm, especially for the clinically more important aspects of retreatment and rebleed rates.

journal_name

J Neurointerv Surg

authors

Darflinger R,Thompson LA,Zhang Z,Chao K

doi

10.1136/neurintsurg-2015-011668

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

507-11

issue

5

eissn

1759-8478

issn

1759-8486

pii

neurintsurg-2015-011668

journal_volume

8

pub_type

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