====== Aneurysm Recanalization Stratification Scale ======
With the increasing use of [[endovascular technique]]s in the treatment of both [[ruptured intracranial aneurysm]] and [[unruptured intracranial aneurysm]]s, the issue of Recanalized [[intracranial aneurysm]] efficacy has become increasingly important.

[[Christopher S. Ogilvy]] et al. retrospectively reviewed medical records that were prospectively collected for 305 patients who received endovascular treatment for [[intracranial aneurysm]]s from 2007 to 2013. Multivariable [[logistic regression]] was performed on candidate predictors identified by univariable screening analysis to detect independent predictors of retreatment. A composite risk score was constructed based on the proportional contribution of independent predictors in the multivariable model.

Size (>10 mm), aneurysm rupture, stent assistance, and posttreatment degree of aneurysm occlusion were independently associated with retreatment, whereas intraluminal thrombosis and flow diversion demonstrated a trend toward retreatment. 

The Aneurysm Recanalization Stratification Scale was constructed by assigning the following weights to statistically and clinically significant predictors: 

aneurysm-specific factors: 

size (>10 mm), 2 points; 

Rupture, 2 points; 

Presence of thrombus, 2 points. 

Treatment-related factors were stent assistance, 1 point; 

flow diversion, 2 points; 

[[Raymond-Roy occlusion classification]] occlusion class 2, 1 point; 

Raymond-Roy occlusion class 3, 2 points. 

This scale demonstrated good discrimination with a C-statistic of 0.799.

Surgical decision-making and patient-centered informed consent require comprehensive and accessible information on treatment efficacy. We constructed the Aneurysm Recanalization Stratification Scale to enhance this decision-making process. This is the first comprehensive model that has been developed to quantitatively predict the risk of retreatment after [[endovascular therapy]]
((Ogilvy CS, Chua MH, Fusco MR, Reddy AS, Thomas AJ. Stratification of
recanalization for patients with endovascular treatment of intracranial
aneurysms. Neurosurgery. 2015 Apr;76(4):390-5. doi: 10.1227/NEU.0000000000000651.
PubMed PMID: 25621984.
))
((Ogilvy CS, Chua MH, Fusco MR, Griessenauer CJ, Harrigan MR, Sonig A, Siddiqui 
AH, Levy EI, Snyder K, Avery M, Mitha A, Shores J, Hoh BL, Thomas AJ. Validation 
of a System to Predict Recanalization After Endovascular Treatment of
Intracranial Aneurysms. Neurosurgery. 2015 Apr 4. [Epub ahead of print] PubMed
PMID: 25850603.
))