未破裂颅内动脉瘤的治疗

The unruptured intracranial aneurysm treatment score The unruptured intracranial aneurysm treatment score (UIATS) model includes and quantifies the key factors for clinical decision-making in the management of unruptured intracranial aneurysms (UIAs), developed based on relevance rating data from Delphi consensus rounds 1–4.¹⁸ To calculate a management recommendation for a UIA, the number of points corresponding to each patient-, aneurysm-, or treatment-related feature on both management columns of the scoring form (“in favor of UIA repair” and “in favor of UIA conservative management”) are added up. This will lead to 2 numerical values, 1 favoring aneurysm repair (surgical or endovascular), and 1 favoring conservative management. The definitions for each category and factor are found in the Methods section. For cases with a score difference of 3 points or more, the direction, i.e., the difference between the calculated numerical values on each side of the recommendation columns, will suggest an individual management recommendation (i.e., aneurysm repair or conservative management). For cases that have similar aneurysm treatment and conservative management scores (±2 point difference or less), the recommendation is “not definitive” and either management approach could be supported, as additional factors apart from those used in the development of UIATS may be considered in making a final decision regarding the management recommendation and long-term follow-up. For cases with multiple aneurysms, every aneurysm must be evaluated separately, which will then also result in separate recommendations for each aneurysm. *The minimal intervention-related risk is always added as a constant factor (5 points). AComA = anterior communicating artery; BasA = basilar artery; BP = blood pressure; multiple = multiple selection category; PComA = posterior communicating artery; SAH = subarachnoid hemorrhage; single = single selection category.