Evidence map›Paper›PMID 26405204›Full record

ArticleStroke2015

Utility of Screening for Cerebral Vasospasm Using Digital Subtraction Angiography.

Eric J Arias, Sravya Vajapey, Matthew R Reynolds, Michael R Chicoine, Keith M Rich, Ralph G Dacey, Ian G Dorward, Colin P Derdeyn, Christopher J Moran, DeWitte T Cross and 2 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 23 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Microvascular platelet aggregation and thrombosis after subarachnoid hemorrhage: A review and synthesis.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2020
    Review
  9. Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 3 countries.

Eric J AriasFrom the Department of Neurological Surgery (E.J.A., S.V., M.R.R., M.R.C., K.M.R., R.G.D., I.G.D., C.P.D., C.J.M., D.T.C., G.J.Z.), Department of Neurology (C.P.D., C.J.M., D.T.C., G.J.Z., R.D.), and Mallinckrodt Institute of Radiology (C.P.D.,C.J.M., D.T.C.), Washington University School of Medicine, St Louis, MO. ejarias@wustl.edu.
Sravya VajapeyFrom the Department of Neurological Surgery (E.J.A., S.V., M.R.R., M.R.C., K.M.R., R.G.D., I.G.D., C.P.D., C.J.M., D.T.C., G.J.Z.), Department of Neurology (C.P.D., C.J.M., D.T.C., G.J.Z., R.D.), and Mallinckrodt Institute of Radiology (C.P.D.,C.J.M., D.T.C.), Washington University School of Medicine, St Louis, MO.
Matthew R ReynoldsFrom the Department of Neurological Surgery (E.J.A., S.V., M.R.R., M.R.C., K.M.R., R.G.D., I.G.D., C.P.D., C.J.M., D.T.C., G.J.Z.), Department of Neurology (C.P.D., C.J.M., D.T.C., G.J.Z., R.D.), and Mallinckrodt Institute of Radiology (C.P.D.,C.J.M., D.T.C.), Washington University School of Medicine, St Louis, MO.
Michael R ChicoineFrom the Department of Neurological Surgery (E.J.A., S.V., M.R.R., M.R.C., K.M.R., R.G.D., I.G.D., C.P.D., C.J.M., D.T.C., G.J.Z.), Department of Neurology (C.P.D., C.J.M., D.T.C., G.J.Z., R.D.), and Mallinckrodt Institute of Radiology (C.P.D.,C.J.M., D.T.C.), Washington University School of Medicine, St Louis, MO.
Keith M RichFrom the Department of Neurological Surgery (E.J.A., S.V., M.R.R., M.R.C., K.M.R., R.G.D., I.G.D., C.P.D., C.J.M., D.T.C., G.J.Z.), Department of Neurology (C.P.D., C.J.M., D.T.C., G.J.Z., R.D.), and Mallinckrodt Institute of Radiology (C.P.D.,C.J.M., D.T.C.), Washington University School of Medicine, St Louis, MO.
Ralph G DaceyFrom the Department of Neurological Surgery (E.J.A., S.V., M.R.R., M.R.C., K.M.R., R.G.D., I.G.D., C.P.D., C.J.M., D.T.C., G.J.Z.), Department of Neurology (C.P.D., C.J.M., D.T.C., G.J.Z., R.D.), and Mallinckrodt Institute of Radiology (C.P.D.,C.J.M., D.T.C.), Washington University School of Medicine, St Louis, MO.
Ian G DorwardFrom the Department of Neurological Surgery (E.J.A., S.V., M.R.R., M.R.C., K.M.R., R.G.D., I.G.D., C.P.D., C.J.M., D.T.C., G.J.Z.), Department of Neurology (C.P.D., C.J.M., D.T.C., G.J.Z., R.D.), and Mallinckrodt Institute of Radiology (C.P.D.,C.J.M., D.T.C.), Washington University School of Medicine, St Louis, MO.
Colin P DerdeynFrom the Department of Neurological Surgery (E.J.A., S.V., M.R.R., M.R.C., K.M.R., R.G.D., I.G.D., C.P.D., C.J.M., D.T.C., G.J.Z.), Department of Neurology (C.P.D., C.J.M., D.T.C., G.J.Z., R.D.), and Mallinckrodt Institute of Radiology (C.P.D.,C.J.M., D.T.C.), Washington University School of Medicine, St Louis, MO.
Christopher J MoranFrom the Department of Neurological Surgery (E.J.A., S.V., M.R.R., M.R.C., K.M.R., R.G.D., I.G.D., C.P.D., C.J.M., D.T.C., G.J.Z.), Department of Neurology (C.P.D., C.J.M., D.T.C., G.J.Z., R.D.), and Mallinckrodt Institute of Radiology (C.P.D.,C.J.M., D.T.C.), Washington University School of Medicine, St Louis, MO.
DeWitte T CrossFrom the Department of Neurological Surgery (E.J.A., S.V., M.R.R., M.R.C., K.M.R., R.G.D., I.G.D., C.P.D., C.J.M., D.T.C., G.J.Z.), Department of Neurology (C.P.D., C.J.M., D.T.C., G.J.Z., R.D.), and Mallinckrodt Institute of Radiology (C.P.D.,C.J.M., D.T.C.), Washington University School of Medicine, St Louis, MO.
Gregory J ZipfelFrom the Department of Neurological Surgery (E.J.A., S.V., M.R.R., M.R.C., K.M.R., R.G.D., I.G.D., C.P.D., C.J.M., D.T.C., G.J.Z.), Department of Neurology (C.P.D., C.J.M., D.T.C., G.J.Z., R.D.), and Mallinckrodt Institute of Radiology (C.P.D.,C.J.M., D.T.C.), Washington University School of Medicine, St Louis, MO.
Rajat DharFrom the Department of Neurological Surgery (E.J.A., S.V., M.R.R., M.R.C., K.M.R., R.G.D., I.G.D., C.P.D., C.J.M., D.T.C., G.J.Z.), Department of Neurology (C.P.D., C.J.M., D.T.C., G.J.Z., R.D.), and Mallinckrodt Institute of Radiology (C.P.D.,C.J.M., D.T.C.), Washington University School of Medicine, St Louis, MO.
I.R.C.C.S. Oasi Maria SS · ITUnited States Nuclear Regulatory Commission · US

Funding

Washington University Institute of Clinical and Translational SciencesKL2TR000450 · NCATS · WASHINGTON UNIVERSITY · PI EVANOFF, BRADLEY A · 2012 to 2016
$8.8M
Washington University Center for Translational NeuroscienceP30NS057105 · NINDS · WASHINGTON UNIVERSITY · PI HOLTZMAN, DAVID M. · 2006 to 2011
$8.7M
NERVOUS SYSTEM DEVELOPMENT AND INJURYT32NS007205 · NINDS · WASHINGTON UNIVERSITY · PI HOLTZMAN, DAVID M. · 1985 to 2017
$4.2M
NCATS NIH HHS 5KL2TR000450-08NCATS NIH HHS KL2 TR000450NINDS NIH HHS NS007205NINDS NIH HHS P30 NS057105NINDS NIH HHS T32 NS007205
6 · The paper itself

Abstract

background and purposeCerebral arterial vasospasm (CVS) is a common complication of aneurysmal subarachnoid hemorrhage strongly associated with neurological deterioration and delayed cerebral ischemia (DCI). The utility of screening for CVS as a surrogate for early detection of DCI, especially in patients without clinical signs of DCI, remains uncertain.

methodsWe performed a retrospective analysis of 116 aneurysmal subarachnoid hemorrhage patients who underwent screening digital subtraction angiography to determine the association of significant CVS and subsequent development of DCI. Patients were stratified into 3 groups: (1) no symptoms of DCI before screening, (2) ≥1 episodes of suspected DCI symptoms before screening, and (3) unable to detect symptoms because of poor examination.

resultsPatients asymptomatic before screening had significantly lower rates of CVS (18%) compared with those with transient symptoms of DCI (60%; P<0.0001). None of the 79 asymptomatic patients developed DCI after screening, regardless of digital subtraction angiography findings, compared with 56% of those with symptoms (P<0.0001). Presence of CVS was significantly associated with DCI in those with transient symptoms and in those whose examinations did not permit clear assessment (odds ratio 16.0, 95% confidence interval 2.2-118.3, P=0.003).

conclusionsPatients asymptomatic before screening have low rates of CVS and seem to be at negligible risk of developing DCI. Routine screening of asymptomatic patients seems to have little utility. Screening may still be considered in patients with possible symptoms of DCI or those with examinations too poor to clinically detect symptoms because finding CVS may be useful for risk stratification and guiding management.

Indexed as

Angiography, Digital SubtractionMass ScreeningCohort StudiesDatabases, FactualFemaleHumansMaleMiddle AgedProspective StudiesRetrospective StudiesRisk FactorsSubarachnoid HemorrhageVasospasm, Intracranialcerebral vasospasmdelayed cerebral ischemiadigital subtraction angiographyscreeningsubarachnoid hemorrhage

Identifiers

PMID26405204
PMCPMC4624568
OpenAlexW2179922317

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.