Evidence map›Paper›PMID 34184178›Full record

SynthesisNeurocritical care2022

Repeat Catheter Angiography in Patients with Aneurysmal-Pattern Angiographically Negative Subarachnoid Hemorrhage.

Cody L Nesvick, Soliman Oushy, Krishnan Ravindran, Lorenzo Rinaldo, Panagiotis Kerezoudis, Eelco F Wijdicks, Giuseppe Lanzino, Alejandro A Rabinstein

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurocritical care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.7field-weighted citation impact, top 28% 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

5 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Imaging of Intracranial Saccular Aneurysms.Stroke (Hoboken, N.J.) · 2023
    Review
  4. Article
  5. Review
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

8 authors at 2 institutions in 2 countries.

Cody L NesvickDepartment of Neurological Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA. Nesvick.Cody@mayo.edu.ORCID http://orcid.org/0000-0002-2249-5054
Soliman OushyDepartment of Neurological Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
Krishnan RavindranMelbourne Medical School, Cnr Grattan Street and Royal Parade, University of Melbourne, Melbourne, VIC, 3010, Australia.
Lorenzo RinaldoDepartment of Neurological Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
Panagiotis KerezoudisDepartment of Neurological Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
Eelco F WijdicksDepartment of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
Giuseppe LanzinoDepartment of Neurological Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
Alejandro A RabinsteinDepartment of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
Mayo Clinic · USThe University of Melbourne · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA significant proportion of patients with subarachnoid hemorrhage have a normal cerebral angiogram. Patients with angiographically negative subarachnoid hemorrhage (anSAH) with either perimesencephalic- (panSAH) or aneurysmal-pattern hemorrhage (aanSAH, also known as diffuse anSAH) have an excellent prognosis, but only if underlying vascular abnormalities are completely excluded. The rate of occult aneurysms in patients with aanSAH varies widely across studies. The purpose of this study was to quantify the value of repeat DSA in these patients.

methodsWe reviewed the records of all patients initially diagnosed with aanSAH after a screening DSA at a single tertiary neurovascular referral center from January 2006-April 2018. Patients with panSAH and traumatic SAH were excluded. We also performed a systematic review and meta-analysis of positive second DSAs in previously published case series of patients with aanSAH who underwent two serial DSAs. For meta-analysis, PubMed Central, MEDLINE and Cochrane Library databases were searched for pertinent studies up to November 2019. The rate of aneurysm detection on repeat angiography was extracted from each study. Pooled rates for positive second angiogram were calculated as untransformed proportions in a binary random-effects model meta-analysis. Inter-study heterogeneity was calculated using an I

resultsThree of 27 patients (11.1%) with aanSAH and at least two DSAs were subsequently found to have a cerebral aneurysm in our institutional dataset. Twenty-six studies in our systematic review met inclusion criteria, and the pooled rate of positive second angiogram was 10.4% (95% CI 7.3%-13.5%, P < 0.001). Substantial inter-study heterogeneity was observed in the meta-analysis (I

conclusionsOne in 10 patients with aanSAH has an occult ruptured aneurysm. A second-look DSA should be strongly considered in these cases.

Indexed as

Intracranial AneurysmSubarachnoid HemorrhageAngiography, Digital SubtractionCathetersCerebral AngiographyHumansRetrospective StudiesAngiographically negative subarachnoid hemorrhageNon-aneurysmal subarachnoid hemorrhageSubarachnoid hemorrhage

Identifiers

PMID34184178
OpenAlexW3174767277

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.