Abstract：
OBJECTIVE: Endovascular treatment (EVT) of unruptured cerebral aneurysms (UCA) offers a safer alternative to clipping. However, it is still associated with an increased risk for Postprocedural Neurological deficit (PPND). Prompt recognition using intraoperative neurophysiologic monitoring (IONM) and intervention can reduce the incidence and impact of new postoperative neurological complications. We aim to evaluate the diagnostic accuracy of IONM in predicting PPND after EVT of UCA.
METHODS: We included 414 patients who underwent EVT for UCA from 2014 to 2019. The sensitivities, specificities, and diagnostic odds ratio of somatosensory evoked potentials and electroencephalography monitoring methods were calculated. We also determined their diagnostic accuracy using receiver operating characteristic plots.
RESULTS: The highest sensitivity of 67.7% (95% confidence interval {CI}, 34.9%-90.1%) was obtained when either modality had a change. Simultaneous changes in both modalities have the highest specificity of 97.8% (95% CI, 95.8%-99.0%). The area under the receiver operating characteristic curve was 0.795 (95% CI, 0.655-0.935) for changes in either modality.
CONCLUSIONS: IONM with somatosensory evoked potentials alone or in combination with electroencephalography has high diagnostic accuracy in detecting periprocedural complications and resultant PPND during EVT of UCA.
METHODS: We included 414 patients who underwent EVT for UCA from 2014 to 2019. The sensitivities, specificities, and diagnostic odds ratio of somatosensory evoked potentials and electroencephalography monitoring methods were calculated. We also determined their diagnostic accuracy using receiver operating characteristic plots.
RESULTS: The highest sensitivity of 67.7% (95% confidence interval {CI}, 34.9%-90.1%) was obtained when either modality had a change. Simultaneous changes in both modalities have the highest specificity of 97.8% (95% CI, 95.8%-99.0%). The area under the receiver operating characteristic curve was 0.795 (95% CI, 0.655-0.935) for changes in either modality.
CONCLUSIONS: IONM with somatosensory evoked potentials alone or in combination with electroencephalography has high diagnostic accuracy in detecting periprocedural complications and resultant PPND during EVT of UCA.
摘要：
目的：未破裂脑动脉瘤（UCA）的血管内治疗（EVT）提供了一种更安全的替代方法。然而,它仍然与术后神经缺陷(PPND)的风险增加相关.使用术中神经生理学监测（IONM）和干预措施进行及时识别可以减少新的术后神经系统并发症的发生率和影响。我们旨在评估IONM在UCAEVT后预测PPND的诊断准确性。
方法：我们纳入了2014年至2019年接受UCAEVT的414例患者。敏感性，特殊性，计算SSEP和脑电图监测方法的诊断比值比。我们还使用接收器工作特性（ROC）图确定了它们的诊断准确性。
结果：当任一方式发生改变时，最高灵敏度为67.7％（95％CI，34.9-90.1％）。两种模式的同时变化具有97.8%的最高特异性(95%CI,95.8-99.0%)。两种模式变化的ROC曲线下面积为0.795(95%CI,0.655-0.935)。
结论：IONM与SSEP单独或联合EEG在检测UCAEVT期间的围手术期并发症和由此产生的PPND方面具有较高的诊断准确性。
结论：当血管内专业人员可能不明显出现明显并发症时，IONM允许自信和早期干预。
方法：我们纳入了2014年至2019年接受UCAEVT的414例患者。敏感性，特殊性，计算SSEP和脑电图监测方法的诊断比值比。我们还使用接收器工作特性（ROC）图确定了它们的诊断准确性。
结果：当任一方式发生改变时，最高灵敏度为67.7％（95％CI，34.9-90.1％）。两种模式的同时变化具有97.8%的最高特异性(95%CI,95.8-99.0%)。两种模式变化的ROC曲线下面积为0.795(95%CI,0.655-0.935)。
结论：IONM与SSEP单独或联合EEG在检测UCAEVT期间的围手术期并发症和由此产生的PPND方面具有较高的诊断准确性。
结论：当血管内专业人员可能不明显出现明显并发症时，IONM允许自信和早期干预。
