Mortimer Alex, Minks David, Bhogal Pervinder, Young Victoria, Macdonald Jason, Sastry Anand, Bosnell Rose, McClelland Sarah Beth, White Philip
Interventional Neuroradiology, North Bristol NHS Trust, Bristol, UK.
Interventional Neuroradiology, Barts Health NHS Trust, London, UK.
Interv Neuroradiol. 2025 Aug 7:15910199251364119. doi: 10.1177/15910199251364119.
BackgroundComplications following mechanical thrombectomy (MT) are common and impact on clinical outcome. However, unless complication reporting is standardised, there is scope for significant variation in results across multiple centres, potentially undermining both inter and intra unit comparisons and multicentre national quality improvement audit programmes. We therefore sought to achieve consensus amongst interventional neuroradiologists (INRs) in England and Wales for reporting of MT complications as part of national audit.MethodsWe conducted a two-round electronic Delphi survey with initial invitation to forty INR panellists representing each neurointerventional centre in England and Wales with questions covering timing, staffing and mode of data entry, specific MT complications (vessel perforation, intracerebral and subarachnoid haemorrhage, vessel dissection, vasospasm and distal or new territory embolisation) and topics for future content inclusion.ResultsThere were 22 and 21 respondents in round one and two, respectively. Consensus was achieved in methods of data entry and in reporting of specific complications (strongly supportive of symptomatic haemorrhagic complication reporting rather than non-clinically relevant changes with clear definitions of when to report distal, new territory embolic or vasospastic complications or arterial dissection). There was also agreement to include tandem lesion, access site and procedural-related physiological complications in future.ConclusionIn this exercise, we have achieved accordance and developed guidance with an emphasis on reporting of clinically relevant/outcome impacting post-MT complications, which will allow for a better standardised and more meaningful national audit process going forward.
背景
机械取栓术（MT）后的并发症很常见，且会影响临床结局。然而，除非并发症报告标准化，否则多个中心的结果可能存在显著差异，这可能会削弱单位间和单位内的比较以及多中心国家质量改进审计计划。因此，我们试图在英格兰和威尔士的介入神经放射科医生（INR）中就MT并发症报告达成共识，作为国家审计的一部分。
方法
我们进行了两轮电子德尔菲调查，最初邀请了代表英格兰和威尔士每个神经介入中心的40名INR小组成员，问题涵盖时间、人员配备和数据录入方式、特定的MT并发症（血管穿孔、脑内和蛛网膜下腔出血、血管夹层、血管痉挛以及远端或新区域栓塞）以及未来纳入内容的主题。
结果
第一轮和第二轮的受访者分别为22人和21人。在数据录入方法和特定并发症报告方面达成了共识（强烈支持报告有症状的出血性并发症，而不是报告与临床无关的变化，并明确了何时报告远端、新区域栓塞或血管痉挛性并发症或动脉夹层的定义）。未来还同意纳入串联病变、穿刺部位和与手术相关的生理并发症。
结论
在这项工作中，我们达成了一致并制定了指导意见，重点是报告MT术后与临床相关/影响结局的并发症，这将使未来的国家审计过程更加标准化且更有意义。
