O'Kelly-Marotta grading scale

Changed by Yuranga Weerakkody, 17 Apr 2017

Updates to Synonym Attributes

Updates to Article Attributes

Title was changed:
O'Kelly-Marotta Grading Scalegrading scale
Body was changed:

The O'Kelly-Marotta (OKM) grading scale is a proposed method of assessing the degree of angiographic filling and contrast stasis in the setting of intracranial aneurysms treated by flow diversion. Taking into account the dynamic nature of the contrast stasis, it is designed for use with cerebral angiography to predict aneurysm closure over time1.

Parameters

A digital subtraction angiogram involving arterial injection and extending completely into the venous phase is necessary for accurate grading.

Two variables are addressed, namely the degree of aneurysm filling and the timing of contrast clearance.

Aneurysm filling
  • A: total filling (>95%) 
  • B: subtotal filling (5-95%)
  • C: entry remnant (<5%)
  • D: no filling (0%)
Stasis phase
  • 1: No stasis (arterial phase clearance, before capillary phase)
  • 2: Moderate stasis (clearance before venous phase)
  • 3: Significant stasis (persistent contrast at venous phase)

Important Pointspoints

  1. possible scores exist (i.e. A1, A2, A3, B1, B2, B3, C1, C2, C3, and D) as the absence of filling by definition precludes the observation of different phases of stasis 
  2. the OKM scale should be applied to both pre- and post-treatment cerebral angiography
  3. the scale has been shown since its inception to demonstrate a high degree of inter- and intraobserver agreement 2
  • -</ul><h4>Important Points</h4><ol>
  • +</ul><h4>Important points</h4><ol>

References changed:

  • 2. Joshi MD, O'Kelly CJ, Krings T, Fiorella D, Marotta TR. Observer variability of an angiographic grading scale used for the assessment of intracranial aneurysms treated with flow-diverting stents. AJNR. American journal of neuroradiology. 34 (8): 1589-92. <a href="https://doi.org/10.3174/ajnr.A3431">doi:10.3174/ajnr.A3431</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/23449648">Pubmed</a> <span class="ref_v4"></span>
  • 2. Joshi MD, O'Kelly CJ, Krings T, et al. Observer variability of an angiographic grading scale used for the assessment of intracranial aneurysms treated with flow-diverting stents. AJNR Am J Neuroradiol 2013;34:1589–92 doi:0.3174/ajnr.A3431

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