Expert Consensus Delphi Survey

EACS Delphi Survey – Expert Consensus on Endovascular Aneurysm Complexity

Endovascular Aneurysm Complexity Score (EACS)

Expert Consensus Delphi Survey

Round 1: Factor Identification and Weighting

Instructions for Experts

Background: This Delphi survey aims to establish expert consensus on factors influencing endovascular treatment complexity for intracranial aneurysms and their relative importance.

Your Task: Please evaluate each proposed factor for inclusion in the EACS, rate their importance, assign relative weights, and provide detailed scoring criteria.

Expertise Required: Minimum 5 years experience in neurointerventional procedures with >100 aneurysm treatments annually.

Note: Upon completion, your responses will be automatically compiled into a PDF and sent to the research team.

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Participant Information

Factor Importance Assessment

Rate the importance of each factor in predicting endovascular treatment complexity and procedural risk. Use the scale: 1 = Not Important, 2 = Slightly Important, 3 = Moderately Important, 4 = Very Important, 5 = Extremely Important

Factor
1
Not Important
2
Slightly
3
Moderate
4
Very
5
Extremely
Morphological Complexity
Shape irregularity, multilobulation, fusiform components
Branch Involvement
Number and eloquence of incorporated vessels
Access Route Difficulty
Tortuosity, vessel caliber, stenosis
Size/Neck Complexity
Aneurysm size, neck width, dome-to-neck ratio
Device Suitability
Appropriateness for coiling, flow diversion, stenting
Patient Risk Factors
Age, comorbidities, anticoagulation status
Eloquence/Collateral Risk
Territory eloquence, collateral circulation adequacy
Technical Complexity
Required techniques (Y-stenting, flow diversion, etc.)
Calcification/Wall Characteristics
Wall calcification, vessel wall integrity

Factor Weighting Assignment

Assign relative weights to each factor (total must equal 100%). Adjust sliders to reflect your assessment of each factor’s contribution to overall complexity.

Note: The sum of all weights must equal 100%. Real-time validation will show current total.

Current Total: 91%

Morphological Complexity

15%

Branch Involvement

14%

Access Route Difficulty

13%

Size/Neck Complexity

12%

Device Suitability

11%

Patient Risk Factors

10%

Eloquence/Collateral Risk

9%

Technical Complexity

8%

Calcification/Wall Characteristics

8%

Scoring Criteria Definition

For each factor, define specific criteria for scoring from 1-10. Provide clear, objective criteria that different practitioners could apply consistently.

Morphological Complexity (1-10 Scale)

Scores 1-2:
Scores 3-4:
Scores 5-6:
Scores 7-8:
Scores 9-10:

Branch Involvement Complexity (1-10 Scale)

Scores 1-2:
Scores 3-4:
Scores 5-6:
Scores 7-8:
Scores 9-10:

Additional Factors Consideration

Are there any additional factors not listed above that you believe significantly influence endovascular treatment complexity?

Complexity Tier Classification

Based on the total EACS score (1-10), suggest appropriate tier classifications for treatment complexity levels.

Proposed Tier System

Score Range
Complexity Level
Clinical Implications

General Comments and Suggestions

Thank you for your expert contribution to developing the EACS

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