A Novel Scoring System Predicting Aneurysm Incomplete Occlusion after Flow Diversion: A 10-year experience.

BACKGROUND

Factors impacting the rate of aneurysm occlusion after FD have been well described in the literature. In this paper, we sought to evaluate those variables to develop and validate a scoring system predicting aneurysm incomplete occlusion after FD.

METHODS

Retrospective review of patients with intracranial aneurysms treated with FD at a single institution between March 2013 and March 2023. Multivariable logistic regression model was developed using factors associated with aneurysm incomplete occlusion. The ABC scoring system consisted of: Age (< 60 years old: 0, 60-69 years: 1, 70-79: 2, and ≥80: 3), Branch coming out of the aneurysm dome/neck (yes: 2, no:0), and Cigarette smoking history (never-smoker:1, current or past smoker: 0). The scoring system performance was evaluated with receiver operating characteristic curve and calculating the area under the curve (AUC).

RESULTS

A total of 449 patients with 563 aneurysms treated in 482 procedures were evaluated. Most cases were females (81.7%) with a median age of 59 years-old. At a median follow-up of 13.2 months, 84.0% of aneurysms were completely or near-complete occluded. The scoring system had an AUC of 0.71. A value ≥2, reached a sensitivity of 74.4%, specificity of 60.9%, an LR+ of 1.90, and proved to be reliable in predicting the risk of incomplete occlusion (OR=4.53; 95% confidence interval, 2.73-7.54; P < 0.001).

CONCLUSION

The proposed ABC scoring system can be used to evaluate the risk of aneurysm incomplete occlusion after treatment with FD, identifying patients who would benefit from adjunctive coiling or alternate treatment modalities.

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.