A Novel Scoring System Predicting Aneurysm Incomplete Occlusion After Flow Diversion: A 10-Year Experience

Area of Science:

• Neurosurgery
• Interventional Radiology
• Medical Device Technology

Background:

• Flow diversion (FD) is a key treatment for intracranial aneurysms.
• Predicting incomplete occlusion after FD is crucial for patient management.
• Existing factors influencing FD outcomes require a consolidated predictive tool.

Purpose of the Study:

• To develop and validate a scoring system for predicting incomplete aneurysm occlusion post-FD.
• To identify key variables associated with suboptimal FD treatment outcomes.
• To create a practical tool for risk stratification in aneurysm treatment.

Main Methods:

• Retrospective review of 449 patients with 563 intracranial aneurysms treated with FD.
• Development of a multivariable logistic regression model.
• Creation of the ABC scoring system based on Age, Branch presence, and Cigarette smoking history.

Main Results:

• The ABC scoring system demonstrated an Area Under the Curve (AUC) of 0.71.
• A score ≥ 2 predicted incomplete occlusion with 74.4% sensitivity and 60.9% specificity.
• The system reliably predicted incomplete occlusion risk (OR=4.53, P<0.001).

Conclusions:

• The ABC scoring system offers a reliable method to assess incomplete aneurysm occlusion risk after FD.
• This tool can guide decisions for adjunctive therapies like coiling.
• It aids in selecting alternative treatment modalities for high-risk patients.