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Related Experiment Video

Updated: Jun 18, 2026

Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
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Proposal of a Machine Learning Based Prognostic Score for Ruptured Microsurgically Treated Anterior Communicating

Massimiliano Minardi1, Andrea Bianconi2,3, Luca Mesin4

  • 1Neurosurgery, Santa Croce and Carle Hospital, 12100 Cuneo, Italy.

Journal of Clinical Medicine
|January 25, 2025
PubMed
Summary

This study analyzed factors affecting outcomes for anterior communicating artery aneurysms. Preoperative scores and intraoperative bleeding/clipping time significantly impact patient recovery and prognosis.

Keywords:
AcoA aneurysmSAHclippingmachine learning

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Area of Science:

  • Neurosurgery
  • Neurology
  • Medical Informatics

Background:

  • Aneurysmal subarachnoid hemorrhage (aSAH) has high mortality and disability rates.
  • Anterior communicating artery (AcoA) aneurysms present a particular rebleeding risk.
  • Predicting outcomes in aSAH patients is crucial for effective management.

Purpose of the Study:

  • To analyze preoperative and intraoperative variables in patients with ruptured AcoA aneurysms.
  • To evaluate the association of these variables with patient outcomes using machine learning.
  • To propose a novel prognostic score for AcoA aneurysms.

Main Methods:

  • Retrospective analysis of 50 patients undergoing microsurgical clipping for ruptured AcoA aneurysms.
  • Utilized machine learning (MRMR, LASSO) for feature selection and predictive model construction.
  • Examined clinical, aneurysmal, and procedural data.

Main Results:

  • Machine learning identified significant predictors of patient outcomes.
  • LASSO models predicted Glasgow Outcome Scale (GOS) at discharge and 6 months.
  • Key predictors included BNI score, vasograde, preoperative edema, intraoperative bleeding, and temporary clipping duration >3 min.

Conclusions:

  • Preoperative factors (BNI score, vasograde, edema) correlate with outcomes.
  • Intraoperative bleeding and prolonged temporary clipping impact patient prognosis.
  • The developed AcoA prognostic score shows potential for predicting outcomes, ICU stay, and discharge planning.