Nomogram for predicting new-onset visual symptoms after pipeline embolization device treatment in patients with...

New-onset visual symptoms (NVS) are a significant complication after pipeline embolization device (PED) treatment for ophthalmic artery (OA) aneurysms, significantly impacting patients' quality of life. This study aimed to develop and validate a nomogram to predict the individualized risk associated with NVS in patients with OA aneurysms. This retrospective study included 669 patients with OA aneurysms treated with PEDs at four institutions from January 2016 to September 2024, with 506 in the training cohort and 163 in the validation cohort. OA was classified into Types 1-3 based on its anatomical relationship with aneurysms. Quantitative digital subtraction angiography assessed hemodynamic parameters changes pre- and post-PED treatment. Multivariate logistic regression identified predictors for nomogram construction. The predictive accuracy and clinical utility of the nomogram was evaluated using area under the curve (AUC), calibration curves, and decision curve analysis (DCA). The mean follow-up for the training cohort was 15.24 months, during which 45 patients (8.9%) developed NVS. Multivariate logistic regression identified age (OR,0.946, P = 0.001), type 3 OA origin (OR,3.699, P = 0.003), and Δ full width at half maximum-OA (OR,0.982, P = 0.020) as predictors for NVS. A nomogram incorporating these predictors yielded AUCs of 0.822 (95%CI, 0.765-0.879) and 0.807 (95%CI, 0.663-0.950) in the training and validation cohorts, respectively. The calibration curve and DCA analyses validate the nomogram's clinical utility. This study developed a novel nomogram to predict the risk of NVS following PED treatment in patients with OA aneurysms, offering valuable insights into preventing ophthalmic complications and improving patients' quality of life.