The C.O.S.T.A.S. project (Clinically Oriented Spasmolysis Treatment- A Scorescale): a pilot study.

Area of Science:

• Neurology
• Interventional Neuroradiology
• Clinical Decision Support

Background:

• Symptomatic cerebral vasospasm (CVS) after aneurysmal subarachnoid hemorrhage (SAH) poses treatment challenges.
• Intra-arterial spasmolysis is a critical intervention but carries procedural risks.

Purpose of the Study:

• To develop the Clinically Oriented Spasmolysis Treatment - A Score Scale (C.O.S.T.A.S.) system.
• To create a patient-oriented scoring system to guide intra-arterial spasmolysis for CVS in SAH patients.

Main Methods:

• Categorized and weighted clinical parameters from SAH patients.
• Included factors such as age, smoking, atherosclerosis, BMI, renal function, ventilation, vasopressor use, and an AI-based vasospasm risk model.
• Assigned scores from 0-3 per parameter, totaling a maximum of 18.

Main Results:

• The C.O.S.T.A.S. scale provides a comprehensive patient overview.
• Integrates AI-driven risk prediction with clinical data to identify patients likely to benefit from intra-arterial spasmolysis.
• Functions as a triage tool to assess suitability for intervention, balancing risks and benefits.

Conclusions:

• C.O.S.T.A.S. is the first scoring scale specifically for guiding intra-arterial spasmolysis in SAH patients with CVS.
• The prototype offers a practical framework for individualized treatment decisions.
• Multicenter validation is needed to optimize accuracy and parameter weighting.