Dynamic risk stratification using the modified Cekirge-Saatci classification (mCSC) predicts recanalization after...

Area of Science:

• Interventional neuroradiology
• Vascular neurosurgery
• Medical imaging analysis

Background:

• Flow diverter (FD) treatment is a key modality for intracranial aneurysms.
• The modified Cekirge-Saatci classification (mCSC) is used to assess aneurysm treatment response.
• Understanding the temporal dynamics of mCSC is crucial for predicting outcomes.

Purpose of the Study:

• To evaluate the temporal evolution of the modified Cekirge-Saatci classification (mCSC) post-flow diverter (FD) treatment.
• To investigate the predictive value of mCSC for aneurysm recanalization.
• To explore an mCSC-based risk stratification approach for patient management.

Main Methods:

• Retrospective analysis of 50 patients with intracranial aneurysms treated with FD.
• Stratification into no-risk, intermediate-risk, and high-risk groups based on mCSC at 4 and 12 months.
• Logistic regression analysis to assess the association between mCSC risk levels and recanalization.

Main Results:

• Recanalization occurred in 28% of cases over a mean follow-up of 104.8 months.
• Both 4-month and 12-month mCSC risk levels significantly correlated with recanalization (p<0.05).
• The 12-month mCSC risk level was an independent predictor of recanalization (OR: 31.031, p=0.015), with dynamic risk transitions observed.

Conclusions:

• The mCSC should be viewed as a dynamic, not static, classification system.
• Longitudinal evaluation of mCSC provides prognostic information for aneurysm recanalization.
• Risk-based interpretation of mCSC can guide individualized follow-up strategies after FD treatment.