AI Article Synopsis
- The pipeline embolization device (PED) is used to treat intracranial aneurysms (IAs), but about 14% of treated IAs still show persistent filling after one year, highlighting the need for better predictive tools.
- Researchers conducted a study involving 1,006 patients across three institutions to develop a nomogram that predicts which aneurysms will not fully occlude after PED treatment using factors like aneurysm location and size.
- The nomogram proved effective, with high predictive accuracy (AUCs of 0.810 and 0.840 for the derivation and validation cohorts, respectively), offering clinicians a practical method to tailor treatment plans for patients with persistent aneurysm filling.
Article Abstract
The pipeline embolization device (PED) is an effective endovascular treatment modality for intracranial aneurysm (IA), but nearly one-fifth of IAs treated with a PED remain persistently filling at 1-year angiography follow-up. Developing a nomogram to predict persistent aneurysm filling after PED treatment can help neurointerventionalists identify aneurysms with incomplete occlusion and change their treatment strategies. This retrospective study included patients with IA treated with a PED from three institutions between April 2016 and April 2022, assigned to a derivation or validation cohort. Multivariate logistic regression analysis was used to identify predictors and develop a nomogram to predict persistent aneurysm filling after PED treatment in the derivation cohort. Predictive accuracy and clinical benefits of the nomogram were assessed using area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA). In total, 1006 patients with IA were included, 786 in the derivation cohort and 220 in the validation cohort. Over mean follow-up time 18.36 ± 8.58 months, 142 (14.1%) patients developed persistent aneurysm filling after PED treatment, 110 (14.0%) in the derivation cohort and 32 (14.5%) in the validation cohort. In multivariate logistic regression analysis, we developed a nomogram incorporating five predictors: aneurysms located in the basilar artery, dissecting aneurysms, maximum diameter, aneurysms with incorporated branches, and PED plus coiling. AUCs of the nomogram were 0.810 (95% confidence interval [CI], 0.765-0.856) in the derivation cohort and 0.840 (95% CI, 0.754-0.925) in the validation cohort. Calibration curve and DCA analysis demonstrated the utility and clinical application value of this nomogram. This nomogram provides individualized prediction of persistent aneurysm filling after PED treatment for patients with IA, representing a practical approach to effectiveness evaluation. This tool can help neurointerventionalists to identify aneurysms with incomplete occlusion and change their treatment strategy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s12975-023-01222-9 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Nomogram Model for Predicting Recurrent Coronary Thrombosis in Kawasaki Disease Patients.
J Inflamm Res
January 2025
Department of Cardiovascular Medicine, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Background: Coronary thrombosis is a serious cardiovascular complication of Kawasaki disease (KD), and recurrence of coronary thrombosis increases the short-term risk of myocardial infarction and the long-term risk of coronary artery disease. However, there are currently no studies predicting the recurrence of coronary thrombosis, so the aim of this study was to develop and validate a nomogram to predict recurrent coronary thrombosis in KD patients.
Methods: This was a retrospective study of data from 149 KD patients who had a history of previous coronary disease at the Children's Hospital of Chongqing Medical University from 2013 to 2020.
Impact of Microcirculatory Dysfunction on Persistent Global Cerebral Edema After Aneurysmal Subarachnoid Hemorrhage: An Age-Stratified Analysis.
Neurocrit Care
January 2025
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, China.
Background: Microcirculatory dysfunction is one of the most important pathophysiology mechanisms of global cerebral edema (GCE) after aneurysmal subarachnoid hemorrhage (aSAH). Data regarding the impact of microcirculatory dysfunction on persistent GCE following aSAH are currently lacking. The aim of our study was to investigate whether microcirculatory dysfunction is correlated with persistent GCE in patients with aSAH across different age groups.
View Article and Find Full Text PDFThoracic vertebral body erosion due to a perianeurysmal outpouching lesion after thoracic endovascular aortic repair: a case report and literature review.
BMC Musculoskelet Disord
January 2025
Spine Center and Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, 1342, Dongil-Ro, Seoul, Nowon-Gu, 01757, Republic of Korea.
Background: The safety of endovascular treatment, such as thoracic endovascular aortic repair (TEVAR), for a descending thoracic aortic aneurysm has been well-established, with a reported low postoperative mortality rate but higher incidences of long-term complications such as endo-leakage, device failure, and aneurysm-related death. Based on this, we report the first case of massive thoracic vertebral body erosion due to a perianeurysmal outpouching lesion after TEVAR.
Case Presentation: A 77-year-old female with a history of TEVAR due to descending thoracic aortic arch aneurysm 4 years ago was referred from the cardiovascular clinic to the spine center.
Endovascular Repair of Spontaneous Rupture of Stent Graft Branch in Thoracoabdominal Aortic Aneurysm-Management, Case Study, and Review.
J Clin Med
December 2024
Department of Vascular Surgery and Transplantation, Medical University of Bialystok, 15-276 Bialystok, Poland.
Stent-graft implantation is a widely recognized method for endovascular treatment of aortic aneurysms. In cases where the aneurysm involves the thoracic and abdominal aorta, repair including fenestrated and branched stent grafts provides a viable alternative. This approach, initially reserved for patients unsuitable for open surgery, has become preferred for anatomically appropriate thoracoabdominal aortic aneurysms.
View Article and Find Full Text PDFThe outcome of late open conversion after endovascular abdominal aortic repair.
Asian Cardiovasc Thorac Ann
January 2025
Department of Cardiovascular Surgery, Chiba University Hospital, Chiba, Japan.
Background: Endovascular abdominal aneurysm repair (EVAR) offers a less invasive approach to treating abdominal aortic aneurysms (AAA) compared to open repair. However, EVAR is associated with higher rates of reintervention. This study investigates the early and mid-term outcomes of patients who underwent late open conversion including aneurysmorrhaphy after EVAR at our institution.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!