Prediction Model For Recanalization Of Patients With Endovascular Treatment Of Intracranial Aneurysms

Part I: Aneurysm Recanalization Scale of Patients With Endovascular Treatment of Intracranial AneurysmsObjective To explore the factors influencing the recanalization of patients with endovascular treatment of intracranial aneurysms.Methods we retrospectively reviewed 441 aneurysms who received endovascular treatment in our Centre for intracranial aneurysms and followed up by DSA from May 2012 to May 2014.Univariable analysis was used to select the possible factors from patient related factors,technology related factors and anatomy related factors.Multivariable logistic regression was performed on candidate predictors identified by univariable analysis.The predictive score was based on the ? coefficient.The discriminative ability was analyzed with the area under the receiver operating characteristic curve(AUC).Results aneurysm size,coil only and Raymond classification were independently associated with recanalization.the the variance inflation factor of aneurysm size,coil only,rupture and Raymond classification are 1.041,1.296,1.323 and 1.146.The ? coefficients of size>25mm,size10.1-25 mm,coil only,Raymond II and III are 3.571,1.620,1.406,1.439,1.502 respectively.The score of each factor is size>25mm-3,size10.1-25mm-1,coil only-1,Raymond II and III-1.The logistic model and scale demonstrated discrimination with an AUC are 0.737,0.735.Conclusions Large or giant aneurysm,without stent-assisted coiling and incomplete occlusion were independently associated with recanalization.The aneurysm recanalization scale was able to predict the risk of recanalization after endovascular treatment.Part II: Validation of Aneurysm Recanalization Scale of Patients With Endovascular Treatment of Intracranial AneurysmsObjective To assess the validation of the Aneurysm Recanalization Scale of Patients With Endovascular Treatment of Intracranial Aneurysms.Methods we retrospectively reviewed 109 aneurysms who received endovascular treatment in our Centre for intracranial aneurysms and followed up by DSA from January 2015 to June 2015.The probability of recanalization by risk score and ARSS were derived for each aneurysm.The validation was analyzed with the area under the receiver operating characteristic curve(AUC).Compare recurrence rate of all aneurysms between different score to establish the risk classification.Results There were no significant differences on the age,gender,smoking,hypertension, diabetes,aneurysm size,rupture between the two groups.(P=0.161,0.466,0.876,0.391,0.444,0.434,0.257, respectively)The risk score and ARSS score were derived for each aneurysm.The predictive value of risk score and ARSS score,in validation group were 0.738 and 0.690.The recurrence rate of each score is 0-1.59%,1-8.90%,2-28.79%,3-55.55%,4-83.33%.Low risk is defined as score 0-1,high risk is defined as score?2.AUC of the risk classification is 0.704.Conclusions The aneurysm recanalization scale was a valid prognostic index to predict the risk of recanalization after endovascular treatment.