E-081 Assessment of the MAFA Ratio as a Quantitative Prognostic Marker of Aneurysm Occlusion after Flow Diverter Treatment
Notice bibliographique
Résumé
Introduction Flow-diverter stents (FDSs) have been used effectively to treat wide neck and complex intracranial aneurysms (IAs). However, treatment strategies vary significantly. Previously, the normalized mean aneurysm flow amplitude ratio (MAFA-R) has been described as a novel metric to quantify aneurysm flow reduction that occurs as a result of FD stenting. The aim of this study was to evaluate the performance of the MAFA-R in predicting complete occlusion for IAs treated with FDSs. Materials and methods We included patients harboring unruptured saccular IAs, which were treated with flow diverter stents. For each patient, a 3D rotational angiogram was performed prior to implantation and two high frame rate DSA sequences were acquired respectively pre- and post- FD stenting. The aneurysmal flow reduction as indicated by the MAFA-R was calculated using dedicated software (AneurysmFlow, Philips Healthcare). The MAFA-R performance for prediction of complete aneurysm occlusion was tested against the thrombosis incidence at 3, 6, and 12 months by using the receiver operating characteristic (ROC) analysis performance test. The AUC was determined, as well as the threshold maximizing the sum of sensitivity and specificity. The analysis was carried out on the total aneurysm cohort as well as for a subgroup of aneurysms >10 mm. Results We included 54 consecutive patients. All cases were successfully treated with a[o1] flow diverter stent. At 3 months follow-up, 11 out of 54 aneurysms were fully occluded (20%), and 43 displayed residual circulation (80%). The performance of MAFA-R test for the total cohort was: AUC = 0.60, p = 0.386 and threshold = 0.62. At 6 months 31/54 aneurysms occluded (57%), AUC = 0.657, p = 0.414, threshold = 0.93. At 12 months 39/52 aneurysms occluded (75%), AUC = 0.66, p = 0.081, threshold =0.89. For the large aneurysm subgroup, the results were: at 3 months 2/19 aneurysms occluded (11%): AUC = 0.97, p = 0.014, threshold = 0.64; at 6 months 7/19 aneurysms occluded (37%): AUC = 0.82, p < 0.0001, threshold = 0.93; and at 12 months 11/18 aneurysms occluded (61%): AUC = 0.91, p < 0.0001, threshold = 0.89. Conclusions Aneurysm occlusion after FD stenting is determined by multiple factors including aneurysm size, morphology and the hemodynamic environment. While for the total aneurysm cohort no significance was reached, the results of this study show that for large aneurysms, the MAFA-R is an independent predictor of aneurysm occlusion at 12 months follow up (MAFA-R threshold = 0.89). This real-time functional assessment may potentially help the clinician to adapt the treatment during the procedure by adding further FDS layers or intra-saccular coils. [o1]Some cases were implanted with 2 devices, BB4-4AE2-9764-89B1B81991A1$$ Disclosures V. Mendes Pereira: 1; C; Philips, Medtronic. O. Brina: None. J. Bracken: 5; C; Philips. T. Krings: None. K. Lovblad: None. F. van Nijnatten: 5; C; Philips. D. Ruijters: 5; C; Philips. T. Grünhagen: 5; C; Philips.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».