Outcome in small aneurysms (<4 mm) treated by endovascular coiling
Bibliographic record
Abstract
BACKGROUND: Coiling of small aneurysms can be technically challenging. These aspects of coiling tend to be less problematic in medium to large aneurysms as they are more accommodating of microcatheters and coils. When physicians are asked their opinion regarding aneurysm coilability in small aneurysms, the decision often lies in the operator's feeling that they could reasonably exclude the aneurysm with a complication rate similar to larger aneurysms. The purpose of our study was to investigate the feasibility, intraprocedural rupture rates and long term durability of endovascular coiling for small (≤4 mm) aneurysms compared with non-small (>4 mm) aneurysms. To control for factors such as vessel tortuosity and aneurysm location, a control group was chosen matched to the study group both in age and aneurysm location. MATERIALS AND METHODS: A retrospective review of 360 intracranial aneurysms coiled at our institution between 2003 and 2008 was performed. For the control group, intracranial aneurysms coiled in the same period matched to location and age were chosen. RESULTS: The frequency of intraprocedural perforations was 4/34 (0.12) and 3/68 (0.04) for the small and non-small cohort, respectively (p=0.22). All patients who had a perforation in the small aneurysm groups had a good clinical outcome compared with 1/3 in the non-small group (two mortalities). The frequency of recanalization for the small and non-small groups was 3/34 (0.09) and 23/68 (0.33), respectively (p=0.006). There was no retreatments in the small aneurysm group and five (0.07) in the non-small group (p=0.116). CONCLUSION: Coiling of small (≤4 mm) aneurysms is feasible with a reasonable complication rate. There is a non-significant increase in frequency of intraprocedural rupture with coiling of small aneurysms compared with controls matched to aneurysm location and age but this is not associated with increased morbidity. Coiling of small aneurysms leads to durable results at long term follow-up.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".