Work

A multicenter hemodynamics–based nomogram predicting incomplete occlusion of intracranial aneurysms treated with pipeline embolization device

Year: 2026

Type: article

Abstract: Background This multicenter study aimed to develop and validate a hemodynamics-based nomogram for predicting incomplete occlusion (ICO) of intracranial aneurysms (IAs) after pipeline embolization device (PED) treatment. Methods 426 IAs from 362 patients were analyzed and divided into a training set ( n = 298) and a validation set ( n = 128). Morphological and hemodynamic parameters of the IAs were calculated using AneuFlow Pro. Independent predictors of ICO were identified using least absolute shrinkage and selection operator (LASSO) regression and logistic regression to develop a predictive nomogram. The nomogram's performance was evaluated using area under the curve (AUC), calibration curves, and decision curve analysis (DCA). Results The aneurysm occlusion rate of the overall cohort was 79.8% with a median angiographic follow-up time of 199 days. No significant differences were observed in patient and aneurysm characteristics between the training and validation sets. Through LASSO and logistic regression analyses, we identified smoking (OR = 0.32, 95% CI 0.14–0.68, p = 0.005), flow complexity (OR = 3.03, 95% CI 1.58–5.89, p < 0.001), device migration (OR = 11.03, 95% CI 1.51–105.55, p = 0.021), poor wall apposition (OR = 3.21, 95% CI 1.37–7.53, p = 0.007), aneurysm angle (OR = 3.46, 95% CI 1.79–6.93, p < 0.001), and low wall shear stress area ratio (LSAR; OR = 2.78, 95% CI 1.46–5.50, p = 0.002) as independent predictors of ICO. A nomogram developed based on these factors showed an AUC of 0.785 (95% CI 0.719–0.850) in the training set and 0.809 (95% CI 0.695–0.923) in the validation set, demonstrating consistent calibration and excellent clinical use. Conclusion The hemodynamics-based nomogram developed in this study effectively predicted ICO of IAs after PED treatment.

Source: Frontiers in Neurology

DOI: 10.3389/fneur.2026.1756374

Authors: Yawen Zhao, Li Bao, Shuang He, Yunfeng Zhang

Institution: Affiliated Hospital of Nantong University

Language: English

Topic: Intracranial Aneurysms: Treatment and Complications

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801