The factors affecting the prognosis of complex intracranial aneurysms treated with pipeline flow-direction device and the construction of a nomogram prediction model
10.3969/j.issn.1008-794X.2024.09.003
- VernacularTitle:Pipeline血流导向装置治疗复杂性颅内动脉瘤预后的影响因素及列线图预测模型构建
- Author:
Ziyin ZHANG
1
;
Dong QIU
;
Ping ZHENG
;
Yang AN
;
Tao ZHANG
;
Xuesong TANG
;
Zhixing YAN
;
Suwen LI
;
Liping YIN
;
Yongji JIANG
;
Ligang HU
;
Jingfeng TANG
Author Information
1. 642350 四川 安岳 安岳县人民医院介入科
- Keywords:
pipeline flow-direction device;
complex intracranial aneurysm;
multivariate analysis;
nomogram predictive model
- From:
Journal of Interventional Radiology
2024;33(9):944-949
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the factors influencing the prognosis of complex intracranial aneurysms treated with pipeline flow-directed device(PED)and to develop a nomogram prediction model.Methods The clinical data of a total of 98 patients with complex intracranial aneurysm,who were admitted to the Anyue County People's Hospital or the Second Affiliated Hospital of Guilin Medical College of China from January 2021 to April 2023 to receive PED treatment,were retrospectively analyzed.The influencing factors that might affect the prognosis of patients with complex intracranial aneurysm were collected.According to the modified Rankin Scale(mRS)score,the patients were divided into good prognosis group(being defined as mRS ≤2 points)and poor prognosis group(being defined as mRS＞2 points).The clinical data were compared between the two groups,and a nomogram model was established and validated.Results In the 98 patients,poor prognosis was seen in 10(10.20％).The differences in age,history of hypertension,history of diabetes mellitus,clopidogrel resistance,Fisher classification,repeated aneurysm rupture,aneurysm location,aneurysm size,aneurysm neck,multiple lesions,and Hunt-Hess grade on admission between good prognosis group and poor prognosis group were statistically significant(all P＜0.05).Multivariate analysis revealed that history of hypertension,clopidogrel resistance,repeated aneurysm rupture,aneurysm location,multiple lesions,and Hunt-Hess grade were the independent factors influencing the prognosis of patients with complex intracranial aneurysm after receiving PED treatment.The AUC of the nomogram model in predicting the prognosis of PED for complex intracranial aneurysms was 0.849(95％CI=0.758-0.939).The predicted curves of the model group and validation group were basically fitted to the standard curves.The results of the decision curve analysis showed that the net benefit to patients was greater than 0 when the probability threshold of the nomogram model for predicting a poor prognosis of PED for complex intracranial aneurysms was 0.10-0.90.Conclusion The factors causing poor prognosis of PED for complex intracranial aneurysms mainly include history of hypertension,clopidogrel resistance,repeated aneurysm rupture,etc.The nomogram model established in this study can predict the risk of poor prognosis in patients with complicated intracranial aneurysm after receiving PED treatment.
