Sheng-Qi Hu, Chun Zeng, Jinbiao Yao, Mirzat Turhon, Ting Liu, Wenqiang Li, Xinjian Yang
{"title":"后交通动脉瘤血管内治疗后不完全闭塞的定量数字减影血管造影分析及预测因素。","authors":"Sheng-Qi Hu, Chun Zeng, Jinbiao Yao, Mirzat Turhon, Ting Liu, Wenqiang Li, Xinjian Yang","doi":"10.1007/s00234-025-03780-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify predictive factors for incomplete occlusion in posterior communicating artery (PCoA) aneurysms after endovascular treatment (EVT) and investigate the role of fetal-type posterior cerebral artery (fPCA) in occlusion outcomes using quantitative digital subtraction angiography (QDSA).</p><p><strong>Methods: </strong>We analyzed 287 patients with 292 PCoA aneurysms treated with EVT between 2016 and 2022. Aneurysms were categorized into incomplete (n = 49) and complete (n = 243) occlusion groups based on follow-up DSA. Clinical, morphological, and hemodynamic parameters from QDSA were compared, and independent risk factors were identified via multivariate logistic regression. Predictive performance was evaluated using area under the curve (AUC) and subgroup analysis with Benjamini-Hochberg correction for fPCA effects.</p><p><strong>Results: </strong>Independent risk factors for incomplete occlusion included size (p < 0.001, OR = 1.127), neck cerebral blood flow (CBF) (p = 0.001, OR = 4.024), simple coiling (p < 0.001, OR = 4.635), ruptured status (p = 0.002, OR = 3.281), and fPCA (p = 0.030, OR = 2.218). AUCs for the combined model, size, neck CBF, simple coiling, ruptured status, and fPCA were 0.822, 0.721, 0.708, 0.656, and 0.603, respectively. In the fPCA subgroup, ruptured status, neck CBF, neck cerebral blood volume (CBV), PCoA CBF, and PCoA CBV showed significance, while in the non-fPCA subgroup, only simple coiling and size remained significant.</p><p><strong>Conclusion: </strong>Size, neck CBF, simple coiling, ruptured status, and fPCA are independent risk factors for incomplete occlusion in PCoA aneurysms treated with EVT. fPCA likely influences incomplete occlusion through hemodynamic changes.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Quantitative digital subtraction angiography analysis and predictive factors for incomplete occlusion in posterior communicating artery aneurysms after endovascular treatment.\",\"authors\":\"Sheng-Qi Hu, Chun Zeng, Jinbiao Yao, Mirzat Turhon, Ting Liu, Wenqiang Li, Xinjian Yang\",\"doi\":\"10.1007/s00234-025-03780-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study aimed to identify predictive factors for incomplete occlusion in posterior communicating artery (PCoA) aneurysms after endovascular treatment (EVT) and investigate the role of fetal-type posterior cerebral artery (fPCA) in occlusion outcomes using quantitative digital subtraction angiography (QDSA).</p><p><strong>Methods: </strong>We analyzed 287 patients with 292 PCoA aneurysms treated with EVT between 2016 and 2022. Aneurysms were categorized into incomplete (n = 49) and complete (n = 243) occlusion groups based on follow-up DSA. Clinical, morphological, and hemodynamic parameters from QDSA were compared, and independent risk factors were identified via multivariate logistic regression. Predictive performance was evaluated using area under the curve (AUC) and subgroup analysis with Benjamini-Hochberg correction for fPCA effects.</p><p><strong>Results: </strong>Independent risk factors for incomplete occlusion included size (p < 0.001, OR = 1.127), neck cerebral blood flow (CBF) (p = 0.001, OR = 4.024), simple coiling (p < 0.001, OR = 4.635), ruptured status (p = 0.002, OR = 3.281), and fPCA (p = 0.030, OR = 2.218). AUCs for the combined model, size, neck CBF, simple coiling, ruptured status, and fPCA were 0.822, 0.721, 0.708, 0.656, and 0.603, respectively. In the fPCA subgroup, ruptured status, neck CBF, neck cerebral blood volume (CBV), PCoA CBF, and PCoA CBV showed significance, while in the non-fPCA subgroup, only simple coiling and size remained significant.</p><p><strong>Conclusion: </strong>Size, neck CBF, simple coiling, ruptured status, and fPCA are independent risk factors for incomplete occlusion in PCoA aneurysms treated with EVT. fPCA likely influences incomplete occlusion through hemodynamic changes.</p>\",\"PeriodicalId\":19422,\"journal\":{\"name\":\"Neuroradiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-09-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neuroradiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00234-025-03780-1\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00234-025-03780-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Quantitative digital subtraction angiography analysis and predictive factors for incomplete occlusion in posterior communicating artery aneurysms after endovascular treatment.
Purpose: This study aimed to identify predictive factors for incomplete occlusion in posterior communicating artery (PCoA) aneurysms after endovascular treatment (EVT) and investigate the role of fetal-type posterior cerebral artery (fPCA) in occlusion outcomes using quantitative digital subtraction angiography (QDSA).
Methods: We analyzed 287 patients with 292 PCoA aneurysms treated with EVT between 2016 and 2022. Aneurysms were categorized into incomplete (n = 49) and complete (n = 243) occlusion groups based on follow-up DSA. Clinical, morphological, and hemodynamic parameters from QDSA were compared, and independent risk factors were identified via multivariate logistic regression. Predictive performance was evaluated using area under the curve (AUC) and subgroup analysis with Benjamini-Hochberg correction for fPCA effects.
Results: Independent risk factors for incomplete occlusion included size (p < 0.001, OR = 1.127), neck cerebral blood flow (CBF) (p = 0.001, OR = 4.024), simple coiling (p < 0.001, OR = 4.635), ruptured status (p = 0.002, OR = 3.281), and fPCA (p = 0.030, OR = 2.218). AUCs for the combined model, size, neck CBF, simple coiling, ruptured status, and fPCA were 0.822, 0.721, 0.708, 0.656, and 0.603, respectively. In the fPCA subgroup, ruptured status, neck CBF, neck cerebral blood volume (CBV), PCoA CBF, and PCoA CBV showed significance, while in the non-fPCA subgroup, only simple coiling and size remained significant.
Conclusion: Size, neck CBF, simple coiling, ruptured status, and fPCA are independent risk factors for incomplete occlusion in PCoA aneurysms treated with EVT. fPCA likely influences incomplete occlusion through hemodynamic changes.
期刊介绍:
Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.