Complete cohort - Case 32 of 83
Case 39
Assigned out-of-fold recommendation
Stent-assisted coil embolization
Alternative: Coil embolization alone
View A is AP; View B is lateral, as confirmed by the data provider.
Case summary
A 61-year-old man presents with an incidental unruptured 7.57mm x 4.1mm anterior communicating artery aneurysm with a 2.2mm neck.
Image observation
On the supplied views, the aneurysm appears as a distinct outpouching arising from the anterior circulation with patent distal flow.
Model-generated clinical rationale
The assigned recommendation of stent-assisted coil embolization is supported by the documented 2.2mm neck width, which may necessitate a stent to maintain coil stability. However, the model's preference is not definitive, and the clinical necessity of a stent remains debatable given the relatively small neck size.
Model uncertainty
The OOF classifier scores for Stent-assisted coil embolization and Coil embolization alone were close, so the assigned recommendation should be treated as uncertain.
Clinical uncertainty / missing factor
The decision is limited by the lack of explicit documentation regarding the aneurysm's dome-to-neck ratio or specific morphological features that would definitively mandate stent assistance.
Explicit evidence used
7.57mm x 4.1mm aneurysm with 2.2mm neck | Unruptured anterior communicating artery aneurysm