Complete cohort - Case 52 of 83
Case 61
Assigned out-of-fold recommendation
Coil embolization alone
Alternative: Flow diversion with coil embolization
View A is AP; View B is lateral, as confirmed by the data provider.
Case summary
A 75-year-old male presents with an unruptured right ACA A1 aneurysm measuring 5.3 mm x 4 mm x 5.4 mm with a 3.1 mm neck and a daughter sac.
Image observation
On the supplied views, a saccular outpouching appears on the proximal anterior cerebral artery with a visible neck connecting to the parent vessel.
Model-generated clinical rationale
The documented dimensions and neck width suggest a morphology that may be amenable to endovascular coiling. However, the presence of a daughter sac and the specific neck-to-dome ratio are critical factors that are not fully quantified in the narrative, potentially complicating coil stability.
Model uncertainty
The OOF classifier showed a relatively clear preference for Coil embolization alone over Flow diversion with coil embolization, but its scores are not probabilities of clinical correctness.
Clinical uncertainty / missing factor
The precise neck-to-dome ratio and the exact relationship of the daughter sac to the aneurysm neck are missing, which are essential for determining the feasibility of coil-only treatment versus adjunctive techniques.
Explicit evidence used
Unruptured right ACA A1 aneurysm | Dimensions 5.3 mm x 4 mm x 5.4 mm with 3.1 mm neck | Presence of a daughter sac