Complete cohort - Case 62 of 83
Case 77
Assigned out-of-fold recommendation
Coil embolization alone
Alternative: Stent-assisted coil embolization
View A is AP; View B is lateral, as confirmed by the data provider.
Case summary
A 51-year-old patient presents with an unruptured 7.2mm right A1 aneurysm with a 3.4mm neck, identified via diagnostic angiography following inconclusive non-invasive imaging.
Image observation
On the supplied views, a saccular outpouching appears to project superiorly and anteriorly from the A1 segment, with the parent vessel and adjacent vasculature opacified.
Model-generated clinical rationale
The assigned recommendation of coil embolization alone is supported by the documented neck width of 3.4mm, which may allow for primary coiling without adjunctive devices. However, the narrative explicitly notes the aneurysm's complex morphology, which could complicate coil stability and potentially necessitate stent assistance.
Model uncertainty
The OOF score distribution was diffuse: Coil embolization alone ranked first, but Stent-assisted coil embolization remained a material alternative.
Clinical uncertainty / missing factor
The definitive suitability of primary coiling remains uncertain due to the lack of specific morphological details regarding the dome-to-neck ratio or irregularities that might compromise coil retention.
Explicit evidence used
7.2mm x 3.6mm x 6.5mm aneurysm with 3.4mm neck | Complex morphology of this aneurysm