Complete cohort - Case 65 of 83
Case 80
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 58-year-old female presents with an unruptured 8.9 x 5.3 mm wide-necked anterior communicating artery aneurysm.
Image observation
On the supplied views, a saccular outpouching appears at the anterior communicating artery junction, with the parent vessel demonstrating a tortuous course.
Model-generated clinical rationale
The documented wide-necked morphology of the aneurysm provides the primary anatomical justification for the assigned stent-assisted coil embolization technique. However, the recommendation is limited by the lack of specific details regarding the aneurysm's orientation relative to the parent vessel or the presence of critical branch vessels that might necessitate stent support.
Model uncertainty
The OOF score distribution was diffuse: Stent-assisted coil embolization ranked first, but Coil embolization alone remained a material alternative.
Clinical uncertainty / missing factor
The most significant missing decision factor is the precise aneurysm neck-to-dome ratio and the specific relationship of the neck to the anterior communicating artery branches.
Explicit evidence used
8.9 x 5.3mm wide-necked anterior communicating artery aneurysm | Unruptured anterior communicating artery aneurysm