Complete cohort - Case 78 of 83
Case 94
Assigned out-of-fold recommendation
Coil embolization alone
Alternative: Balloon-assisted coil embolization
View A is AP; View B is lateral, as confirmed by the data provider.
Case summary
A 48-year-old female presents for elective treatment of an unruptured left A1 aneurysm measuring approximately 4.2 x 3.7 x 3.7 mm with a 1.6 mm neck.
Image observation
On the supplied views, a saccular aneurysm appears at the carotid terminus with contrast filling the adjacent A1 and M1 segments.
Model-generated clinical rationale
The documented 1.6 mm neck width suggests a favorable neck-to-dome ratio that may support the feasibility of coil embolization alone. The small aneurysm dimensions and lack of reported wide-neck morphology provide a basis for this classification. However, the recommendation is limited by the absence of explicit documentation regarding the aneurysm's specific dome morphology or the presence of incorporated branch vessels.
Model uncertainty
The OOF classifier showed a relatively clear preference for Coil embolization alone over Balloon-assisted coil embolization, but its scores are not probabilities of clinical correctness.
Clinical uncertainty / missing factor
The specific dome morphology and the exact relationship of the aneurysm neck to the A1 origin are not fully detailed, which are critical factors for determining the necessity of balloon assistance.
Explicit evidence used
aneurysm measuring approx. 4.2 x 3.7 x 3.7 | neck measuring approx. 1.6mm