Complete cohort - Case 82 of 83
Case 98
Assigned out-of-fold recommendation
Stent-assisted coil embolization
Alternative: Flow diversion alone
View A is AP; View B is lateral, as confirmed by the data provider.
Case summary
A 66-year-old woman presents with an unruptured basilar tip aneurysm measuring 5.3 mm with a 2.4 mm neck.
Image observation
On the supplied views, a saccular outpouching appears at the basilar apex with patent bilateral posterior cerebral arteries.
Model-generated clinical rationale
The assigned recommendation of stent-assisted coil embolization is supported by the documented 2.4 mm neck width, which may necessitate adjunctive support for coil retention. However, the model scores indicate a close alternative to flow diversion, suggesting the anatomical features do not definitively favor one modality over the other.
Model uncertainty
The OOF classifier scores for Stent-assisted coil embolization and Flow diversion 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 irregularities that would definitively prioritize stenting over flow diversion.
Explicit evidence used
Unruptured basilar tip aneurysm | Aneurysm dimensions 5.3 mm by 3.8 mm with 2.4 mm neck