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P164 Retrospective application of risk scores to unruptured anterior communicating artery aneurysms
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  1. Katarzyna Wójtowicz1,
  2. Łukasz Przepiórka2,
  3. Sławomir Kujawski3,
  4. Edyta Maj2,
  5. Andrzej Marchel2,
  6. Przemysław Kunert2
  1. 1Medical University of Warsaw, Poland
  2. 2Medical University of Warsaw
  3. 3Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń

Abstract

Introduction Treatment decisions for unruptured intracranial aneurysms (UIAs) pose a challenge for neurosurgeons, prompting the development of clinical scales assessing hemorrhage risk to provide management guidance.

Aim of Study This study compares recommendations from the PHASES and UIA treatment scores (UIATS) applied to anterior communicating artery (AComA) UIAs against real-world management.

Methods While UIATS recommends management, for PHASES, an aneurysm with score of 10 or more was considered ’high-risk’. Analysis involved assessing the concordance in each group alongside comparison to real-word management

Results Among 129 patients, 46.5% were observed and 53.5% were treated. PHASES scores were significantly higher in the treatment group (p = 0.00002), and UIATS recommendations correlated with real-world decisions (p < 0.001). We observed no difference in the frequencies of UIATS recommendations between high- and low-risk groups. When comparing the UIATS and PHASES, 33% of high-risk aneurysms received a UIATS conservative management recommendation. In 39% of high-risk aneurysms, the UIATS recommendation was not definitive. Conversely, 27% of low-risk aneurysms obtained a UIATS UIA repair recommendation. Overall, concordance between PHASES and UIATS was 32%

Conclusion Significant discordance in therapeutic suggestions underscores the predominant influence of center experience and individual assessments. Future studies should refine and validate decision-making strategies, potentially exploring alternative applications or developing tailored scales.

Disclosure of Interest no.

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