Class | Description | Commentaries |
Class 1 | Complete aneurysm occlusion | In aneurysms with no incorporated branches |
1A | With full patency of the integrated branch | Subclassification 1A–C is reserved for aneurysms cases with an incorporated branch |
1B | With the branch reduced in caliber | |
1C | With no anterograde filling of the branch | |
Class 2 | Residual neck filling | |
Class 3 | Residual aneurysm filling | Residual aneurysms with unaltered dimensions, regardless of the presence of a side branch |
3A | With stable residuum in a sidewall aneurysm (with no incorporated branch) | Residual aneurysm with no incorporated branch showing stable or progressive reduced size on subsequent follow-up(s) |
3C | With documented growth | Aneurysms showing growth on subsequent angiogram, regardless of the presence of a side branch |
Class 4 | Aneurysm filling (immediate results) | Class 4 is reserved for immediate postoperative results |
4A | With contrast stagnation within the aneurysm sac | |
4B | Without contrast stagnation | |
Class 5 | Residual aneurysm filling with remodeling | Aneurysms with an incorporated vessel branch demonstrating stable reduced size on subsequent follow-up(s)* |
5A | Progressive remodeling | Aneurysm with an incorporated vessel branch demonstrating a progressive decrease in dimensions on subsequent follow-up(s)* |
For satisfactory radiological classification of aneurysm remodeling, two imaging controls are required (at least 6 months apart) and extending beyond 1 year of the index procedure.
*According to the original definition, there is an exceptional situation in which class 5 can be adjudicated at the first imaging control. It pertains to cases in which the branch is seen patent but with a different contrast course than originally expected within the aneurysm sac, in the absence of apparent aneurysm filling.