The PHASES score: To treat or not to treat? Retrospective evaluation of the risk of rupture of intracranial aneurysms in patients with aneurysmal subarachnoid hemorrhage

Pagiola, Igor; Mihalea, Cristian; Caroff, Jildaz; Ikka, Léon; Chalumeau, Vanessa; Iacobucci, Marta; Ozanne, Augustin; Gallas, Sophie; Marques, Marcio Chaves; Nalli, Dárcio; Carrete, Henrique; Caldas, José Guilherme Mendes Pereira; Frudit, Michel Eli; Moret, Jacques; Spelle, Laurent

doi:10.1016/j.neurad.2019.06.003

Cited by 37 publications

(19 citation statements)

References 14 publications

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“…Several methods, such as clinical risk factor assessments and scoring systems, have been used in IA stratification in clinical practice [ 4 , 5 , 29 ]. However, the usage of these clinical tools in clinical practice remains controversial [ 30 – 32 ], especially for patients with MIAs. This study intended to establish a relatively accurate, convenient, and noninvasive method for assessing IA rupture based on radiomics-extracted morphological features.…”

Section: Discussionmentioning

confidence: 99%

Morphology-based radiomics signature: a novel determinant to identify multiple intracranial aneurysms rupture

Tong

Feng

Peng

et al. 2021

Aging

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We aimed to develop and validate a morphology-based radiomics signature nomogram for assessing the risk of intracranial aneurysm (IA) rupture. A total of 254 aneurysms in 105 patients with subarachnoid hemorrhage and multiple intracranial aneurysms from three centers were retrospectively reviewed and randomly divided into the derivation and validation cohorts. Radiomics morphological features were automatically extracted from digital subtraction angiography and selected by the least absolute shrinkage and selection operator algorithm to develop a radiomics signature. A radiomics signature-based nomogram was developed by incorporating the signature and traditional morphological features. The performance of calibration, discrimination, and clinical usefulness of the nomogram was assessed. Ten radiomics morphological features were selected to build the radiomics signature model, which showed better discrimination with an area under the curve (AUC) equal to 0.814 and 0.835 in the derivation and validation cohorts compared with 0.747 and 0.666 in the traditional model, which only include traditional morphological features. When radiomics signature and traditional morphological features were combined, the AUC increased to 0.842 and 0.849 in the derivation and validation cohorts, thus showing better performance in assessing aneurysm rupture risk. This novel model could be useful for decision-making and risk stratification for patients with IAs.

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Section: Discussionmentioning

confidence: 99%

Morphology-based radiomics signature: a novel determinant to identify multiple intracranial aneurysms rupture

Tong

Feng

Peng

et al. 2021

Aging

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“…Comorbidities were recorded in the categories of arterial hypertension, type 2 diabetes mellitus, and nicotine consumption. The PHASES score was calculated for each patient according to Greving et al [21,22]. Angiographic imaging was reviewed for aneurysm site, size, and shape [23].…”

Section: Methodsmentioning

confidence: 99%

Management of Cavernous Carotid Artery Aneurysms: A Retrospective Single-Center Experience

et al. 2022

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Objective: While cavernous carotid aneurysms can cause neurological symptoms, their often-uneventful natural course and the increasing options of intravascular aneurysm closure call for educated decision-making. However, evidence-based guidelines are missing. Here, we report 64 patients with cavernous carotid aneurysms, their respective therapeutic strategies, and follow-up. Methods: We included all patients with cavernous carotid aneurysms who presented to our clinic between 2014 and 2020 and recorded comorbidities (elevated blood pressure, diabetes mellitus, and nicotine consumption), PHASES score, aneurysm site, size and shape, therapeutic strategy, neurological deficits, and clinical follow-up. Results: The mean age of the 64 patients (86% female) was 53 years, the mean follow-up time was 3.8 years. A total of 22 patients suffered from cranial nerve deficit. Of these patients, 50% showed a relief of symptoms regardless of the therapy regime. We found no significant correlations between aneurysm size or PHASES score and the occurrence of neurological symptoms. Conclusion: If aneurysm specific symptoms persist over a longer period of time, relief is difficult to achieve despite aneurysm treatment. Patients should be advised by experts in neurovascular centers, weighing the possibility of an uneventful course against the risks of treatment. In this regard, more detailed prospective data is needed to improve individual patient counseling.

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“…Designed to help interventionalists decide whether to proceed with neurointervention or consider conservative management, the UIATS uses a more complex score. However, both the PHASES and UIATS scores exhibited low sensitivity in retrospective studies performed on SAH patients [18,19]. Recently, a third predicting score, the Intracranial Aneurysm Rupture Score (IARS), has been published [20].…”

Section: Rupture Predicting Scoresmentioning

confidence: 99%

Endovascular Treatment of Intracranial Aneurysms

Adamou

Alexandrou

Roth

et al. 2021

Life

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Traditionally, surgical clipping was the only available treatment modality for intracranial aneurysms. However, in the last few decades, the endovascular therapy of intracranial aneurysms (IAs) has seen a tremendous evolution and development. From coiling to flow diversion and flow disruptor devices, endovascular treatment modalities have increased in number and received broader indications throughout the years. In this review article, the treatment modalities for the endovascular management of IAs are presented, emphasizing newer devices and technologies.

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The PHASES score: To treat or not to treat? Retrospective evaluation of the risk of rupture of intracranial aneurysms in patients with aneurysmal subarachnoid hemorrhage

Cited by 37 publications

References 14 publications

Morphology-based radiomics signature: a novel determinant to identify multiple intracranial aneurysms rupture

Morphology-based radiomics signature: a novel determinant to identify multiple intracranial aneurysms rupture

Management of Cavernous Carotid Artery Aneurysms: A Retrospective Single-Center Experience

Endovascular Treatment of Intracranial Aneurysms

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