An online dynamic nomogram for predicting the recurrence of patients with endovascular treatment of intracranial aneurysms

Purpose Intracranial aneurysm (IA) is a serious cerebrovascular disease with a relatively high incidence, once ruptured, it an cause severely mortality and morbidity rate. Currently, endovascular coiling has become one of the main treatment methods for IAs.The purpose of this study is to develop and validate a novel clinically assessment system dynamic nomogram based on pre- and post-operative clinical and imaging characteristics to predict IAs recurrence after patients treated with endovascular coiling. Methods This single-institution retrospective study collected 113 patients with single IA who underwent coil embolization. Patients were followed up by using digital subtraction angiography (DSA) or Computed Tomography Angiography (CTA) or Magnetic Resonance Angiography (MRA) to observe IAs recurrence in 12 months after coil embolization. The univariate and multivariate logistic regression analysis were used to select recurrence factors to generate the nomogram. The discrimination and calibration of the nomogram were assessed using concordance index (C-index), area under time-dependent receiver operating characteristic curve (ROC), and calibration curves. Decision curve analysis (DCA) was used to assess clinical utility. Result Logistic regression analysis identified age, angle inflow tract > 90℃ and postoperative Raymond grade II or III as predictors of IAs recurrence after patients treated with endovascular coiling (all P < 0.05). The area under ROC curve (AUC) of the nomogram was 0.838 suggested satisfactory discriminative ability of the nomogram. The calibration plots with a 1,000 bootstrap resampling indicated that probabilities predicted by the nomogram favorable consistency with the actual observation. The DCA showed that our model can gain a greater net benefit. Conclusion This useful technique of nomogram was developed and validated which can help physicians in predicting the recurrence of patients with endovascular coiling of IAs.