ArticleNeuroradiology2026
Dynamic risk stratification using the modified Cekirge-Saatci classification (mCSC) predicts recanalization after flow diversion.
Article in Neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate the temporal evolution of the modified Cekirge-Saatci classification (mCSC) after flow diverter (FD) treatment and to investigate its predictive value for recanalization using an exploratory mCSC-based risk stratification approach.
methodsThis retrospective study included 50 patients with intracranial aneurysms treated with FD between 2015 and 2026. Patients were stratified into no-risk, intermediate-risk, and high-risk levels based on mCSC classes at 4- and 12-month angiographic follow-up. Clinical, morphological, and treatment-related variables were analyzed. The association between mCSC risk levels and recanalization was assessed using univariate and multivariate logistic regression analyses.
resultsThe mean age was 55.2 ± 12.9 years, and 70% of patients were female. Recanalization occurred in 28% of cases during a mean follow-up of 104.8 ± 24.4 months. In univariate analysis, hypertension (71.4% vs. 36.1%, p = 0.024) and aneurysm size (median 5.5 mm vs. 3.5 mm, p = 0.036) were associated with recanalization. Both 4-month and 12-month mCSC risk levels were significantly correlated with recanalization (p = 0.015 and p = 0.014, respectively). In multivariate analysis, the 12-month mCSC risk level remained associated with recanalization within the exploratory multivariable model, with higher-risk categories demonstrating increased odds of recanalization (OR: 31.031, p = 0.015). Temporal analysis demonstrated dynamic transitions between risk categories, with a subset of patients progressing from no to high risk over time.
conclusionThe mCSC should be considered a dynamic rather than a static classification system. A risk-based interpretation and longitudinal evaluation of mCSC may provide prognostic information regarding recanalization and may assist future development of individualized follow-up strategies after FD treatment.
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