Development of the SAFETEA endovascular and neurosurgical risk prediction scores for complications of preventive intracranial aneurysm treatment
Refereed conference paper presented and published in conference proceedings


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AbstractBackground And Aims: In management decisions on saccular unruptured intracranial aneurysms (UIA) the complication risk of preventive aneurysm treatment is an important factor. To improve individualized prediction of treatment complications, we developed risk prediction scores for complications of endovascular treatment (EVT) and neurosurgical treatment (NST).

Methods: We combined data from UIA patients who underwent EVTor NST between 2000 and 2018 in 10 centres from three continents. EVT was subdivided into simple coiling, balloon-assisted coiling, stent-assisted coiling, WEB-device or flow-diverter. For NST we only included clipping. The primary outcome was procedural (30-day) death or any neurological complication. All complications were assessed in a multidisciplinary setting. We performed logistic regression analyses to study the association between predictors and procedural risk. Model performance was assessed with concordance (c) statistics and calibration plots.

Results: We included 1288 UIA patients. Predictors of treatment complications were Size of aneurysm, Aneurysm location, Familial UIA or SAH, Earlier vascular disease, Treatment modality (for EVT), Treatment complexity (for NST; artery from aneurysm neck or dome-neck-ratio >2.5), Experience and Age at treatment. This resulted in the acronym SAFETEA. For the EVT model, the c-statistic was 0.73 (95%CI:0.68–0.78) and the absolute risk of complications ranged from 1 to 74%. For the NST model, the c-statistic was 0.72 (95%CI:0.67–0.77) and the absolute risk of complications ranged from 2 to 82%.

Conclusions: The SAFETEA risk scores for EVT and NST are easily applicable aids for prediction of the risk of treatment complications in patients with UIA.

Trial Registration Number: Not applicable
Acceptance Date08/11/2020
All Author(s) ListA.M. Algra, J. Greving, J. De Winkel, A. Kurtelius, K. Laban, D. Verbaan, R. Van Den Berg, P. Vandertop5, A. Lindgren, T. Krings, P. Woo, G. Wong, B. Roozenbeek, A. Van Es, R. Dammers, N. Etminan, H.D. Boogaarts,
I. Van Der Schaaf, T. Van Doormaal, A. Van Der Zwan, G.J.E. Rinkel, M. Vergouwen
Name of ConferenceWorld Stroke Congress
Start Date of Conference07/11/2020
End Date of Conference09/11/2020
Place of ConferenceVirtual
Country/Region of ConferenceAustria
Proceedings TitleInternational Journal of Stroke
Year2020
Volume Number15
Issue NumberSuppl 1
Pages45 - 46
ISSN1747-4930
eISSN1747-4949
LanguagesEnglish-United Kingdom

Last updated on 2022-15-01 at 00:37