RPS 1009 - Emerging trends in neuro and head and neck interventional radiology

Author Block: J. H. Choi, B. Kwon, Y. Song, D. H. Lee; Seoul/KR
Purpose: Neurointerventional procedures often require simultaneous use of multiple devices, necessitating compatibility checks. Because device specifications are reported in mixed units (e.g., catheter ID in inches, OD in French, wire OD in inches), direct calculation is difficult. In addition, when more than two devices are used in a guiding catheter, simply summing outer diameters can be misleading. This study evaluated the usefulness of a self-developed, web-based compatibility checking program.
Methods or Background: A device database was built using specifications of neurointerventional devices in use since 2016. Spatial compatibility was assessed with circle geometry, and length compatibility incorporated catheter hub length and additional device placement. Clinical experience with specific combinations was also integrated. Program performance was tested using cases from 2020 to 2024 in which compatibility checks were required. Results were compared with actual clinical use or in-vitro testing to determine sensitivity, specificity, accuracy, and predictive values. Three users also measured the time required for compatibility evaluation using the program versus manual calculation.
Results or Findings: A total of 355 compatibility checks were analyzed: 126 with one insert device, 173 with two, and 56 with three. The program showed sensitivity of 94.6%, specificity of 86.4%, accuracy of 91.4%, positive predictive value of 91.5%, and negative predictive value of 91.2%. Evaluation time with the program was consistently shorter than with manual calculation across all users.
Conclusion: This web-based compatibility program provides rapid access to device specifications and supports optimal device selection by combining mathematical modeling with clinical data. Broader use across centers and accumulation of additional clinical experience are expected to enhance its reliability and clinical value.
Limitations: Although the database was constructed based on specifications provided by the manufacturers, the acceptable tolerance ranges of the devices were not specified.
Funding for this study: None
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: This retrospective study was approved by the Institutional Review Board of our institution (approval number:
No. 2025-1217)

Author Block: M. Stanton; Brisbane/AU
Purpose: Thromboembolic complications remain a significant risk in endovascular aneurysm stenting, with clopidogrel resistance implicated as a major contributing factor. This study aims to evaluate thromboembolic outcomes in clopidogrel-resistant patients undergoing endovascular aneurysm stenting and to assess whether switching to ticagrelor mitigates these risks.
Methods or Background: This single-centre retrospective cohort study included 228 patients treated between 2020 and 2024. All patients underwent VerifyNow P2Y12 testing prior to the procedure. Clopidogrel non-responders (<40% inhibition) were switched to ticagrelor. The primary endpoint was thromboembolic complication, defined as radiological or clinical infarct, aiming to capture all patients with thromboembolic complication, whether symptomatic or not. Secondary analyses evaluated aneurysm characteristics and associated risk factors.
Results or Findings: Of the 228 patients, a significant 122 patients (54%) were found to be non-responders and switched to ticagrelor. No statistically significant differences were observed in rates of clinical infarct (13% vs 11%, p=0.7) between clopidogrel responders and ticagrelor-treated non-responders. Evidence of radiological infarct was included to incorporate any asymptomatic patients and also was found to have no difference between groups (19% vs 12%, p=0.2) . Larger aneurysm size correlated with both higher number of radiological (p=0.011) and clinical infarcts (p=0.002). Diabetes and advanced age were associated with multiple aneurysms. Younger patients with prior subarachnoid haemorrhage were more likely to undergo stent-assisted coiling.
Conclusion: Preoperative platelet function testing and switching clopidogrel non-responders to ticagrelor resulted in comparable thromboembolic complication rates to clopidogrel responders. These findings support the role of routine platelet function testing and individualized antiplatelet management in endovascular aneurysm treatment.
Limitations: Limitations for this study are that it's a single centre, retrospective study. Although powered adequately, some subgroup analyses may still be underpowered.
Funding for this study: No funding was received for this study
Has your study been approved by an ethics committee? Not applicable
Ethics committee - additional information:

Author Block: F. Dugar¹, T. D. L. Nguyen-Kim¹, A. Dmytriw², D. Coluccia¹, M-N. Psychogios³, P. Sporns¹; ¹Zurich/CH, ²Boston, MA/US, ³Basel/CH
Purpose: Smaller Woven EndoBridge (WEB) devices (≤ 4.5 mm) for the treatment of intracranial aneurysms are technically challenging to deploy, and data on their safety and efficacy remain scarce. This study compared functional, anatomic, and safety outcomes of small WEBs with those of large (> 4.5 mm) and very large (> 7.5 mm) devices.
Methods or Background: The WorldWideWEB consortium is a retrospective, multicenter collaboration across 30 international institutions, including adults with intracranial aneurysms treated with WEB. Patients were stratified into small (≤ 4.5 mm) and large (> 4.5 mm) groups; a subanalysis compared small and very large (> 7.5 mm) devices. The primary outcome was retreatment rate. Secondary outcomes comprised mRS, anatomic outcomes periprocedurally and at last follow-up (FU), and safety events, including intracranial hemorrhage (ICH) and thromboembolic complications (TECs).
Results or Findings: Among 1473 patients, 229 (15.5%) received a small WEB. Baseline characteristics were similar. Retreatment was less frequent (4.3% vs 8.8%, p = 0.037) and complete occlusion higher with small WEBs (periprocedurally: 57.1% vs 36.6%, p < 0.001; last FU: 76.2% vs 58.5%, p < 0.001). Median mRS at last FU was comparable (1 [1–2] vs 1 [1–2], p = 0.88), as were safety events (ICH 2.6% vs 0.9%, p = 0.102; TECs 3.1% vs 3.9%, p = 0.686). Very large WEBs had higher retreatment (16.1%, p < 0.001) and lower complete occlusion (periprocedurally: 32.2%, p < 0.001; last FU: 50.5%, p < 0.001), with comparable safety outcomes (ICH 0.9%, p = 0.266; TECs 4.5%, p = 0.512).
Conclusion: Small WEBs showed superior anatomic outcomes and lower retreatment rates compared with large devices, without significant differences in functional or safety outcomes.
Limitations: Absence of core laboratory adjudication for anatomic outcomes and retrospective design.
Funding for this study: No funding was provided for this study.
Has your study been approved by an ethics committee? Not applicable
Ethics committee - additional information:

Author Block: N. Çetinkaya, F. Zengin, U. Erdem, E. Çamurcuoğlu; Istanbul/TR
Purpose: Mechanical thrombectomy has been shown to be effective for large vessel occlusions in the anterior circulation, but its safety and success in treating distal vasculature remain unclear. This study evaluates outcomes of M2 versus M1 occlusions in acute ischemic stroke.
Methods or Background: A retrospective analysis of prospectively collected data was performed on patients with similar NIHSS scores who underwent stent retriever-based mechanical thrombectomy for isolated M1 or M2 MCA occlusions. Between March 2022 and May 2024, 198 patients were treated: 134 (67.7%) with M1 and 64 (32.3%) with M2 occlusions. Primary outcomes included recanalization success (TICI 2b/3), periprocedural complications, hemorrhage, 90-day mRS scores, and mortality.
Results or Findings: Mechanical thrombectomy is a safe, effective treatment for MCA occlusions in both M1 and M2 segments. Recanalization rates were higher in M1 (88%) than M2 (70.3%). Procedure time averaged 91.2 minutes for M1 and 104.6 for M2. Fewer attempts were required in M2 cases (1.57 vs. 2.4). Anticoagulant use occurred in 44.2% of M2 and 40.1% of M1 cases. M2 patients were slightly older (73.0 vs. 71.8 years). Despite lower recanalization, M2 outcomes and complication rates, including hemorrhage and mortality, were comparable. NIHSS scores at admission did not differ significantly (p = 0.296). Aspiration showed high efficacy in both groups.
Conclusion: The findings indicate that. M2 thrombectomy is safe, with many patients achieving good outcomes. Angiographic and clinical results were similar to M1. Endovascular treatment of severe M2 cases does not increase procedural risk or bleeding. Poor outcomes were linked to older age and prior anticoagulant use. Therefore, stent-retriever thrombectomy should be considered for severe acute M2 occlusion.
Limitations: This study was limited by its single-center design and lack of outcome assessment beyond 90 days.
Funding for this study: This research received no specific grant from any funding agency.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: University of Health Sciences Şişli Hamidiye Etfal Training and Research Hospital Clinical Research Ethics Committee-4430

Author Block: C. Sallemi, C. Viola, F. Bodini, M. Pegorer, R. Bellosta; Brescia/IT
Purpose: To describe a novel endovascular approach using low-profile neurovascular stents for coil embolization of wide-neck visceral artery aneurysms (VAAs), with focus on a dual-stent “kissing” configuration for bifurcation aneurysms and tortuous anatomy.
Methods or Background: Thirteen patients (12 women, 1 man; mean age 57 years) with wide-neck VAAs were treated between 2020 and 2025 using intracranial remodeling stents (Solitaire AB, Medtronic; Neuroform Atlas, Stryker) adapted for visceral circulation. Aneurysm locations included splenic (n=7), renal (n=3), hepatic (n=1), and pancreaticoduodenal (n=2) arteries. A dual-stent “kissing” configuration was used in eight anatomically complex cases (bifurcation aneurysms n=6, severe tortuosity n=2). All patients received dual antiplatelet therapy with aspirin and clopidogrel (Duoplavin) starting 5 days before the procedure, continued for 1 month postoperatively, followed by aspirin monotherapy for 6 months. Technical success, periprocedural events, and contrast-enhanced CT follow-up at 6, 12, and 24 months were assessed.
Results or Findings: Technical success was achieved in all cases (100%). Mean procedural time was 95 minutes, with radiation exposure consistent with comparable endovascular procedures. Dual-stent cases involved larger aneurysms (mean 22 mm) and required more coils (mean 7.8) than single-stent cases (mean 19.8 mm; 3.2 coils). No periprocedural complications or delayed ischemic events occurred. Median hospital stay was 2 days. Follow-up CT at 6, 12, and 24 months confirmed durable aneurysm exclusion, preserved parent artery flow, and maintained stent patency in all patients.
Conclusion: The NEVAR technique is a safe and effective solution for wide-neck visceral aneurysms. The dual-stent “kissing” configuration provides stable scaffolding and precise coil delivery while maintaining branch perfusion. This approach may represent a paradigm shift for treating complex visceral aneurysms previously requiring open surgery or parent vessel sacrifice.
Limitations: Single-center, retrospective design with a small cohort; long-term validation is warranted.
Funding for this study: No external funding was received for this study
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: This study was approved by the Territorial Ethics Committee Lombardia 6 (Pavia, Italy), in the session held on July 29, 2025 (Protocol No. NEVAR, Prot. 0049213/25).

Author Block: F. Ozden, İ. Özer, U. MUSTAK, O. Taydaş, M. Ozdemir, E. Arık, V. Taşçi, Ö. F. Topaloğlu, M. H. Öztürk; Sakarya/TR
Purpose: To evaluate the current role and effectiveness of primary coiling in managing acute aneurysmal subarachnoid hemorrhage (aSAH).
Methods or Background: We conducted a retrospective single-center study involving all patients who were admitted with aSAH and treated with primary coiling between January 2019 and March 2025. The information extracted included patient demographics, such as age and sex, as well as specific details about the aneurysm, including its location, size, and morphology. The immediate angiographic outcomes were assessed based on the grade of aneurysm occlusion. Our primary focus was on two key endpoints: the rebleeding rate following the procedure and the overall mortality rate one year post-treatment.
Results or Findings: A total of 127 patients (mean age 57.0 ± 12.6 years; 76 female, 65%) who underwent primary coiling for aSAH were included in this study. The most common location for the aneurysms was the internal carotid artery (ICA) at 35.5%. The mean size of the aneurysms was 9.0 ± 5.6 mm. Immediate post-procedural angiography showed complete aneurysm occlusion (Raymond-Roy Class 1) in 35 patients (27.6%). Partial occlusion (Raymond-Roy Class 2 or 3) was observed in the remaining 92 patients (72.4%). During the 1-year follow-up period, the overall mortality rate was 20.5% (26 of 127 patients). Rebleeding from the treated aneurysm occurred in 2 patients (1.6%).
Conclusion: Primary coiling is a safe and effective method for managing aSAH. Its minimally invasive nature makes it one of the preferred treatments for aneurysms.
Limitations: Firstly, the retrospective design of this study introduces inherent selection bias and depends on the accuracy of medical records. Secondly, the lack of a direct comparative group, such as surgical clipping, prevents us from making definitive conclusions about the superiority of the treatment.
Funding for this study: This study did not receive funding from any external sources.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Sakarya University/E-43012747-050.04-463752/07.03.2025

Author Block: N. Schmitt¹, A. Berting², C. Herweh¹, T. Hilgenfeld¹, F. Preisner¹, L. Wucherpfennig¹, M. Bendszus¹, D. F. Vollherbst¹, M. Möhlenbruch¹; ¹Heidelberg/DE, ²Forchheim/DE
Purpose: Cerebral angiography remains the gold standard for diagnosing and endovascular management of cerebral aneurysms. Three-dimensional rotational angiography (3D-RA) provides superior ana-tomical detail compared to conventional 2D imaging; however, it is associated with relatively high radiation exposure, raising concerns regarding patient safety. This study aimed to evaluate the potential of copper (Cu) filtration to reduce radiation dose in 3D-RA.
Methods or Background: Forty subsequent patients undergoing endovascular treatment of unruptured cerebral aneu-rysms were included. All underwent 3D-RA using the ARTIS icono angiography system (Siemens Healthineers). In 20 patients, standard hardware with a 0.8mm aluminum (Al) filter was applied; in the subsequent 20, the Al filter was replaced by a 0.1mm Cu filter. Image quality was assessed quantitatively via contrast-to-noise ratio (CNR) and qualitatively using a five-point scale. Radiati-on dose was evaluated using entrance-skin dose (mGy) and dose-area product (Gy·cm²).
Results or Findings: Image quality was preserved in both groups with no differences in CNR (CNR±SD, Al: 20.72±1.82 vs. Cu: 20.66±1.54; p=0.93) or qualitative scoring (score±SD, Al: 4.55 ± 0.54 vs. Cu: 4.63±0.46; p=0.75). Total radiation dose was lower with Cu filtration (e.g., mGy±SD, Al: 110.63±10.75 vs. Cu: 68.70±6.03; Gy·cm²±SD, Al: 6.26±1.57 vs. Cu: 3.35±0.6733, p<0.001 respectively), corre-sponding to a dose reduction of 38% (entrance-skin dose) and 46% (dose-area product). These findings highlight Cu filtration as an effective and easily implementable strategy for dose opti-mization in 3D-RA. Given its compatibility with existing imaging protocols and its capacity to reduce patient exposure without compromising image quality, this approach is especially valu-able in young patients or in patients requiring repeated imaging.
Conclusion: Copper filtration substantially reduces radiation dose during 3D-RA while preserving image qua-lity, supporting its adoption as a practical improvement for patient safety in clinical practice.
Limitations: Retrospective. Single-center study.
Funding for this study: This study was supported by research funding from Siemens Healthineers. The authors declare no other conflicts of interest.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Approval for data collection was obtained from the local ethics committee and written informed consent was provided by all participants.

Author Block: M. Szmygin, T. Roman, P. Szmygin, M. Zbroja-Putowska, M. Czeczelewski, R. Rola; Lublin/PL
Purpose: Intracranial dural arteriovenous fistulas (DAVFs) are rare vascular malformations characterized by abnormal connections between meningeal arteries and dural venous sinuses or cortical veins. They might result from trauma, surgery, or infection. Clinical presentation varies widely, ranging from benign symptoms to life-threatening intracranial hemorrhage. This study aims to present our center’s experience with the endovascular management of DAVFs, with emphasis on technical aspects of the procedures and associated clinical outcomes.
Methods or Background: We retrospectively reviewed all patients with intracranial DAVFs Cognard grade IIb-V treated via endovascular embolization at our institution in last 10 years. DAVFs characteristics, demographics as well as procedura and clinical data were collected and evaluated. Complications and mortality rate was calculated.
Results or Findings: In total 48 patients (19 female, mean age of 53 years) were included. Most common presenting symptoms include tinnitus, headaches and neurological deficits. In majority of cases, embolizations were carried out via arterial access and treatment decisions were based by fistula angioarchitecture and venous drainage patterns. All fistulas were treated with liquid embolic (glue and ethylene vinyl alcohol copolymers). Targeted vessels included middle meningeal artery, occipital artery and meningohypophyseal trunk. Obliteration of >90% of fistula was observed in 71% of cases. Satisfactory clinical outcome (defined as >75% symptoms alleviation) was achieved in 79%. Procedural complications occurred in 2 cases. One patient died due to intracranial hemorrhage caused by embolization.
Conclusion: Endovascular embolization is a safe and effective first-line therapy for intracranial DAVFs. Careful evaluation of fistula angioarchitecture, especially venous drainage and individualized procedural planning are essential for optimal clinical outcome.
Limitations: Relatively small sample size, monocentric and retrospective character of the study as well as lack of control arm with patients treated with different methods.
Funding for this study: None
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Medical University of Lublin

Author Block: M. Szmygin¹, P. Luchowski¹, M. Zbroja-Putowska¹, M. Czeczelewski¹, T. J. Popiela²; ¹Lublin/PL, ²Krakow/PL
Purpose: While mechanical thrombectomy (MT) is an established treatment for acute ischemic stroke due to large vessel occlusion, its role in anterior cerebral artery (ACA) occlusions remains uncertain due to their rarity and conflicting clinical outcomes. This study aims to evaluate outcomes of MT in patients with primary or secondary ACA occlusions across two tertiary stroke centers in Poland.
Methods or Background: This retrospective, multicenter study included patients treated with MT for ACA occlusions between 2016 and 2024. Inclusion criteria included: ACA occlusion (segments A1–A4), NIHSS ≥6, age ≥18, and pre-stroke mRS ≤3. Clinical and procedural parameters, reperfusion success, complications and functional outcomes at 90 days were analyzed.
Results or Findings: Of the 134 patients (median age 74; 57% female), 63% had primary ACA occlusions. Risk factors included hypertension (78%), coronary artery disease (67%), and atrial fibrillation (51%). The average baseline NIHSS was 18. Intravenous thrombolysis was administered in 58% of cases. Successful reperfusion (mTICI 2B-3) was achieved in 86% of cases, with a first-pass effect in 40%. Symptomatic intracranial hemorrhage (sICH) occurred in 5% of patients . At 90 days, favorable functional outcomes (mRS 0–2) was observed in 41 patients (31%) and overall mortality rate was 37%. Higher NIHSS scores at admission and the presence of sICH were identified as independent predictors of 90-day mortality.
Conclusion: MT for ACA occlusions demonstrates high rates of successful recanalization and acceptable safety profiles. However, the moderate rate of favorable outcomes and relatively high mortality rate underscore the need for further prospective studies to define its efficacy compared to best medical therapy in this patient subgroup.
Limitations: Retrospective design of the study, absence of a control group treated with intravenous rt-PA alone and high percentage of aspiration used as a primary technique.
Funding for this study: None
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: The ethics committee of Medical University of Lublin (KE-0254/285/2019)

Author Block: A. Görmez, B. Uzunoğlu, T. Orhan, O. M. Topcuoğlu; Istanbul/TR
Purpose: The American College of Radiology Thyroid Imaging and Reporting Data System (ACR-TIRADS), Kwak-TIRADS, Korean TIRADS (K-TIRADS), European TIRADS (EU-TIRADS), American Thyroid Association (ATA), and China (C-TIRADS) provide recommendations for fine needle aspiration biopsy (FNAB) based on ultrasound findings and size in thyroid nodules. However, some malignant nodules do not meet the biopsy criteria and are missed. This study aimed to evaluate the sonographic features and clinical outcomes of malignant thyroid nodules that do not meet the biopsy criteria of the six existing international guidelines.
Methods or Background: Ultrasound images of pathologically proven malignant thyroid nodules between January 2007-2025 were retrospectively evaluated by two radiologists with 15 years of experience in thyroid ultrasonography and two radiology assistants. Nodules were classified according to ACR-TIRADS, Kwak-TIRADS, K-TIRADS, EU-TIRADS, ATA, and C-TIRADS. Categorical variables were expressed as percentages, and continuous variables as mean ± standard deviation. Chi-square and Mann–Whitney U tests were used for intergroup comparisons.
Results or Findings: A total of 277 malignant nodules with a mean diameter of 14.8±10.6 mm (range 3–74 mm) were included. Pathological confirmation was obtained by FNAB in 123 nodules and by surgery in 154 nodules. A total of 129 nodules were classified as ACR-TIRADS 5, and 56.6% of these were <10 mm. Similarly, 218 nodules were classified as EU-TIRADS 5, and 50.4% of these were <10 mm. Overall, 110 malignant nodules (39.7%) were ≤10 mm. Only 6 nodules were in TR3 category, while the remaining 104 nodules (94.5%) were in TR4 or TR5 category. However, due to the size criterion, biopsy was not recommended.
Conclusion: The current thresholds for performing and following up on FNAB are debatable. Larger study populations may determine the optimal size threshold for thyroid nodule management.
Limitations: No limitations were identified.
Funding for this study: No funding was received for this study.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: The study was approved by Yeditepe University Ethics Committee (202308Y0442).

Author Block: T. C. Yeh, C-K. Wang, W-C. Lin; Kaoshiung City/TW
Purpose: According to a previous study by Kosho Yamanouchi et al., thyroids that weigh more than 200 grams present as a predictive factor for excessive bleeding during surgery for Graves’ disease. We would like to propose that preoperative transarterial embolization (pre-op TAE) can effectively improve the intraoperative and postoperative outcomes in hyperthyroidism patients undergoing thyroidectomy, especially those with a thyroid weight of more than 120 grams.
Methods or Background: This is a single-center, retrospective study in which patients with clinically diagnosed overt hyperthyroidism that eventually underwent thyroidectomy were selected. We divided the patients into two subgroups, patients that underwent direct surgical resection and patients that underwent pre-operative embolization of thyroid arteries.
Results or Findings: A total of 55 patients were enrolled, including 36 in the resection-only group and 19 in the pre-op TAE group. The mean intraoperative blood loss in the pre-op TAE group was significantly reduced (99.5 ml) compared with the resection-only group (210.7 ml; p= 0.041) with a p-value of . Similarly, the mean postoperative hospital stay was shorter in the pre-op TAE group (1.18 days vs. 2.15 days; p<0.001). Postoperative pain, evaluated by the numerical rating scale, was also less severe in the pre-op TAE group (scores of 1–2) compared with the resection-only group (scores of 2–3; p<0.001). All differences reached statistical significance. Further stratification by thyroid specimen weight supported the hypothesis that patients with glands weighing more than 120 grams particularly benefited from pre-op TAE.
Conclusion: Pre-operative thyroid TAE can reduce the amount of intraoperative blood loss, shorten the length of hospital stay and lessen the degree of wound pain compared to those that underwent thyroidectomy directly.
Limitations: Small sample size. Potential bias in pain evaluation.
Funding for this study: This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Has your study been approved by an ethics committee? Not applicable
Ethics committee - additional information:

Author Block: X. Shan; Shanghai/CN
Purpose: To develop and validate a nomogram based on clinical and ultrasound (US) parameters for preoperative prediction of the complete absorption rate following thermal ablation (TA) in benign thyroid nodules (BTNs).
Methods or Background: This multicenter retrospective study included 372 patients with 395 BTNs treated with TA from May 2018 to September 2021. Complete absorption was defined as a volume reduction rate (VRR) of 100% at 12 months. Predictors were identified by logistic regression with LASSO selection and incorporated into a nomogram. Model performance was assessed with receiver operating characteristic analysis, calibration, decision curve analysis, and external validation.
Results or Findings: Of the 395 nodules included, 87 (22.0%) nodules achieved complete absorption at the 12-month follow-up after TA. Predictive factors included in the nomogram are location between nodule and dangerous triangle area (OR, 0.36 [95% confidence interval [CI]: 0.15, 0.84]; P =0.018), morphology (OR, 0.18 [95% CI: 0.05, 0.65]; P =0.009), vascularity (OR, 0.32 [95% CI: 0.11, 0.92]; P <0.034), volume (OR, 0.08 [95% CI: 0.01, 0.69]; P =0.021), enhancement mode (OR, 0.25 [95% CI: 0.11, 0.59]; P =0.001). This prognostic nomogram showed great calibration and discrimination with an AUC of 0.818 (95% CI, 0.759–0.878) and 0.710 (95% CI, 0.597–0.823) in the training and external validating sets, respectively.
Conclusion: A clinical nomogram was successfully established to preoperatively and noninvasively predict the complete absorption rate for nodules undergoing TA. The model might guide physicians in evaluating the efficacy of TA and to facilitate developing individualized treatment and prognostic plans.
Limitations: The number of cases is not large enough.
Funding for this study: None
Has your study been approved by an ethics committee? Not applicable
Ethics committee - additional information:

Author Block: K. Desalos, N. Amoretti; Nice/FR
Purpose: To evaluate the feasibility, safety, and clinical outcomes of percutaneous transfacet screw fixation under local anesthesia as a minimally invasive alternative for post-laminectomy instability.
Methods or Background: Prospective monocentric study (2022–2025) including 30 patients with lumbar segmental instability after laminectomy. All underwent CT- and fluoroscopy-guided percutaneous transfacet fixation under local or regional anesthesia. Pain (VAS) and quality of life (EQ-5D) were assessed preoperatively and at 1, 6, and 12 months and 2 years follow-up.
Results or Findings: Technical success rate: 100%. Significant pain reduction (mean VAS −3 points, p<0.05) and improved EQ-5D (median reduction of 2 points) were observed at 6 and 12 months. No major adverse events were reported. No cases required conversion to open fusion. Screws could be safely repositioned or removed if needed
Conclusion: CT- and fluoroscopy-guided transfacet fixation under local anesthesia is safe, feasible, and effective. It provides durable pain relief and improved quality of life, while avoiding general anesthesia, conventional surgery, and prolonged hospitalization.
Limitations: Single-center, limited sample size, and relatively short follow-up for some patients. Larger multicenter trials are required to validate long-term outcomes
Funding for this study: No funding was received for this study.
Has your study been approved by an ethics committee? Not applicable
Ethics committee - additional information: