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To explore whether computed morphologic features can be used as independent predictors of incomplete occlusion of aneurysms treated with the Pipeline embolization device.

From January 2016 to September 2017, 58 patients with 58 aneurysms were treated with the Pipeline embolization device. Aneurysms were manually segmented from the Digital Imaging and Communications in Medicine file, and we calculated 16 shape features voxel by voxel on the segmented aneurysm image. Along with 13 other clinical and radiographic variables, we performed univariate and multivariate analysis to explore predictors of incomplete occlusion.

At last angiographic follow-up (median 6.2 months), complete occlusion was achieved in 41 aneurysms (70.7%). In multivariate analysis, malapposition of stent (odds ratio = 0.03; 95% confidence interval, 0.00–0.32; P = 0.004) and higher elongation value …