Abstract
This study aims to develop and validate nomograms for predicting the risk of aneurysm rupture and adverse prognosis in patients with Moyamoya disease (MMD) and associated intracranial aneurysms (IAs). We analyzed 286 saccular and 22 non-saccular IAs from 231 MMD patients. We used logistic regression to identify risk factors for IA rupture and Cox regression to find factors associated with prognosis. Nomograms were constructed using R 4.3.3 software based on these risk factors and validated via receiver operating characteristic (ROC) curves, calibration curves, and clinical decision curves. Among 3293 MMD patients, 231 (7.01%) harbored IAs. Saccular IAs had a higher rupture rate (24.2%) compared to non-saccular IAs (13.64%). Independent risk factors for rupture in non-saccular IAs included the presence of a daughter sac, whereas the location, flow angle, and aspect ratiowere risk factors for saccular IA rupture. Prognostic factors included rerupture and modified Fisher scale. The constructed nomograms demonstrated robust predictive performance in the validation cohort. Our nomograms effectively predict the risk of rupture in saccular IAsand poor prognosis in MMD patients with IAs, offering valuable tools for clinical decision-making.