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This study investigated whether pre-treatment geometric and hemodynamic characteristics from image-based blood flow simulations are associated with clinical outcome and follow-up CNS shape modifications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Pre-treatment vascular geometries and blood flow simulations were analyzed in 39 CNS-treated cases. Geometric, hemodynamic, and ostium-flow clustering features were extracted, followed by global feature thinning to reduce redundancy. Associations with binary clinical outcome and follow-up shape modifications (SM1\u2013SM3) were assessed using nonparametric univariate statistics with false discovery rate correction. Exploratory outcome discrimination was evaluated using a support vector machine classifier.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Aneurysm geometry showed the strongest association with clinical outcome. Smaller dome and ostium areas were associated with positive outcome (Cliff\u2019s\n                      <jats:italic>\u03b4<\/jats:italic>\n                      \u2009=\u2009\u2009\u2212\u20090.57 and\u2009\u2212\u20090.43), while hemodynamic parameters showed weaker but directionally consistent trends, including lower peak outflow velocity, and reduced inflow intensity. Shape-modification patterns differed across deformation classes. SM1 and SM2 showed no FDR-significant features but moderate effects for aneurysm geometry and selected hemodynamic metrics. SM3 showed the strongest associations with oscillatory flow characteristics (\n                      <jats:italic>\u03b4<\/jats:italic>\n                      \u2248 0.56\u20130.57) and peripheral outflow dominance. Exploratory machine learning showed limited, non-significant outcome discrimination (mean AUC\u2009=\u20090.57), with selected features consistent with univariate findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pre-treatment geometric and hemodynamic characteristics are linked not only to clinical outcome but also to post-treatment CNS shape modifications. By linking pre-operative flow conditions to follow-up device behavior, this study improves the understanding of hemodynamic factors associated with CNS shape modifications and suggests that simulation-based analysis may support future patient-specific treatment planning using exclusively pre-operative data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11548-026-03777-y","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T16:20:11Z","timestamp":1787415611000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcome prediction of Contour Neurovascular System treatment based on pre-treatment geometric and hemodynamic characteristics"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1702-6533","authenticated-orcid":false,"given":"Fina","family":"Gie\u00dfler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Bernovskis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Gaidzik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Korte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Berg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f6nke","family":"Peters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Larsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Saalfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,22]]},"reference":[{"issue":"2","key":"3777_CR1","doi-asserted-by":"publisher","first-page":"141","DOI":"10.26443\/mjm.v9i2.672","volume":"9","author":"A Keedy","year":"2006","unstructured":"Keedy A (2006) An overview of intracranial aneurysms. 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