Cerebrovascular diseases (CVDs) such as aneurysms, arteriovenous malformations, stenosis, and Moyamoya disease are major public health concerns. Accurate classification of these conditions is essential for timely intervention, yet current computer-aided methods often exhibit limited representational capacity, feature redundancy, and insufficient interpretability, restricting clinical applicability. We propose PASAformer, a Swin-Transformer-based framework for cerebrovascular disease classification on Digital Subtraction Angiography (DSA). PASAformer incorporates a Pathology-Aware Sparse Attention (PASA) module that emphasizes lesion-related regions while suppressing background redundancy. Inserted into the Swin backbone, PASA replaces dense window self-attention, improving computational efficiency while preserving the hierarchical architecture. We further employ the MiAMix data augmenter to increase sample diversity, and incorporate a CombinedAdapter encoder that injects anatomical priors from the frozen Medical Segment Anything Model (MED-SAM) into early-stage representations, strengthening discriminative power under limited supervision. To support research in this underexplored area, we curate CDSA-NEO, a proprietary DSA dataset comprising more than 1,700 static images across four major cerebrovascular disease categories, constituting the first large-scale benchmark of its kind. Furthermore, an external cohort of angiographic runs with sequential, unselected frames is used to assess robustness in realistic temporal workflows. Extensive experiments on CDSA-NEO and public vascular datasets demonstrate that PASAformer achieves competitive precision and balanced accuracy compared to representative state-of-the-art models, while providing more focused visual explanations. These results suggest that PASAformer can support automated cerebrovascular disease classification on angiography, and that CDSA-NEO provides a benchmark for future method development and evaluation.
Chen et al. (Thu,) studied this question.