Stories» Go to news main
Angiographic results of surgical or endovascular treatment of intracranial aneurysms: a systematic review and inter‑observer reliability study
Publication by Dr. David Volders.
Results of surgical or endovascular treatment of intracranial aneurysms are often assessed using angiography. A reliable method to report results irrespective of treatment modality is needed to enable comparisons. Our goals were to systematically review existing classification systems, and to propose a 3-point classification applicable to both treatments and assess its reliability.
We conducted two systematic reviews on classification systems of angiographic results after clipping or coiling to select a simple 3-category scale that could apply to both treatments. We then circulated an electronic portfolio of angiograms of clipped (n=30) or coiled (n=30) aneurysms, and asked raters to evaluate the degree of occlusion using this scale. Raters were also asked to choose an appropriate follow-up management for each patient based on the degree of occlusion. Agreement was assessed using Krippendorff’s α statistics (αK), and relationship between occlusion grade and clinical management was analyzed using Fisher’s exact and Cramer’s V tests.
The systematic reviews found 70 different grading scales with heterogeneous reliability (kappa values from 0.12 to 1.00). The 60-patient portfolio was independently evaluated by 19 raters of diverse backgrounds (neurosurgery, radiology, and neurology) and experience. There was substantial agreement (αK=0.76, 95%CI, 0.67–0.83) between raters, regardless of background, experience, or treatment used. Intra-rater agreement ranged from moderate to almost perfect. A strong relationship was found between angiographic grades and management decisions (Cramer’s V: 0.80±0.12).
A simple 3-point scale demonstrated sufficient reliability to be used in reporting aneurysm treatments or in evaluating treatment results in comparative randomized trials.
- Post‑administration dosimetry in yttrium‑90 radioembolization through micro‑CT imaging of radiopaque microspheres in a porcine renal model
- Canadian Society of Thoracic Radiology/Canadian Association of Radiologists Best Practice Guidance for Investigation of Acute Pulmonary Embolism, Part 1: Acquisition and Safety Considerations
- Optimal Transport Scenario for Access to Endovascular Therapy With Consideration of Patient Outcomes and Cost
- Dalhousie Radiology outperforms again at the Canadian Association of Radiologists Annual Meeting
- Angiographic results of surgical or endovascular treatment of intracranial aneurysms: a systematic review and inter‑observer reliability study
- The Many Care Models to Treat Thoracic Aortic Disease in Canada – A Nationwide Survey of Cardiac Surgeons, Cardiologists, Interventional Radiologists and Vascular Surgeons
- Reliability of the Diagnosis of Cerebral Vasospasm Using Catheter Cerebral Angiography: A Systematic Review and Inter‑ and Intraobserver Study
- Magnetic Resonance Imaging Based Radiomic Models of Prostate Cancer: A Narrative Review
comments powered by Disqus