Interobserver variability in the assessment of aneurysm occlusion with the WEB aneurysm embolization system

David Fiorella, Adam Arthur, James Byrne, Laurent Pierot, Andy Molyneux, Gary Duckwiler, Thomas McCarthy, Charles Strother

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective The WEB (WEB aneurysm embolization system, Sequent Medical, Aliso Viejo, California, USA) is a self-expanding, nitinol, mesh device designed to achieve aneurysm occlusion after endosaccular deployment. The WEB Occlusion Scale (WOS) is a standardized angiographic assessment scale for reporting aneurysm occlusion achieved with intrasaccular mesh implants. This study was performed to assess the interobserver variability of the WOS. Methods Seven experienced neurovascular specialists were trained to apply the WOS. These physicians independently reviewed angiographic image sets from 30 patients treated with the WEB under blinded conditions. No additional clinical information was provided. Raters graded each image according to the WOS (complete occlusion, residual neck or residual aneurysm). Final statistics were calculated using the dichotomous outcomes of complete occlusion or incomplete occlusion. The interobserver agreement was measured by the generalized κ statistic. Results In this series of 30 test case aneurysms, observers rated 12-17 as completely occluded, 3-9 as nearly completely occluded, and 9-11 as demonstrating residual aneurysm filling. Agreement was perfect across all seven observers for the presence or absence of complete occlusion in 22 of 30 cases. Overall, interobserver agreement was substantial (κ statistic 0.779 with a 95% CI of 0.700 to 0.857). Conclusions The WOS allows a consistent means of reporting angiographic occlusion for aneurysms treated with the WEB device.

Original languageEnglish (US)
Pages (from-to)591-595
Number of pages5
JournalJournal of NeuroInterventional Surgery
Volume7
Issue number8
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Observer Variation
Aneurysm
Equipment and Supplies
Neck
Physicians

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Interobserver variability in the assessment of aneurysm occlusion with the WEB aneurysm embolization system. / Fiorella, David; Arthur, Adam; Byrne, James; Pierot, Laurent; Molyneux, Andy; Duckwiler, Gary; McCarthy, Thomas; Strother, Charles.

In: Journal of NeuroInterventional Surgery, Vol. 7, No. 8, 01.01.2015, p. 591-595.

Research output: Contribution to journalArticle

Fiorella, David ; Arthur, Adam ; Byrne, James ; Pierot, Laurent ; Molyneux, Andy ; Duckwiler, Gary ; McCarthy, Thomas ; Strother, Charles. / Interobserver variability in the assessment of aneurysm occlusion with the WEB aneurysm embolization system. In: Journal of NeuroInterventional Surgery. 2015 ; Vol. 7, No. 8. pp. 591-595.
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abstract = "Objective The WEB (WEB aneurysm embolization system, Sequent Medical, Aliso Viejo, California, USA) is a self-expanding, nitinol, mesh device designed to achieve aneurysm occlusion after endosaccular deployment. The WEB Occlusion Scale (WOS) is a standardized angiographic assessment scale for reporting aneurysm occlusion achieved with intrasaccular mesh implants. This study was performed to assess the interobserver variability of the WOS. Methods Seven experienced neurovascular specialists were trained to apply the WOS. These physicians independently reviewed angiographic image sets from 30 patients treated with the WEB under blinded conditions. No additional clinical information was provided. Raters graded each image according to the WOS (complete occlusion, residual neck or residual aneurysm). Final statistics were calculated using the dichotomous outcomes of complete occlusion or incomplete occlusion. The interobserver agreement was measured by the generalized κ statistic. Results In this series of 30 test case aneurysms, observers rated 12-17 as completely occluded, 3-9 as nearly completely occluded, and 9-11 as demonstrating residual aneurysm filling. Agreement was perfect across all seven observers for the presence or absence of complete occlusion in 22 of 30 cases. Overall, interobserver agreement was substantial (κ statistic 0.779 with a 95{\%} CI of 0.700 to 0.857). Conclusions The WOS allows a consistent means of reporting angiographic occlusion for aneurysms treated with the WEB device.",
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AU - Byrne, James

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AU - Duckwiler, Gary

AU - McCarthy, Thomas

AU - Strother, Charles

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N2 - Objective The WEB (WEB aneurysm embolization system, Sequent Medical, Aliso Viejo, California, USA) is a self-expanding, nitinol, mesh device designed to achieve aneurysm occlusion after endosaccular deployment. The WEB Occlusion Scale (WOS) is a standardized angiographic assessment scale for reporting aneurysm occlusion achieved with intrasaccular mesh implants. This study was performed to assess the interobserver variability of the WOS. Methods Seven experienced neurovascular specialists were trained to apply the WOS. These physicians independently reviewed angiographic image sets from 30 patients treated with the WEB under blinded conditions. No additional clinical information was provided. Raters graded each image according to the WOS (complete occlusion, residual neck or residual aneurysm). Final statistics were calculated using the dichotomous outcomes of complete occlusion or incomplete occlusion. The interobserver agreement was measured by the generalized κ statistic. Results In this series of 30 test case aneurysms, observers rated 12-17 as completely occluded, 3-9 as nearly completely occluded, and 9-11 as demonstrating residual aneurysm filling. Agreement was perfect across all seven observers for the presence or absence of complete occlusion in 22 of 30 cases. Overall, interobserver agreement was substantial (κ statistic 0.779 with a 95% CI of 0.700 to 0.857). Conclusions The WOS allows a consistent means of reporting angiographic occlusion for aneurysms treated with the WEB device.

AB - Objective The WEB (WEB aneurysm embolization system, Sequent Medical, Aliso Viejo, California, USA) is a self-expanding, nitinol, mesh device designed to achieve aneurysm occlusion after endosaccular deployment. The WEB Occlusion Scale (WOS) is a standardized angiographic assessment scale for reporting aneurysm occlusion achieved with intrasaccular mesh implants. This study was performed to assess the interobserver variability of the WOS. Methods Seven experienced neurovascular specialists were trained to apply the WOS. These physicians independently reviewed angiographic image sets from 30 patients treated with the WEB under blinded conditions. No additional clinical information was provided. Raters graded each image according to the WOS (complete occlusion, residual neck or residual aneurysm). Final statistics were calculated using the dichotomous outcomes of complete occlusion or incomplete occlusion. The interobserver agreement was measured by the generalized κ statistic. Results In this series of 30 test case aneurysms, observers rated 12-17 as completely occluded, 3-9 as nearly completely occluded, and 9-11 as demonstrating residual aneurysm filling. Agreement was perfect across all seven observers for the presence or absence of complete occlusion in 22 of 30 cases. Overall, interobserver agreement was substantial (κ statistic 0.779 with a 95% CI of 0.700 to 0.857). Conclusions The WOS allows a consistent means of reporting angiographic occlusion for aneurysms treated with the WEB device.

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