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Interobserver agreement after pipeline embolization device implantation.

S H Suh¹, H J Cloft, G Lanzino

¹Department of Radiology, Gangnam Severance Hospital, Yonsei University, Seoul, Korea.

AJNR. American Journal of Neuroradiology

|January 1, 2013

Summary

This summary is machine-generated.

Interobserver agreement for assessing intracranial aneurysm occlusion after Pipeline embolization device (PED) therapy is excellent. A 3-point grading system showed high reliability, with few major discrepancies in occlusion assessment.

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Area of Science:

Neurology
Interventional Neuroradiology
Medical Devices

Background:

Flow diversion devices are increasingly used for intracranial aneurysm treatment.
Standardized angiographic assessment and its reliability are crucial for evaluating treatment efficacy.
Limited studies have assessed interobserver variability in grading outcomes after flow diversion.

Purpose of the Study:

To evaluate the interobserver agreement of a 3-point grading system for angiographic outcomes after Pipeline embolization device (PED) therapy for saccular intracranial aneurysms.
To identify factors that may influence agreement in occlusion assessment.

Main Methods:

Five independent readers assessed pretreatment and follow-up angiograms of 96 patients treated with PED.
A 3-point grading system (complete, near-complete, incomplete occlusion) was used.
Interobserver agreement was analyzed using the intraclass correlation coefficient (ICC), with subgroup analysis for previously coiled aneurysms.

Main Results:

Excellent interobserver agreement was observed (ICC = 0.76).
Absolute agreement was achieved in 77% of cases; complete occlusion was unanimously agreed upon in 67 cases.
Major discrepancies (complete vs. incomplete occlusion) occurred in only 7.3% of cases. Minor discrepancies were more frequent in previously coiled aneurysms.

Conclusions:

The 3-point grading system demonstrates excellent interobserver agreement for assessing angiographic occlusion after PED therapy.
The Pipeline embolization device (PED) offers reliable outcomes with high consensus among observers.
The grading system is reliable, with a low rate of significant disagreement, supporting its use in clinical practice and research.