CT Angiography in Occlusion Assessment of Intracranial Aneurysms Treated with the WEB Device

Capabilities of CTA for evaluation of intracranial aneurysms treated with the Woven EndoBridge (WEB) system has not been thoroughly studied yet. Our aim is to compare the ability of CTA to that of DSA to depict the occlusion status of aneurysms treated with WEB device and present the level of reproducibility of results from CTA.

Patients with intracranial aneurysm treated only with the WEB device and having a CTA and a DSA during the same hospital stay were included. Aneurysm occlusion was evaluated by two methods: a simplified binomial system grading as either adequate occlusion (complete occlusion or neck remnant) or aneurysm remnant and a four-grade scale. Interobserver and intermodality agreement were determined using the κ statistic. Using DSA as a reference test, the diagnostic capabilities of CTA were calculated.

Sixteen patients with 16 aneurysms were included. Interobserver agreement was fair for DSA (κ = .26) and good for CTA (κ = .78) using the four-grade scale, and moderate for DSA (κ = .44) and good for CTA (κ = .63) using the binomial scale. CTA and DSA were in agreement in 15 of 16 aneurysms (93.75%) using the binomial scale meaning good intermodality agreement for aneurysm remnant detection (κ = .63). Sensitivity of CTA for detection of an aneurysm remnant was 50%, specificity was 100%, positive prediction value was 100%, and negative prediction value was 93.33%.

CTA is a reliable and reproducible method to evaluate the aneurysm occlusion status and could be implemented on the follow-up of aneurysms treated with WEB.