David Fiorella1, Adam Arthur2, James Byrne3, Laurent Pierot4, Andy Molyneux3, Gary Duckwiler5, Thomas McCarthy6, Charles Strother7. 1. Stony Brook University Medical Center, Stony Brook, New York, USA. 2. Semmes-Murphy Clinic, Memphis, Tennessee, USA. 3. Oxford University Neurovascular and Neuroradiology Research Unit, Oxford, UK. 4. Hôpital Maison-Blanche, Université Reims-Champagne-Ardenne, Reims, France. 5. Department of Interventional Neuroradiology, UCLA, Los Angeles, California, USA. 6. Sequent Medical, Inc, Aliso Viejo, California, USA. 7. University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: L Pierot; J Moret; F Turjman; D Herbreteau; H Raoult; X Barreau; S Velasco; H Desal; A-C Januel; P Courtheoux; J-Y Gauvrit; C Cognard; A Molyneux; J Byrne; L Spelle Journal: AJNR Am J Neuroradiol Date: 2015-10-29 Impact factor: 3.825
Authors: A Rouchaud; W Brinjikji; Y-H Ding; D Dai; Y Q Zhu; H J Cloft; D F Kallmes; R Kadirvel Journal: AJNR Am J Neuroradiol Date: 2015-09-24 Impact factor: 3.825
Authors: Jacob Cherian; Stephen R Chen; Ajit Puri; Kunal Vakharia; Elad Levy; Sheila Eshraghi; Brian M Howard; Frank C Tong; C Michael Cawley; Bradley Gross; Matthew D Alexander; Ramesh Grandhi; Visish M Srinivasan; Jan-Karl Burkhardt; Jeremiah N Johnson; Peter Kan Journal: Neurosurgery Date: 2021-07-15 Impact factor: 4.654