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Research ArticleNeurointervention
Open Access

Noninvasive Angiographic Results of Clipped or Coiled Intracranial Aneurysms: An Inter- and Intraobserver Reliability Study

A. Benomar, B. Farzin, G. Gevry, W. Boisseau, D. Roy, A. Weill, D. Iancu, F. Guilbert, L. Létourneau-Guillon, G. Jacquin, C. Chaalala, M.W. Bojanowski, M. Labidi, R. Fahed, D. Volders, T.N. Nguyen, J.-C. Gentric, E. Magro, G. Boulouis, G. Forestier, J.-F. Hak, J.S. Ghostine, Z. Kaderali, J.J. Shankar, M. Kotowski, T.E. Darsaut and J. Raymond
American Journal of Neuroradiology September 2021, 42 (9) 1615-1620; DOI: https://doi.org/10.3174/ajnr.A7236

Article Figures & Data

Figures

  • FIG 1.
    FIG 1.

    Illustrative cases from the portfolio of CTA clipped or MRA coiled aneurysms for each grade. The left MCA (A), anterior communicating artery (B), and right MCA (C) are CTA examples of clipped aneurysms, while the left superior cerebellar artery (D), basilar tip (E), and left MCA (F) are MRA examples of coiled aneurysms. Grade 1 (A and D): complete occlusion; grade 2 (B and E): residual neck (<2 mm using visual estimation only); grade 3 (C and F): residual aneurysm.

  • FIG 2.
    FIG 2.

    Total number of follow-up management choices (n = 1440) per chosen grade of aneurysm residuum. A choice or judgment is defined as a rater’s choice of grade and clinical follow-up management for a selected treated aneurysm. FU indicates follow-up.

Tables

  • Table 1:

    Characteristics of patients and aneurysms included in the portfolioa

    CharacteristicsClipped (n = 30)Coiled (n = 30)Total (n = 60)
    Women24 (80%)22 (73%)46 (77%)
    Age (yr)54.5 (SD, 10.4)51.1 (SD, 13.0)52.8 (SD, 11.8)
    Ruptured aneurysms15 (50%)20 (67%)35 (58%)
    Retreated aneurysms4 (13%)6 (20%)10 (17%)
    Anterior circulation28 (93%)19 (63%)47 (78%)
    Aneurysm size (mm)11.0 (2–27)9.7 (3–30)10.4 (2–30)
    Wide neck (>4 mm)17 (56%)14 (47%)31 (52%)

    • ↵a Data are (No.) (%), mean (SD), or mean (minimum–maximum).

  • Table 2:

    Interrater agreement for the grading scalea

    CTA, Surgical (n = 30)MRA, Endovascular (n = 30)Total
    (n = 60)
    Overall0.58 (0.44–0.69)0.69 (0.56–0.76)0. 63 (0.55–0.70)
    Experience
     Junior (0–10 years; n = 14)0.59 (0.43–0.72)0.68 (0.56–0.76)0.64 (0.54–0.71)
     Senior (>10 years; n = 10)0.56 (0.40–0.68)0.69 (0.55–0.77)0.62 (0.52–0.69)
    Background
     Core lab (n = 2)0.74 (0.54–0.87)0.81 (0.63–0.91)0.77 (0.64–0.86)
     INR (n = 11)0.54 (0.38–0.68)0.65 (0.53–0.74)0.60 (0.50–0.68)
     DNR (n = 2)0.58 (0.23–0.80)0.87 (0.72–0.97)0.73 (0.55–0.85)
     NSX (n = 7)0.67 (0.54–0.77)0.71 (0.56–0.81)0.69 (0.59–0.76)
     INL (n = 4)0.53 (0.30– 0.71)0.72 (0.57–0.82)0.63 (0.50–0.73)

    • Note:—INR indicates interventional neuroradiology; DNR, diagnostic neuroradiology; NSX, neurosurgery; INL, interventional neurology.

    • ↵a Data are αK (95% CI) for the ordinal 3-grade classification. Classification grades: 1, complete occlusion; 2, residual neck (<2 mm); 3, residual aneurysm.

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Noninvasive Angiographic Results of Clipped or Coiled Intracranial Aneurysms: An Inter- and Intraobserver Reliability Study
A. Benomar, B. Farzin, G. Gevry, W. Boisseau, D. Roy, A. Weill, D. Iancu, F. Guilbert, L. Létourneau-Guillon, G. Jacquin, C. Chaalala, M.W. Bojanowski, M. Labidi, R. Fahed, D. Volders, T.N. Nguyen, J.-C. Gentric, E. Magro, G. Boulouis, G. Forestier, J.-F. Hak, J.S. Ghostine, Z. Kaderali, J.J. Shankar, M. Kotowski, T.E. Darsaut, J. Raymond
American Journal of Neuroradiology Sep 2021, 42 (9) 1615-1620; DOI: 10.3174/ajnr.A7236
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