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Research ArticleNeurointervention

Differences in the Angiographic Evaluation of Coiled Cerebral Aneurysms between a Core Laboratory Reader and Operators: Results of the Cerecyte Coil Trial

I. Rezek, R.K. Lingineni, M. Sneade, A.J. Molyneux, A.J. Fox and D.F. Kallmes
American Journal of Neuroradiology January 2014, 35 (1) 124-127; DOI: https://doi.org/10.3174/ajnr.A3623
I. Rezek
aFrom the Departments of Radiology (I.R., D.F.K.)
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R.K. Lingineni
bHealth Sciences Research (R.K.L.)
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M. Sneade
dOxford Neurovascular and Neuroradiology Research Unit (M.S., A.J.M.), Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
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A.J. Molyneux
dOxford Neurovascular and Neuroradiology Research Unit (M.S., A.J.M.), Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
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A.J. Fox
eDepartment of Neuroradiology (A.J.F.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
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D.F. Kallmes
aFrom the Departments of Radiology (I.R., D.F.K.)
cNeurosurgery (D.F.K.), Mayo Clinic, Rochester, Minnesota
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    Table 1:

    Definitions of the scales of assessment used

    Angiographic Assessment Scale in the Current StudyOperator Angiographic Assessment ScaleaCore Laboratory Angiographic Assessment Scale Immediately after EmbolizationCore Laboratory Angiographic Assessment Scale at Follow-Up
    Grade 1Complete occlusionApparently complete occlusion or overlapping coils/neckComplete occlusion
    Grade 2Subtotal occlusion or neck remnantNeck remnantStable neck appearance/neck remnant
    Grade 3Incomplete occlusion/aneurysm fillingInflow/incomplete occlusion (body filling)Residual filling
    • ↵a Cases assessed as “failed embolization” by the operators were excluded from the analysis of this study.

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    Table 2:

    Immediate postembolization angiographic appearance on the 3-point scale

    Core Laboratory ReadingsOperator Readings
    Grade 1, n (%)aGrade 2, n (%)Grade 3, n (%)Total
    Grade 1108 (48)41 (24)18 (46)167
    Grade 297 (43)100 (59)18 (46)215
    Grade 321 (9)28 (17)3 (8)52
    Total22616939434
    • ↵a Percentages follow columnar order.

    • View popup
    Table 3:

    Follow-up angiographic appearance on the 3-point scale

    Core Laboratory ReadingsOperator Readings
    Grade 1, n (%)aGrade 2, n (%)Grade 3, n (%)Total
    Grade 1105 (43)24 (16)1 (2)130
    Grade 2124 (51)80 (55)19 (43)223
    Grade 314 (6)43 (29)24 (55)81
    Total24314744434
    • ↵a Percentages follow columnar order.

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    Table 4:

    Agreement between operators and the core laboratory reader on different time point assessments

    Simple κ Coefficient (95% CI)Interpretation
    Immediately after embolization on 3-point scale0.138 (0.067–0.209)Slight agreement
    Follow-up on 3-point scale0.189 (0.121–0.258)Slight agreement
    Favorable versus unfavorable outcomes0.121 (0.042–0.199)Slight agreement
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American Journal of Neuroradiology: 35 (1)
American Journal of Neuroradiology
Vol. 35, Issue 1
1 Jan 2014
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Cite this article
I. Rezek, R.K. Lingineni, M. Sneade, A.J. Molyneux, A.J. Fox, D.F. Kallmes
Differences in the Angiographic Evaluation of Coiled Cerebral Aneurysms between a Core Laboratory Reader and Operators: Results of the Cerecyte Coil Trial
American Journal of Neuroradiology Jan 2014, 35 (1) 124-127; DOI: 10.3174/ajnr.A3623

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Differences in the Angiographic Evaluation of Coiled Cerebral Aneurysms between a Core Laboratory Reader and Operators: Results of the Cerecyte Coil Trial
I. Rezek, R.K. Lingineni, M. Sneade, A.J. Molyneux, A.J. Fox, D.F. Kallmes
American Journal of Neuroradiology Jan 2014, 35 (1) 124-127; DOI: 10.3174/ajnr.A3623
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