Abstract
Novel angiographic grading scales for the assessment of intracranial aneurysms treated with flow-diverting stents have been recently developed because previous angiographic grading scales cannot be applied to these aneurysms. The purpose of this study was to evaluate the inter- and intraobserver variability of the novel O'Kelly Marotta grading scale, which was developed specifically for the angiographic assessment of aneurysms treated with flow-diverting stents. Multiple raters (n = 31) from the disciplines of neuroradiology and neurosurgery were presented with pre- and posttreatment angiographic images of 14 aneurysms treated with intraluminal flow diverters. Raters were asked to classify pre- and posttreatment angiograms by using the OKM grading scale. Statistical analyses were subsequently performed with calculation of a generalized multirater κ statistic for assessment of inter- and intraobserver variability and by performing a Wilcoxon signed rank sum test for assessment of group differences. Variability analysis of the OKM grading scale yielded substantial (κ = 0.74) and almost perfect (κ = 0.99) inter- and intraobserver agreement, respectively, with no statistically significant differences between raters with a background of neuroradiology versus neurosurgery or attending physician versus trainee. The OKM grading scale for the assessment of intracranial aneurysms treated with flow-diverting stents is a reliable grading scale that can be used equally well by users of varying backgrounds and levels of training. Comparison with interobserver variability of pre-existing angiographic grading scales shows equal or better performance.
Highlights
BACKGROUND AND PURPOSENovel angiographic grading scales for the assessment of intracranial aneurysms treated with flowdiverting stents have been recently developed because previous angiographic grading scales cannot be applied to these aneurysms
The OKM grading scale for the assessment of intracranial aneurysms treated with flow-diverting stents is a reliable grading scale that can be used well by users of varying backgrounds and levels of training
We present here an analysis of the interand intraobserver variability of the OKM grading scale based on evaluation of conventional angiographic images of aneurysms pre- and posttreatment with flow-diverting stents by 31 evaluators with a background in neurointervention from the disciplines of neuroradiology and neurosurgery
Summary
BACKGROUND AND PURPOSENovel angiographic grading scales for the assessment of intracranial aneurysms treated with flowdiverting stents have been recently developed because previous angiographic grading scales cannot be applied to these aneurysms. The purpose of this study was to evaluate the inter- and intraobserver variability of the novel O’Kelly Marotta grading scale, which was developed for the angiographic assessment of aneurysms treated with flow-diverting stents
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