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

Rezek, Issa; Lingineni, Ravi K.; Sneade, Mary; Molyneux, Andrew; Fox, Allan J.; Kallmes, David F.

doi:10.3174/ajnr.a3623

Cited by 44 publications

(33 citation statements)

References 23 publications

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“…In HELPS, differences in occlusion grades were reversed (favoring hydrogel) at the time of follow-up imaging. 13 Thus, if one keeps in mind that angiographic outcomes judged locally are typically more optimistic than corelaboratory results, 26,27 these preliminary findings cannot be used to anticipate follow-up imaging results, which remain to be collected, analyzed by the core lab, and reported. While we wait for long-term results from this trial and witness an increasing use of flow diversion for large, wide-neck, and recurrent aneurysms (a practice with as-yet-unknown short-and long-term benefits), 28 the PRET trial serves as a reminder that difficult aneurysms can be coiled with a safety that will be difficult to improve.…”

Section: Discussionmentioning

confidence: 99%

Patients Prone to Recurrence after Endovascular Treatment: Periprocedural Results of the PRET Randomized Trial on Large and Recurrent Aneurysms

Raymond

Klink

Chagnon

et al. 2014

American Journal of Neuroradiology

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BACKGROUND AND PURPOSE: Some patients with large or recurrent aneurysms may be at increased risk of recurrence postcoiling. The Patients Prone to Recurrence after Endovascular Treatment (PRET) trial was designed to assess whether hydrogel coils were superior to platinum coils in these high-risk patients. This article reports periprocedural safety and operator-assessed angiographic results from the PRET trial.

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Section: Discussionmentioning

confidence: 99%

Patients Prone to Recurrence after Endovascular Treatment: Periprocedural Results of the PRET Randomized Trial on Large and Recurrent Aneurysms

Raymond

Klink

Chagnon

et al. 2014

American Journal of Neuroradiology

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“…In 3 studies, the evaluated sample was judged to be of limited representativeness, as 1 study included only aneurysms of the Anterior Communicating Artery; 6 in 1 study, 71% of aneurysms originated from the Anterior Communicating Artery, 8 and 1 study 14 did not observe middle cerebral artery aneurysms. About the quality of image analysis and risk for bias, 2 studies pointed out that they did not provide any specific training to the readers 29,30 ; the other studies did not comment on this point. Twenty-two studies explicitly stated that raters were blinded to the findings of other raters.…”

Section: Methodological Characteristics Of the Included Studiesmentioning

confidence: 99%

Is Visual Evaluation of Aneurysm Coiling a Reliable Study End Point?

Ernst

Yoo

Kriston

et al. 2015

Stroke

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Background and Purpose-Angiographic occlusion as a surrogate marker of satisfactory aneurysm treatment is commonly used in clinical trials although some pitfalls have to be considered. To investigate the inter-rater reliability of visual rating of aneurysm occlusion as study end point, we performed a systematic review and meta-analysis. Methods-Electronic databases (MEDLINE, EMBASE, PubMed, and the Cochrane Library) were searched up to June 2014. Assessment of risk for bias was based on the Quality Appraisal Tool for Studies of Diagnostic Reliability and the Guidelines for Reporting Reliability and Agreement studies. Inter-rater reliability estimates were pooled across studies using meta-analysis, and the influence of several factors (eg, imaging methods, grading scales, and occlusion rate) was tested with meta-regression. Results-From 1193 titles, 644 abstracts and 87 full-text versions were reviewed. Twenty-six articles met the inclusion criteria and provided 77 reliability estimates. Twenty-one different rating scales were used, and statistical analysis varied. Mean inter-rater agreement of the pooled studies was substantial (κ=0.65; 95% confidence interval, 0.60-0.69).Reliability varied significantly as a function of imaging methods, grading scales, occlusion rates, and their interaction. Observer agreement substantially increased with increasing occlusion rate in digital subtraction angiography but not in MR angiography. Reliability was higher in studies using 2-or 3-value grading scales than in studies with 4-value grading scales. Conclusions-There is significant heterogeneity between studies evaluating the reliability of visual evaluation of aneurysm coiling. On the basis of our analysis, we found that the combination of magnetic resonance angiography, 3-value grading scale, and 2 trained raters seems most promising for usage as surrogate study end points. Ernst et al Reliability of Visual Evaluation of Aneurysm Coiling 1575 Data Sources and Study SelectionStudies were identified by searching electronic databases (Ovid MEDLINE and EMBASE, PubMed, and the Cochrane Library) up to June 2014. The full electronic search strategy for all databases is presented in Table I in the online-only Data Supplement. In addition, we handsearched systematic reviews and high-impact journals in the field of interventional neuroradiology (Stroke, American Journal of Neuroradiology, and Neuroradiology).The reference lists of all retrieved articles were checked for other relevant articles. Duplicates were removed, and the titles and abstracts of the retrieved articles were reviewed for appropriateness to the study question. Case reports, conference abstracts, reviews, editorials, meta-analysis, guidelines, and animal studies were excluded. Only articles in English, German, French, and Spanish were screened.From the remaining articles, full-text versions were reviewed in detail. Studies were eligible for inclusion if they evaluated the reliability of MRA or DSA of patients with intracranial aneurysms treated with endovascular c...

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“…9,11 To be consistent with prior publications that did not recognize the difference between presumed complete occlusion and overlapping coils/neck, and to facilitate comparison between baseline and follow-up angiographic appearance, overlapping coils/neck was combined with complete occlusion, and no change at follow-up was assigned to the postembolization category. 8,11 Cases with incomplete angiographic data or no follow-up data were excluded from this analysis.…”

Section: Methodsmentioning

confidence: 99%

Effects of Circle of Willis Anatomic Variations on Angiographic and Clinical Outcomes of Coiled Anterior Communicating Artery Aneurysms

Tarulli

Sneade

Clarke

et al. 2014

American Journal of Neuroradiology

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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

Cited by 44 publications

References 23 publications

Patients Prone to Recurrence after Endovascular Treatment: Periprocedural Results of the PRET Randomized Trial on Large and Recurrent Aneurysms

Patients Prone to Recurrence after Endovascular Treatment: Periprocedural Results of the PRET Randomized Trial on Large and Recurrent Aneurysms

Is Visual Evaluation of Aneurysm Coiling a Reliable Study End Point?

Effects of Circle of Willis Anatomic Variations on Angiographic and Clinical Outcomes of Coiled Anterior Communicating Artery Aneurysms

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