TY - JOUR T1 - Interobserver variability in the assessment of aneurysm occlusion with the WEB aneurysm embolization system JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 591 LP - 595 DO - 10.1136/neurintsurg-2014-011251 VL - 7 IS - 8 AU - David Fiorella AU - Adam Arthur AU - James Byrne AU - Laurent Pierot AU - Andy Molyneux AU - Gary Duckwiler AU - Thomas McCarthy AU - Charles Strother Y1 - 2015/08/01 UR - http://jnis.bmj.com/content/7/8/591.abstract N2 - 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. ER -