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30 ["Inter-rater reliability of published flow diversion occlusion scales"] 10.1136/neurintsurg-2015-012193 http://dx.doi.org/10.1136/neurintsurg-2015-012193 2016-01-20T23:04:34Z ["Surgery", "Clinical Neurology", "General Medicine"] 14 3 ["1759-8478", "1759-8486"] Journal of NeuroInterventional Surgery <jats:sec><jats:title>Background</jats:title><jats:p>With increasing use of flow-diverting stents for the treatment of intracranial aneurysms, standardized methods and a common language to evaluate angiographic outcomes are needed. Multiple grading scales have been developed for this purpose but none has been widely adopted.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To analyze these scales to determine interobserver reliability.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Four independent assessors scored the intraprocedural angiograms of patients who underwent flow-diverting stent deployment for an intracranial saccular or fusiform aneurysm at our institution between October 2012 and June 2015. Angiographic outcome immediately after flow-diverting stent deployment was scored using three grading scales (Kamran–Byrne (KB), Simple Measurement of Aneurysm Residual after Treatment (SMART), and O'Kelley, Krings, Marotta (OKM)). Statistical analysis was performed using Light's κ for multiple raters (κ), Kendall's coefficient of concordance (W), and intraclass correlation (ICC).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We included the angiograms of 50 consecutive patients (mean age 58 years, range 30–79) who underwent flow-diverting stent deployment for an intracranial aneurysm (40 saccular, 10 fusiform). Six aneurysms were located in the posterior circulation. The inter-rater reliability was typically poor or fair: SMART aneurysm filling (κ=0.30, W=0.36, ICC=0.12), SMART parent vessel stenosis (κ=0.07, W=0.33, ICC=0.12), KB axis I (κ=0.24, W=0.50, ICC=0.25), KB axis II (κ=0.07, W=0.30, ICC=0.06), OKM aneurysm filling (κ=0.23, W=0.45, ICC=0.13), OKM contrast stasis (κ=0.36,W=0.71, ICC=0.54).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Existing flow-diverting stent grading scales have low inter-rater reliability for most categories.</jats:p></jats:sec> 5 [] ["Marcus D Mazur", "Philipp Taussky", "Lubdha M Shah", "Blair Winegar", "Min S Park"] [""] [""] [""]