Comby Pierre-Olivier, Finitsis Stefanos, Iancu Daniela, Alexandratou Maria, Benomar Anass, Roy Daniel, Weill Alain, Jabre Roland, Lecaros Nicolas, Alhazmi Hanan, Darsaut Tim E, Raymond Jean
Department of Radiology, Service of Neuroradiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada.
Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, Dijon, France.
Neuroradiology. 2025 Jan;67(1):191-199. doi: 10.1007/s00234-024-03526-5. Epub 2024 Dec 20.
Various angiographic assessment scales have been used to report the results of endovascular treatment with the WEB device. We aimed to review the use and reliability of these scales.
We systematically reviewed studies reporting angiographic outcomes of WEB-treated aneurysms from January 2010 to May 2023. We identified the studies that reported the reliability of the various scales. Data from eligible studies were extracted and evaluated by two independent reviewers, with discrepancies resolved by a third reviewer.
The review identified 138 studies that used 12 different occlusion scales. The non-specific Raymond-Roy occlusion classification (RROC) was most commonly used (94/138 (68%)), followed by the Bicêtre Occlusion Scale Score (BOSS; 21/138 (15%)) and the Web Occlusion Scale (WOS; 16/138 (12%)), both specifically adapted to the WEB. Six reliability studies were identified, which included 16-30 cases evaluated by few (2-7) raters. Studies were too heterogenous to proceed with a meta-analysis. Substantial agreement in reporting angiographic results was shown in one study using the WOS (K = 0.70; 0.64-0.75), and one using the BOSS (K = 0.82; 0.68-0.96), but only when categories were dichotomized as complete versus incomplete occlusion. Most classifications can be translated into the RROC, allowing comparisons with other devices and treatment modalities. The RROC reached substantial agreement, but only between 2 raters in a small 26-patient study (k = 0.69; 0.46-0.93).
More agreement studies are needed to validate the reliability of angiographic outcome scales that can be used to compare WEB with other endovascular or surgical treatments.
多种血管造影评估量表已被用于报告使用WEB装置进行血管内治疗的结果。我们旨在回顾这些量表的使用情况和可靠性。
我们系统回顾了2010年1月至2023年5月期间报告WEB治疗动脉瘤血管造影结果的研究。我们确定了报告各种量表可靠性的研究。来自符合条件研究的数据由两名独立评审员提取和评估，如有分歧则由第三名评审员解决。
该综述确定了138项使用12种不同闭塞量表的研究。非特异性的雷蒙德-罗伊闭塞分类（RROC）使用最为频繁（94/138（68%）），其次是比塞特尔闭塞量表评分（BOSS；21/138（15%））和WEB闭塞量表（WOS；16/138（12%）），这两种量表都是专门针对WEB进行调整的。确定了六项可靠性研究，其中包括由少数（2 - 7名）评估者评估的16 - 30例病例。研究的异质性太大，无法进行荟萃分析。一项使用WOS的研究（K = 0.70；0.64 - 0.75）和一项使用BOSS的研究（K = 0.82；0.68 - 0.96）显示在报告血管造影结果方面有实质性一致性，但仅当类别分为完全闭塞与不完全闭塞时。大多数分类可以转换为RROC，以便与其他装置和治疗方式进行比较。RROC达成了实质性一致性，但仅在一项26例患者的小型研究中的两名评估者之间（k = 0.69；0.46 - 0.93）。
需要更多的一致性研究来验证血管造影结果量表的可靠性，这些量表可用于将WEB与其他血管内或外科治疗进行比较。
