ArticleAJNR. American journal of neuroradiology2011
Observer agreement regarding the necessity of retreatment of previously coiled recurrent cerebral aneurysms.
Article in AJNR. American journal of neuroradiology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed.
- Aneurysm Recurrence Volumetry Is More Sensitive than Visual Evaluation of Aneurysm Recurrences.Clinical neuroradiology · 2016Trial
- Use of Cobalt-Chromium 64 Wires Surpass Evolve for the Treatment of Remnant Intracranial Aneurysms: A Subanalysis From the SEASE International Registry.Stroke (Hoboken, N.J.) · 2025Article
- Outcome of retreatment for recurrent saccular cerebral aneurysms: a propensity score-matched analysis.Neurosurgical review · 2021Article
- Pipeline Embolization for Salvage Treatment of Previously Stented Residual and Recurrent Cerebral Aneurysms.Interventional neurology · 2018Article
- Treatment of recurrent aneurysms using the Woven EndoBridge (WEB): anatomical and clinical results.Journal of neurointerventional surgery · 2018Article
- Factors Influencing Confidence in Diagnostic Ratings and Retreatment Recommendations in Coiled Aneurysms.AJNR. American journal of neuroradiology · 2018Article
- Endovascular coiling for cerebral aneurysm: single-center experience in Egypt.The Egyptian journal of neurology, psychiatry and neurosurgery · 2018Article
- Validity of the Meyer Scale for Assessment of Coiled Aneurysms and Aneurysm Recurrence.AJNR. American journal of neuroradiology · 2016Article
- Stratification of recanalization for patients with endovascular treatment of intracranial aneurysms.Neurosurgery · 2015Article
- Point-TAR: a useful index to follow-up coiled intracranial aneurysms?AJNR. American journal of neuroradiology · 2015Article
- Predictors of residual flow in embolized intracranial ruptured aneurysms at early follow-up.Polish journal of radiology · 2014Article
- Stent-assisted embolization of recurrent or residual intracranial aneurysms.Neuroradiology · 2013Article
- Interobserver variability in retreatment decisions of recurrent and residual aneurysms.AJNR. American journal of neuroradiology · 2013Article
- Review of 2 decades of aneurysm-recurrence literature, part 2: Managing recurrence after endovascular coiling.AJNR. American journal of neuroradiology · 2013Review
- Comparison of 3D computer-aided with manual cerebral aneurysm measurements in different imaging modalities.Neuroradiology · 2013Article
- Comparison of remnant size in embolized intracranial aneurysms measured at follow-up with DSA and MRA.Neuroradiology · 2012Article
- Endovascular treatment of recurrent coiled aneurysms: assessment of complications and rebleeding during a decade in a single center.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2012Article
- Observer agreement in the assessment of minor and major cerebral aneurysm recurrence.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2011Article
- Variability in visual assessment of cerebral aneurysms could be reduced by quantification of recurrence volumes.AJNR. American journal of neuroradiology · 2011Article
- Interobserver agreement after pipeline embolization device implantation.AJNR. American journal of neuroradiologyArticle
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8 authors.
Funding
Abstract
background and purposeThe decision regarding whether or not to retreat a previously treated aneurysm not only directly impacts patient care but also serves as a primary outcome measure in numerous, leading randomized controlled trials of modified coils. Our aim was to determine the degree of interobserver variability regarding the need and type of treatment for recurrent aneurysms following coil embolization. MATERIALS AND
methodsTwenty-seven previously treated recurrent aneurysms were identified. Five independent readers rated each aneurysm on a 5-point scale: 1, definitely do not retreat; 2, probably do not retreat; 3, unsure; 4, probably retreat; and 5, definitely retreat. The readers noted, in grades 2-5, the type of retreatment preferred, including simple coiling, balloon- or stent-assist coiling, or surgical clipping. Intraobserver agreement κ was calculated. Retreatment recommendations were evaluated between observers by using a Wilcoxon signed rank comparison. Descriptive statistics were performed for categoric treatment-type comparisons.
resultsAt least 2- or 3-point differences between 2 readers were present in 17 (63%) and 11 (41%) of 27 cases, respectively. The median κ was 0.27 (range, 0.04-0.43), which indicates fair agreement. Differences between readers varied, with readers 4 and 5 more often recommending retreatment compared with reviewers 1-3 (P < .05). Wide variation was noted in treatment approach, with recommendations for surgical clipping ranging from 2 (7%) to 18 (67%) of 27 cases between readers 1 and 5.
conclusionsThe current study demonstrates substantial variability among observers not only in whether to retreat a recurrent aneurysm but also how to treat it. These findings suggest that patient management varies widely across treating physicians and also calls into question the use of "retreatment" as an objective end point in clinical trials.
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