title: Inter-observer variability in sizing fenestrated and/or branched aortic stent-grafts.
abstract: BACKGROUND
  Several studies have examined inter-observer variability in measurements for standard EVAR, but little is known about measurements for complex aortic aneurysm.
  
  
  METHODS
  Two independent observers reviewed all preoperative CT scans of 268 patients in a French trial of fenestrated and/or branched aortic stent-grafts (f/b-EVAR). Those data were compared with those obtained (1) by investigators (extent of aneurysm, target vessel stenosis, and aortic diameters), and (2) from manufacturers (proximal landing zone, device diameter, and target vessel position). We assessed the reproducibility using kappa statistics for qualitative data and both Bland-Altman plot and Passing-Bablok regression analysis for quantitative data.
  
  
  RESULTS
  Reproducibility was moderate to almost perfect for all factors. However, a few critical discrepancies were found, such as target vessel clock position (≥45 minutes) and location (≥5 mm), level of proximal landing zone, and diameters of the endograft.
  
  
  CONCLUSIONS
  This is the first large-scale analysis focused on inter-observer variability in sizing for f/b-EVAR. The measurement data showed good agreement, but there were some critical discrepancies between observers that may affect clinical results.
authors.affiliation: Department of Vascular Surgery, Henri Mondor Hospital, University Paris XII, Creteil, France. Electronic address: hiroshib@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Banno
authors.affiliation: Department of Radiology, Henri Mondor Hospital, University Paris XII, Creteil, France.
authors.forename: H
authors.initials: H
authors.lastname: Kobeiter
authors.affiliation: Department of Vascular Surgery, Henri Mondor Hospital, University Paris XII, Creteil, France.
authors.forename: J
authors.initials: J
authors.lastname: Brossier
authors.affiliation: Department of Vascular Surgery, Henri Mondor Hospital, University Paris XII, Creteil, France.
authors.forename: J
authors.initials: J
authors.lastname: Marzelle
authors.affiliation: Department of Clinical Research, Saint-Étienne University Hospital, St-Étienne, France.
authors.forename: E
authors.initials: E
authors.lastname: Presles
authors.affiliation: Department of Vascular Surgery, Henri Mondor Hospital, University Paris XII, Creteil, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Becquemin
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000295:instrumentation*; D005602:France; D006801:Humans; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D015607:Stents; D014057:Tomography, X-Ray Computed
keywords: Aortic aneurysm; EVAR; Fenestrated endovascular aneurysm repair; Inter-observer variability; Sizing