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Titolo:
Interobserver variation in interpretation of arteriography and management of severe lower leg arterial disease
Autore:
Koelemay, MJW; Legemate, DA; Reekers, JA; Koedam, NA; Balm, R; Jacobs, MJHM;
Indirizzi:
Acad Med Ctr, Dept Surg, NL-1100 DE Amsterdam, Netherlands Acad Med Ctr Amsterdam Netherlands NL-1100 DE DE Amsterdam, Netherlands Acad Med Ctr, Dept Radiol, NL-1100 DE Amsterdam, Netherlands Acad Med CtrAmsterdam Netherlands NL-1100 DE DE Amsterdam, Netherlands
Titolo Testata:
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
fascicolo: 5, volume: 21, anno: 2001,
pagine: 417 - 422
SICI:
1078-5884(200105)21:5<417:IVIIOA>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
DIGITAL SUBTRACTION ANGIOGRAPHY; MAGNETIC-RESONANCE ANGIOGRAPHY; DISTAL LOWER-EXTREMITY; LOWER-LIMB ISCHEMIA; GENERATED RUN-OFF; CONVENTIONAL ANGIOGRAPHY; BYPASS-SURGERY; MR-ANGIOGRAPHY; RECONSTRUCTION; ACCURACY;
Keywords:
arteriography; interobserver variation; arterial disease; patient management;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Legemate, DA Acad Med Ctr, Dept Surg, G4-111,POB 22700, NL-1100 DE Amsterdam, Netherlands Acad Med Ctr G4-111,POB 22700 Amsterdam Netherlands NL-1100 DE
Citazione:
M.J.W. Koelemay et al., "Interobserver variation in interpretation of arteriography and management of severe lower leg arterial disease", EUR J VAS E, 21(5), 2001, pp. 417-422

Abstract

Objective: arteriography is the reference standard for the assessment of the lower leg arteries in patients with severe lower limb ischaemia. Inter observer variation in arteriography interpretation may cause disparities with non-invasive imaging modalities. We determined interobserver variation inlower leg artery assessment with intra-arterial digital subtraction angiography (IaDSA) and subsequent patient management. Materials: iaDSA studies of patients evaluated for severe claudication (n = 5) or critical ischaemia (n = 43). Methods: arteriograms were independently judged by four observers. The popliteal and tibial arteries were graded as fully patent, severely diseased, occluded ol non-diagnostic The dorsalis pedis, common and deep plantar artery were graded as directly, indirectly or not filling the pedal arch or non-diagnostic. Agreement on grading arteries was expressed as kappa -values. Treatment plans (conservative, PTA, surgery, amputation, non-diagnostic) proposed by each observer based on clinical information and iaDSA were compared. Results: the rate of non-diagnostic judgements ranged from 1% in the popliteal to 22% in the pedal auter ies. Overall agreement tons good for gradingthe popliteal arteries (kappa = 0.64), moderate for the tibial (kappa = 0.47-0.54) and fair for the pedal arteries (kappa = 0.39). Agreement was goodto excellent for grading occlucled or fully patent popliteal and tibial artery segments, and fair to moderate for grading severe disease. In 57% of cases at least 3 observers proposed identical treatment, which indicates fair overall agreement (kappa = 0.33). Conclusion: interobserver agreement on iaDSA is good to determine occludedor fully patent popliteal or tibial arteries, but not for severe disease. This should be taken into account when other diagnostic modalities nr e compared with iaDSA. Evaluation of diagnostic modalities as concordance in treatment plans is flawed by interindividual variation.

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Documento generato il 19/01/20 alle ore 00:26:27