TY - JOUR
T1 - An international, expert-based, Delphi consensus document on controversial issues in the management of abdominal aortic aneurysms
AU - Paraskevas, Kosmas I.
AU - Schermerhorn, Marc L.
AU - Haulon, Stephan
AU - Beck, Adam W.
AU - Verhagen, Hence J.M.
AU - Lee, Jason T.
AU - Verhoeven, Eric L.G.
AU - Blankensteijn, Jan D.
AU - Kölbel, Tilo
AU - Lyden, Sean P.
AU - Clair, Daniel G.
AU - Faggioli, Gianluca
AU - Bisdas, Theodosios
AU - D'Oria, Mario
AU - Mani, Kevin
AU - Sörelius, Karl
AU - Gallitto, Enrico
AU - Fernandes e Fernandes, Jose
AU - Katsargyris, Athanasios
AU - Lepidi, Sandro
AU - Vacirca, Andrea
AU - Myrcha, Piotr
AU - Koelemay, Mark J.W.
AU - Mansilha, Armando
AU - Zeebregts, Clark J.
AU - Pini, Rodolfo
AU - Dias, Nuno V.
AU - Karelis, Angelos
AU - Bosiers, Michel J.
AU - Stone, David H.
AU - Venermo, Maarit
AU - Farber, Mark A.
AU - Blecha, Matthew
AU - Melissano, Germano
AU - Riambau, Vincent
AU - Eagleton, Matthew J.
AU - Gargiulo, Mauro
AU - Scali, Salvatore T.
AU - Torsello, Giovanni B.
AU - Eskandari, Mark K.
AU - Perler, Bruce A.
AU - Gloviczki, Peter
AU - Malas, Mahmoud
AU - Dalman, Ronald L.
N1 - Publisher Copyright:
© 2024 Society for Vascular Surgery
PY - 2025/2
Y1 - 2025/2
N2 - Objective: As a result of conflicting, inadequate or controversial data in the literature, several issues concerning the management of patients with abdominal aortic aneurysms (AAAs) remain unanswered. The aim of this international, expert-based Delphi consensus document was to provide some guidance for clinicians on these controversial topics. Methods: A three-round Delphi consensus document was produced with 44 experts on 6 prespecified topics regarding the management of AAAs. All answers were provided anonymously. The response rate for each round was 100%. Results: Most participants (42 of 44 [95.4%]) agreed that a minimum case volume per year is essential (or probably essential) for a center to offer open or endovascular AAA repair (EVAR). Furthermore, 33 of 44 (75.0%) believed that AAA screening programs are (probably) still clinically effective and cost effective. Additionally, most panelists (36 of 44 [81.9%]) voted that surveillance after EVAR should be (or should probably be) lifelong. Finally, 35 of 44 participants (79.7%) thought that women smokers should (or should probably/possibly) be considered for screening at 65 years of age, similar to men. No consensus was achieved regarding lowering the threshold for AAA repair and the need for deep venous thrombosis prophylaxis in patients undergoing EVAR. Conclusions: This expert-based Delphi consensus document provides guidance for clinicians regarding specific unresolved issues. Consensus could not be achieved on some topics, highlighting the need for further research in those areas.
AB - Objective: As a result of conflicting, inadequate or controversial data in the literature, several issues concerning the management of patients with abdominal aortic aneurysms (AAAs) remain unanswered. The aim of this international, expert-based Delphi consensus document was to provide some guidance for clinicians on these controversial topics. Methods: A three-round Delphi consensus document was produced with 44 experts on 6 prespecified topics regarding the management of AAAs. All answers were provided anonymously. The response rate for each round was 100%. Results: Most participants (42 of 44 [95.4%]) agreed that a minimum case volume per year is essential (or probably essential) for a center to offer open or endovascular AAA repair (EVAR). Furthermore, 33 of 44 (75.0%) believed that AAA screening programs are (probably) still clinically effective and cost effective. Additionally, most panelists (36 of 44 [81.9%]) voted that surveillance after EVAR should be (or should probably be) lifelong. Finally, 35 of 44 participants (79.7%) thought that women smokers should (or should probably/possibly) be considered for screening at 65 years of age, similar to men. No consensus was achieved regarding lowering the threshold for AAA repair and the need for deep venous thrombosis prophylaxis in patients undergoing EVAR. Conclusions: This expert-based Delphi consensus document provides guidance for clinicians regarding specific unresolved issues. Consensus could not be achieved on some topics, highlighting the need for further research in those areas.
KW - AAA
KW - Abdominal aortic aneurysm
KW - Delphi
KW - EVAR
KW - Open surgical repair
KW - Perioperative mortality
UR - http://www.scopus.com/inward/record.url?scp=85204475636&partnerID=8YFLogxK
U2 - 10.1016/j.jvs.2024.08.012
DO - 10.1016/j.jvs.2024.08.012
M3 - Review article
C2 - 39147288
AN - SCOPUS:85204475636
SN - 0741-5214
VL - 81
SP - 483-492.e2
JO - Journal of Vascular Surgery
JF - Journal of Vascular Surgery
IS - 2
ER -