An International, Expert-based, Delphi Consensus Document on Controversial Issues in the Management of Abdominal Aortic Aneurysms

Kosmas I Paraskevas; Marc L Schermerhorn; Stephan Haulon; Adam W Beck; Hence J M Verhagen; Jason T Lee; Eric L G Verhoeven; Jan D Blankensteijn; Tilo Kölbel; Sean P Lyden; Daniel G Clair; Gianluca Faggioli; Theodosios Bisdas; Mario D'Oria; Kevin Mani; Karl Sörelius; Enrico Gallitto; Jose Fernandes E Fernandes; Athanasios Katsargyris; Sandro Lepidi; Andrea Vacirca; Piotr Myrcha; Mark J W Koelemay; Armando Mansilha; Clark J Zeebregts; Rodolfo Pini; Nuno V Dias; Angelos Karelis; Michel J Bosiers; David H Stone; Maarit Venermo; Mark A Farber; Matthew Blecha; Germano Melissano; Vincent Riambau; Matthew J Eagleton; Mauro Gargiulo; Salvatore T Scali; Giovanni B Torsello; Mark K Eskandari; Bruce A Perler; Peter Gloviczki; Mahmoud Malas; Ronald L Dalman

doi:10.1016/j.jvs.2024.08.012

An International, Expert-based, Delphi Consensus Document on Controversial Issues in the Management of Abdominal Aortic Aneurysms

Kosmas I Paraskevas^*, Marc L Schermerhorn, Stephan Haulon, Adam W Beck, Hence J M Verhagen, Jason T Lee, Eric L G Verhoeven, Jan D Blankensteijn, Tilo Kölbel, Sean P Lyden, Daniel G Clair, Gianluca Faggioli, Theodosios Bisdas, Mario D'Oria, Kevin Mani, Karl Sörelius, Enrico Gallitto, Jose Fernandes E Fernandes, Athanasios Katsargyris, Sandro LepidiAndrea Vacirca, Piotr Myrcha, Mark J W Koelemay, Armando Mansilha, Clark J Zeebregts, Rodolfo Pini, Nuno V Dias, Angelos Karelis, Michel J Bosiers, David H Stone, Maarit Venermo, Mark A Farber, Matthew Blecha, Germano Melissano, Vincent Riambau, Matthew J Eagleton, Mauro Gargiulo, Salvatore T Scali, Giovanni B Torsello, Mark K Eskandari, Bruce A Perler, Peter Gloviczki, Mahmoud Malas, Ronald L Dalman

^*Corresponding author af dette arbejde

Afdeling for Karkirurgi

Abstract

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.

Originalsprog	Engelsk
Tidsskrift	Journal of Vascular Surgery
ISSN	0741-5214
DOI	https://doi.org/10.1016/j.jvs.2024.08.012
Status	E-pub ahead of print - 13 aug. 2024

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10.1016/j.jvs.2024.08.012

Citationsformater

Paraskevas, K. I., Schermerhorn, M. L., Haulon, S., Beck, A. W., Verhagen, H. J. M., Lee, J. T., Verhoeven, E. L. G., Blankensteijn, J. D., Kölbel, T., Lyden, S. P., Clair, D. G., Faggioli, G., Bisdas, T., D'Oria, M., Mani, K., Sörelius, K., Gallitto, E., Fernandes E Fernandes, J., Katsargyris, A., ... Dalman, R. L. (2024). An International, Expert-based, Delphi Consensus Document on Controversial Issues in the Management of Abdominal Aortic Aneurysms. Journal of Vascular Surgery. Advance online publication. https://doi.org/10.1016/j.jvs.2024.08.012

Paraskevas, KI, Schermerhorn, ML, Haulon, S, Beck, AW, Verhagen, HJM, Lee, JT, Verhoeven, ELG, Blankensteijn, JD, Kölbel, T, Lyden, SP, Clair, DG, Faggioli, G, Bisdas, T, D'Oria, M, Mani, K, Sörelius, K, Gallitto, E, Fernandes E Fernandes, J, Katsargyris, A, Lepidi, S, Vacirca, A, Myrcha, P, Koelemay, MJW, Mansilha, A, Zeebregts, CJ, Pini, R, Dias, NV, Karelis, A, Bosiers, MJ, Stone, DH, Venermo, M, Farber, MA, Blecha, M, Melissano, G, Riambau, V, Eagleton, MJ, Gargiulo, M, Scali, ST, Torsello, GB, Eskandari, MK, Perler, BA, Gloviczki, P, Malas, M & Dalman, RL 2024, 'An International, Expert-based, Delphi Consensus Document on Controversial Issues in the Management of Abdominal Aortic Aneurysms', Journal of Vascular Surgery. https://doi.org/10.1016/j.jvs.2024.08.012

@article{63e893d369564c6389beab2866fbcb0d,

title = "An International, Expert-based, Delphi Consensus Document on Controversial Issues in the Management of Abdominal Aortic Aneurysms",

abstract = "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.",

author = "Paraskevas, {Kosmas I} and Schermerhorn, {Marc L} and Stephan Haulon and Beck, {Adam W} and Verhagen, {Hence J M} and Lee, {Jason T} and Verhoeven, {Eric L G} and Blankensteijn, {Jan D} and Tilo K{\"o}lbel and Lyden, {Sean P} and Clair, {Daniel G} and Gianluca Faggioli and Theodosios Bisdas and Mario D'Oria and Kevin Mani and Karl S{\"o}relius and Enrico Gallitto and {Fernandes E Fernandes}, Jose and Athanasios Katsargyris and Sandro Lepidi and Andrea Vacirca and Piotr Myrcha and Koelemay, {Mark J W} and Armando Mansilha and Zeebregts, {Clark J} and Rodolfo Pini and Dias, {Nuno V} and Angelos Karelis and Bosiers, {Michel J} and Stone, {David H} and Maarit Venermo and Farber, {Mark A} and Matthew Blecha and Germano Melissano and Vincent Riambau and Eagleton, {Matthew J} and Mauro Gargiulo and Scali, {Salvatore T} and Torsello, {Giovanni B} and Eskandari, {Mark K} and Perler, {Bruce A} and Peter Gloviczki and Mahmoud Malas and Dalman, {Ronald L}",

note = "Copyright {\textcopyright} 2024. Published by Elsevier Inc.",

year = "2024",

month = aug,

day = "13",

doi = "10.1016/j.jvs.2024.08.012",

language = "English",

journal = "Journal of Vascular Surgery",

issn = "0741-5214",

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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

PY - 2024/8/13

Y1 - 2024/8/13

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.

U2 - 10.1016/j.jvs.2024.08.012

DO - 10.1016/j.jvs.2024.08.012

M3 - Review

C2 - 39147288

SN - 0741-5214

JO - Journal of Vascular Surgery

JF - Journal of Vascular Surgery

ER -

An International, Expert-based, Delphi Consensus Document on Controversial Issues in the Management of Abdominal Aortic Aneurysms

Abstract

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