An international, expert-based, Delphi consensus document on controversial issues in the management of abdominal aortic aneurysms

被引：2

作者：

Paraskevas, Kosmas I. ^{[1
]}

Schermerhorn, Marc L. ^{[2
]}

Haulon, Stephan ^{[3
]}

Beck, Adam W. ^{[4
]}

Verhagen, Hence J. M. ^{[5
]}

Lee, Jason T. ^{[6
]}

Verhoeven, Eric L. G. ^{[7
,8
]}

Blankensteijn, Jan D. ^{[9
]}

Lyden, Sean P. ^{[11
]}

Clair, Daniel G. ^{[12
]}

Faggioli, Gianluca ^{[13
,14
]}

Bisdas, Theodosios ^{[14
]}

D'Oria, Mario ^{[16
]}

Mani, Kevin ^{[17
]}

Soerelius, Karl ^{[18
,19
]}

Gallitto, Enrico ^{[13
,14
]}

Fernandes, Jose Fernandes e ^{[20
]}

Katsargyris, Athanasios ^{[7
,8
,21
]}

Lepidi, Sandro ^{[15
]}

Vacirca, Andrea

Myrcha, Piotr ^{[22
]}

Koelemay, Mark J. W. ^{[23
,38
]}

Mansilha, Armando ^{[24
]}

Zeebregts, Clark J. ^{[25
]}

Pini, Rodolfo

Dias, Nuno, V ^{[26
,27
]}

Karelis, Angelos ^{[28
]}

Bosiers, Michel J. ^{[28
]}

Stone, David H. ^{[29
]}

Venermo, Maarit ^{[30
]}

Farber, Mark A. ^{[31
]}

Blecha, Matthew ^{[32
]}

Melissano, Germano ^{[33
]}

Riambau, Vincent ^{[34
]}

Eagleton, Matthew J. ^{[35
]}

Gargiulo, Mauro ^{[13
,14
]}

Scali, Salvatore T. ^{[36
]}

Torsello, Giovanni B. ^{[37
]}

Eskandari, Mark K.

Kolbel, Tilo ^{[10
]}

Perler, Bruce A. ^{[39
]}

Gloviczki, Peter ^{[40
]}

Malas, Mahmoud ^{[41
]}

Dalman, Ronald L. ^{[13
]}

机构：

[1] Red Cross Hosp, Dept Vasc Surg, Athens, Greece

[2] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Div Vasc & Endovasc Surg, Boston, MA USA

[3] Paris Saclay Univ, Marie Lannelongue Hosp, Aort Ctr, Grp Hosp Paris St Joseph, Paris Saclay, France

[4] Univ Alabama Birmingham, Div Vasc Surg & Endovasc Therapy, Birmingham, AL USA

[5] Erasmus Univ, Med Ctr, Med Ctr, Rotterdam, Netherlands

[6] Stanford Univ, Sch Med, Div Vasc Surg, Stanford, CA USA

[7] Amsterdam Univ Med Ctr, Dept Vasc & Endovasc Surg, Amsterdam, Netherlands

[8] Paracelsus Med Univ, Nurnberg, Germany

[9] Univ Med Ctr Hamburg Eppendorf, German Aort Ctr, Dept Vasc Med, D-20251 Hamburg, Germany

[10] Cleveland Clin, Dept Vasc Surg, Cleveland, OH USA

[11] Cleveland Clin, Dept Vasc Surg, Cleveland, OH USA

[12] Vanderbilt Univ, Med Ctr, Dept Vasc Surg, Sect Surg Sci, Nashville, TN USA

[13] Univ Bologna, Vasc Surg, DIMEC, Bologna, Italy

[14] Azienda Osped Univ, Vasc Surg Unit, IRCCS St Orsola, Bologna, Italy

[15] Univ Trieste, Clin Vasc Surg 3, Trieste, Italy

[16] Univ Trieste, Dept Vasc & Endovasc Surg, Dept Clin Surg & Hlth Sci, Trieste, Italy

[17] Uppsala Univ, Dept Surg Sci, Sect Vasc Surg, Uppsala, Sweden

[18] Univ Copenhagen, Dept Vasc Surg, Rigshosp, Copenhagen, Denmark

[19] Univ Copenhagen, Fac Hlth & Med Sci, Copenhagen, Denmark

[20] Natl & Kapodistrian Univ Athens, Laiko Gen Hosp, Propaedeut Dept Surg 2, Athens, Greece

[21] Natl & Kapodistrian Univ Athens, Laiko Gen Hosp, Dept Vasc Surg 2, Athens, Greece

[22] Vrije Univ, Dept Surg, Amsterdam UMC, Amsterdam, Netherlands

[23] Univ Amsterdam, Dept Surg, Amsterdam UMC, Amsterdam Cardiovasc Sci, Amsterdam, Netherlands

[24] Univ Porto, Sao Joao Univ Hosp, Porto, Portugal

[25] Northwestern Univ, Feinberg Sch Med, Dept Surg, Div Vasc Surg, Chicago, IL 60611 USA

[26] Lund Univ, Skane Univ Hosp, Groningen, Netherlands

[27] Lund Univ, Dept Clin Sci Malmo, Malmo, Sweden

[28] Univ Bern, Univ Hosp Bern, Malmo, Sweden

[29] Dartmouth Hitchcock Med Ctr, Sect Vasc Surg, Lebanon, NH USA

[30] Univ Helsinki, Helsinki Univ Hosp, Dept Vasc Surg, Helsinki, Finland

[31] Univ North Carolina, Sch Med, Dept Surg, Vasc Surg Div, Chapel Hill, NC USA

[32] Loyola Univ Chicago, Stritch Sch Med, Div Vasc Surg, Chicago, IL USA

[33] Univ Vita Salute San Raffaele, IRCCS San Raffaele Hosp, Dept Vasc Surg, Sch Med, Milan, Italy

[34] Univ Barcelona, Hosp Clin Barcelona, Cardiovasc Inst, Dept Vasc Surg, Barcelona, Spain

[35] Dedinje Cardiovasc Inst, Div Vasc & Endovasc Surg, Milana Tepica 1, YU-11000 Belgrade, Yugoslavia

[36] Univ Barcelona, Div Vasc Surg & Endovasc Therapy, Barcelona, Spain

[37] Massachusetts Gen Hosp, Div Vasc & Endovascular Surg, Munster, MA USA

[38] Northwestern Univ, Dept Surg, Div Vasc Surg, Feinberg Sch Med, Chicago, IL USA

[39] St Franziskus Hosp, Inst Vasc Res, Munster, Germany

[40] Mayo Clin, Gonda Vasc Ctr, Div Vasc & Endovasc Surg, Chicago, IL 60611 USA

[41] Univ Calif San Diego Hlth Syst, Dept Surg, Div Vasc & Endovasc Surg, San Diego, CA USA

来源：

JOURNAL OF VASCULAR SURGERY | 2025年 / 81卷 / 02期

关键词：

Abdominal aortic aneurysm; EVAR; Perioperative mortality; Delphi; AAA; Open surgical repair; HOSPITAL VOLUME; VENOUS THROMBOEMBOLISM; ENDOVASCULAR REPAIR; PRACTICE GUIDELINES; EDITORS CHOICE; MORTALITY; SURGERY; SOCIETY; RISK; METAANALYSIS;

D O I：

10.1016/j.jvs.2024.08.012

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

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.

引用

页码：483 / 492.e2

页数：12

共 49 条

[1] Characteristics and 1-year outcomes of patients with rupture of small abdominal aortic aneurysms
Bellamkonda, Kirthi S.
Zogg, Cheryl
Nassiri, Naiem
Sadeghi, Mehran M.
Zhang, Yawei
Guzman, Raul J.
Chaar, Cassius Iyad Ochoa
[J]. JOURNAL OF VASCULAR SURGERY, 2023, 77 (06) : 1649 - 1657
[2] Characteristics and outcomes of small abdominal aortic aneurysm rupture in the American College of Surgeons National Surgical Quality Improvement Program database
Bellamkonda, Kirthi S.
Nassiri, Naiem
Sadeghi, Mehran M.
Zhang, Yawei
Guzman, Raul J.
Chaar, Cassius Iyad Ochoa
[J]. JOURNAL OF VASCULAR SURGERY, 2021, 74 (03) : 729 - 737
[3] Editor's Choice - Management of Lower Extremity Venous Outflow Obstruction: Results of an International Delphi Consensus
Black, Stephen A.
Gohel, Manjit
de Graaf, Rick
Gagne, Paul
Silver, Mitchell
Fleck, Bruce
Hofmann, Lawrence, V
[J]. EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2024, 67 (02) : 341 - 350
[4] Extended screening guidelines for the diagnosis of abdominal aortic aneurysm
Carnevale, Matthew L.
Koleilat, Issam
Lipsitz, Evan C.
Friedmann, Patricia
Indes, Jeffrey E.
[J]. JOURNAL OF VASCULAR SURGERY, 2020, 72 (06) : 1917 - 1926
[5] cdn, Guidance on Conducting and reporting Delphi studies (CREDES) Checklist
[6] The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm
Chaikof, Elliot L.
Dalman, Ronald L.
Eskandari, Mark K.
Jackson, Benjamin M.
Lee, W. Anthony
Mansour, M. Ashraf
Mastracci, Tara M.
Mell, Matthew
Murad, M. Hassan
Nguyen, Louis L.
Oderich, Gustavo S.
Patel, Madhukar S.
Schermerhorn, Marc L.
Starnes, Benjamin W.
[J]. JOURNAL OF VASCULAR SURGERY, 2018, 67 (01) : 2 - +
[7] A Delphi Consensus Study on Undergoing Carotid Endarterectomy: Patient Reported Outcome Measures
Coelho, Andreia
Peixoto, Joao
Canedo, Alexandra
de Borst, Gert J.
Mansilha, Armando
[J]. EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2023, 65 (06) : 787 - 801
[8] Size thresholds for repair of abdominal aortic aneurysms warrant reconsideration
Columbo, Jesse A.
Scali, Salvatore T.
Jacobs, Benjamin N.
Scully, Rebecca E.
Suckow, Bjoern D.
Huber, Thomas S.
Neal, Dan
Stone, David H.
[J]. JOURNAL OF VASCULAR SURGERY, 2024, 79 (05)
[9] Association Between Hospital Volume and Failure to Rescue After Open or Endovascular Repair of Intact Abdominal Aortic Aneurysms in the VASCUNET and International Consortium of Vascular Registries
D'Oria, Mario
Scali, Salvatore
Mao, Jialin
Szeberin, Zoltan
Thomson, Ian
Beiles, Barry
Stone, David
Sedrakyan, Art
Eldrup, Nikolaj
Venermo, Maarit
Cassar, Kevin
Altreuther, Martin
Boyle, Jonathan R.
Behrendt, Christian-Alexander
Beck, Adam W.
Mani, Kevin
[J]. ANNALS OF SURGERY, 2021, 274 (05) : E452 - E459
[10] Epidemiology of endovascular and open repair for abdominal aortic aneurysms in the United States from 2004 to 2015 and implications for screening
Dansey, Kirsten D.
Varkevisser, Rens R. B.
Swerdlow, Nicholas J.
Li, Chun
de Guerre, Livia E. V. M.
Liang, Patric
Marcaccio, Christina
O'Donnell, Thomas F. X.
Carroll, Brett J.
Schermerhorn, Marc L.
[J]. JOURNAL OF VASCULAR SURGERY, 2021, 74 (02) : 414 - 424

← 1 2 3 4 5 →