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
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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.
期刊介绍：
Journal of Vascular Surgery ® aims to be the premier international journal of medical, endovascular and surgical care of vascular diseases. It is dedicated to the science and art of vascular surgery and aims to improve the management of patients with vascular diseases by publishing relevant papers that report important medical advances, test new hypotheses, and address current controversies. To acheive this goal, the Journal will publish original clinical and laboratory studies, and reports and papers that comment on the social, economic, ethical, legal, and political factors, which relate to these aims. As the official publication of The Society for Vascular Surgery, the Journal will publish, after peer review, selected papers presented at the annual meeting of this organization and affiliated vascular societies, as well as original articles from members and non-members.
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