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

Paraskevas, Kosmas I. ; Schermerhorn, Marc L. ; Haulon, Stephan ; Beck, Adam W. ; Verhagen, Hence J.M. ; Lee, Jason T. ; Verhoeven, Eric L.G. ; Blankensteijn, Jan D. ; Kölbel, Tilo LU and Lyden, Sean P. , et al. (2025) In Journal of Vascular Surgery 81(2). p.2-492
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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
AAA, Abdominal aortic aneurysm, Delphi, EVAR, Open surgical repair, Perioperative mortality
in
Journal of Vascular Surgery
volume
81
issue
2
pages
2 - 492
publisher
Mosby-Elsevier
external identifiers
  • scopus:85204475636
  • pmid:39147288
ISSN
0741-5214
DOI
10.1016/j.jvs.2024.08.012
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2024 Society for Vascular Surgery
id
e3cbc1ac-844f-49a3-81c0-64350360be8a
date added to LUP
2024-12-03 14:09:10
date last changed
2025-03-11 21:21:31
@article{e3cbc1ac-844f-49a3-81c0-64350360be8a,
  abstract     = {{<p>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.</p>}},
  author       = {{Paraskevas, Kosmas I. and Schermerhorn, Marc L. and Haulon, Stephan and Beck, Adam W. and Verhagen, Hence J.M. and Lee, Jason T. and Verhoeven, Eric L.G. and Blankensteijn, Jan D. and Kölbel, Tilo and Lyden, Sean P. and Clair, Daniel G. and Faggioli, Gianluca and Bisdas, Theodosios and D'Oria, Mario and Mani, Kevin and Sörelius, Karl and Gallitto, Enrico and Fernandes e Fernandes, Jose and Katsargyris, Athanasios and Lepidi, Sandro and Vacirca, Andrea and Myrcha, Piotr and Koelemay, Mark J.W. and Mansilha, Armando and Zeebregts, Clark J. and Pini, Rodolfo and Dias, Nuno V. and Karelis, Angelos and Bosiers, Michel J. and Stone, David H. and Venermo, Maarit and Farber, Mark A. and Blecha, Matthew and Melissano, Germano and Riambau, Vincent and Eagleton, Matthew J. and Gargiulo, Mauro and Scali, Salvatore T. and Torsello, Giovanni B. and Eskandari, Mark K. and Perler, Bruce A. and Gloviczki, Peter and Malas, Mahmoud and Dalman, Ronald L.}},
  issn         = {{0741-5214}},
  keywords     = {{AAA; Abdominal aortic aneurysm; Delphi; EVAR; Open surgical repair; Perioperative mortality}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{2--492}},
  publisher    = {{Mosby-Elsevier}},
  series       = {{Journal of Vascular Surgery}},
  title        = {{An international, expert-based, Delphi consensus document on controversial issues in the management of abdominal aortic aneurysms}},
  url          = {{http://dx.doi.org/10.1016/j.jvs.2024.08.012}},
  doi          = {{10.1016/j.jvs.2024.08.012}},
  volume       = {{81}},
  year         = {{2025}},
}