Objective: Management of follow-up protocols after endovascular aortic repair (EVAR) varies significantly between centers and is not standardized according to sac regression. By designing an international expert-based Delphi consensus, the study aimed to create recommendations on follow-up after EVAR according to sac evolution. Methods: Eight facilitators created appropriate statements regarding the study topic that were voted, using a 4-point Likert scale, by a selected panel of international experts using a three-round modified Delphi consensus process. Based on the experts' responses, only those statements reaching a grade A (full agreement ≥75%) or B (overall agreement ≥80% and full disagreement <5%) were included in the final document. Results: One-hundred and seventy-four participants were included in the final analysis, and each voted the initial 29 statements related to the definition of sac regression (Q1-Q9), EVAR follow-up (Q10-Q14), and the assessment and role of sac regression during follow-up (Q15-Q29). At the end of the process, 2 statements (6.9%) were rejected, 9 statements (31%) received a grade B consensus strength, and 18 (62.1%) reached a grade A consensus strength. Of 27 final statements, 15 (55.6%) were classified as grade I, whereas 12 (44.4%) were classified as grade II. Experts agreed that sac regression should be considered an important indicator of EVAR success and always be assessed during follow-up after EVAR. Conclusions: Based on the elevated strength and high consistency of this international expert-based Delphi consensus, most of the statements might guide the current clinical management of follow-up after EVAR according to the sac regression. Future studies are needed to clarify debated issues.
The sac evolution imaging follow-up after endovascular aortic repair: an international expert opinion-based Delphi consensus study / Tinelli, Giovanni; D'Oria, Mario; Sica, Simona; Mani, Kevin; Rancic, Zoran; Andrew Resch, Timothy; Beccia, Flavia; Azizzadeh, Ali; Martins Da Volta Ferreira, Marcelo; Gargiulo, Mauro; Lepidi, Sandro; Tshomba, Yamume; S Oderich, Gustavo; Haulon, Stéphan; W Beck, Adam; Hertault, Adrien; Savlania, Ajay; Froio, Alberto; Giaquinta, Alessia; Zimmermann, Alexander; Psyllas, Anastasios; Wanhainen, Anders; Ascoli Marchetti, Andrea; Brito Queiroz, Andre; Kahlberg, Andrea; Reyes-Valdivia, Andrés; Schanzer, Andres; Tambyraja, Andrew; Freyrie, Antonio; Lorido, Antonio; Millon, Antoine; Ippoliti, Arnaldo; Abai, Babak; Mees, Barend; Reutersberg, Benedikt; Maurel, Blandine; Michel, Bosiers; Magnus Wahlgren, Carl; Cavazzini, Carlo; Setacci, Carlo; Jun Lee, Cheong; Ferrer, Ciro; Bicknell, Colin; Raphaël, Coscas; Clair, Daniel; L Dawson, David; J Arnaoutakis, Dean; Böckler, Dittmar; Kotelis, Drosos; Mujagic, Edin; Chisci, Emiliano; Cieri, Enrico; Gallitto, Enrico; Maria Marone, Enrico; Ducasse, Eric; Verzini, Fabio; Pecoraro, Felice; Serracino-Inglott, Ferdinand; Benedetto, Filippo; Speziale, Francesco; Stilo, Francesco; Álvarez-Marcos, Francisco; Pagliariccio, Gabriele; Piffaretti, Gabriele; Lanza, Gaetano; Philipp, Geisbüsch; Geenberg, George; Jung, Georg; Melissano, Germano; Franco Veraldi, Gian; Parlani, Gianbattista; Faggioli, Gianluca; de Donato, Gianmarco; Simonte, Gioele; Colacchio, Giovanni; De Caridi, Giovanni; Pratesi, Giovanni; Spinella, Giovanni; Torsello, Giovanni; Wei Leong Tan, Glenn; A Magee, Gregory; Verhagen, Hence; Andrew, Holden; Koleilat, Issam; Westley Ohman, J; M de Vries, J P P; Budtz-Lilly, Jacob; Black, James; Eldrup-Jorgensen, Jens; Hockley, Joe; Bath, Jonathan; Sobocinski, Jonathan; A van Herwaarden, Joost; Reinhard, Kopp; C Orion, Kristine; Amankwah, Kwame; Bertoglio, Luca; DI MARZO, Luca; Garriboli, Luca; Rizzo, Luigi; Hakimi, Maani; Sheahan, Malachi; Khashram, Manar; Schermerhorn, Marc; Lescan, Mario; Conrad, Mark; G Davies, Mark; Czerny, Martin; Orrico, Matteo; J Eagleton, Matthew; R Smeds, Matthew; Taurino, Maurizio; Wohlauer, Max; J Sharafuddin, Mel; Anna-Leonie, Menges; Reijnen, Michel; Antonello, Michele; Piazza, Michele; Settembre, Nicla; J Mouawad, Nicolas; Tsilimparis, Nikolaos; Dias, Nuno; Martinelli, Ombretta; Frigatti, Paolo; Sirignano, Pasqualino; Chong, Patrick; Bevis, Paul; Dimuzio, Paul; Henke, Peter; Düppers, Philip; Holt, Peter; Helmiö, Päivi; Vriens, Patrick; Pulli, Raffaele; Bellosta, Raffaello; Micheli, Raimondo; Veeraswamy, Ravi; Cuff, Robert; Chiappa, Roberto; Gattuso, Roberto; Pini, Rodolfo; L Dalman, Ronald; Milner, Ross; T Scali, Salvatore; Bahia, Sandeep; Laukontaus, Sani; Trimarchi, Santi; Fernandez-Alonso, Sebastian; Deglise, Sebastien; Bellmunt-Montoya, Sergi; Hofer, Simone; W Yusuf, Syed; Ronchey, Sonia; Bartoli, Stefano; Bonvini, Stefano; Camparini, Stefano; Fazzini, Stefano; Pirrelli, Stefano; Hörer, Tal; Bisdas, Theodosios; Vasudevan, Thodur; Lattmann, Thomas; Rudolf Wyss, Thomas; Maldonado, Thomas; Pfammatter, Thomas; Kölbel, Tilo; Jakimowicz, Tomasz; Donati, Tommaso; Tracci, Margaret; Marcello Bracale, Umberto; Stefano Tolva, Valerio; Riambau, Vincent; Palazzo, Vincenzo; Makaloski, Vladimir; S Von Allmen, Regula; Dorigo, Walter; Mansour, Wassim; Van den Eynde, Wouter. - In: JOURNAL OF VASCULAR SURGERY. - ISSN 0741-5214. - 80:3(2024), pp. 937-945. [10.1016/j.jvs.2024.03.007]
The sac evolution imaging follow-up after endovascular aortic repair: an international expert opinion-based Delphi consensus study
Francesco SpezialeMembro del Collaboration Group
;Luca di MarzoMembro del Collaboration Group
;Luigi RizzoMembro del Collaboration Group
;Maurizio TaurinoMembro del Collaboration Group
;Ombretta MartinelliMembro del Collaboration Group
;Pasqualino SirignanoMembro del Collaboration Group
;Roberto GattusoMembro del Collaboration Group
;Stefano Fazzini;Wassim MansourMembro del Collaboration Group
;
2024
Abstract
Objective: Management of follow-up protocols after endovascular aortic repair (EVAR) varies significantly between centers and is not standardized according to sac regression. By designing an international expert-based Delphi consensus, the study aimed to create recommendations on follow-up after EVAR according to sac evolution. Methods: Eight facilitators created appropriate statements regarding the study topic that were voted, using a 4-point Likert scale, by a selected panel of international experts using a three-round modified Delphi consensus process. Based on the experts' responses, only those statements reaching a grade A (full agreement ≥75%) or B (overall agreement ≥80% and full disagreement <5%) were included in the final document. Results: One-hundred and seventy-four participants were included in the final analysis, and each voted the initial 29 statements related to the definition of sac regression (Q1-Q9), EVAR follow-up (Q10-Q14), and the assessment and role of sac regression during follow-up (Q15-Q29). At the end of the process, 2 statements (6.9%) were rejected, 9 statements (31%) received a grade B consensus strength, and 18 (62.1%) reached a grade A consensus strength. Of 27 final statements, 15 (55.6%) were classified as grade I, whereas 12 (44.4%) were classified as grade II. Experts agreed that sac regression should be considered an important indicator of EVAR success and always be assessed during follow-up after EVAR. Conclusions: Based on the elevated strength and high consistency of this international expert-based Delphi consensus, most of the statements might guide the current clinical management of follow-up after EVAR according to the sac regression. Future studies are needed to clarify debated issues.| File | Dimensione | Formato | |
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