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

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An International, Expert-based, Delphi Consensus Document on Controversial Issues in the Management of Abdominal Aortic Aneurysms. Journal of vascular surgery Paraskevas, K. I., Schermerhorn, M. L., Haulon, S., Beck, A. W., Verhagen, H. J., Lee, J. T., Verhoeven, E. L., 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., Lepidi, S., Vacirca, A., Myrcha, P., Koelemay, M. J., Mansilha, A., Zeebregts, C. J., Pini, R., Dias, N. V., Karelis, A., Bosiers, M. J., Stone, D. H., Venermo, M., Farber, M. A., Blecha, M., Melissano, G., Riambau, V., Eagleton, M. J., Gargiulo, M., Scali, S. T., Torsello, G. B., Eskandari, M. K., Perler, B. A., Gloviczki, P., Malas, M., Dalman, R. L. 2024

Abstract

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.A 3-Round Delphi Consensus document was produced with 44 experts on 6 pre-specified topics regarding the management of AAAs. All answers were provided anonymously. The response rate for each round was 100%.Most participants (42 of 44; 95.4%) agreed that a minimum case volume/year is essential (or probably essential) for a center to offer open/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 (79.7%) participants 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.This expert-based Delphi Consensus document provides guidance for clinicians regarding specific unresolved issues. Consensus could not be achieved in some topics, highlighting the need for further ÌÇÐÄ´«Ã½ in those areas.

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