The Sac Evolution Imaging Follow-Up after EVAR: an international expert opinion-based Delphi consensus study.

Tinelli, Giovanni; D'Oria, Mario; Sica, Simona; Mani, Kevin; Rancic, Zoran; Resh, Timothy Andrew; Beccia, Flavia; Azizzadeh, Ali; Da Volta Ferreira, Marcelo Martins; Gargiulo, Mauro; Lepidi, Sandro; Tshomba, Yamume; Oderich, Gustavo S; Haulon, Stephan (2024). The Sac Evolution Imaging Follow-Up after EVAR: an international expert opinion-based Delphi consensus study. Journal of vascular surgery, 80(3), pp. 937-945. Elsevier 10.1016/j.jvs.2024.03.007

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OBJECTIVE

Management of follow-up protocols after endovascular aortic repair (EVAR), vary significantly between centres and is not standardized according to the 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. Out of twenty-seven final statements, fifteen statements (55.6%) were classified as grade I, while twelve (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 current clinical management of follow-up after EVAR according to the sac regression. Future studies are needed to clarify debated issues.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Vascular Surgery

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0741-5214

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

11 Mar 2024 16:22

Last Modified:

24 Aug 2024 00:12

Publisher DOI:

10.1016/j.jvs.2024.03.007

PubMed ID:

38462062

Additional Information:

Member of SLIM F-U EVAR Collaborative Study Group: Bosiers Michel, Drosos Kotelis, Vladimir Makaloski (Department of Vascular Surgery, University Hospital Bern, Inselspital, University of Bern)

Uncontrolled Keywords:

CTA DUS Delphi Consensus EVAR Follow-up Sac Regression

BORIS DOI:

10.48350/194103

URI:

https://boris.unibe.ch/id/eprint/194103

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