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The Sac Evolution Imaging Follow-Up after EVAR: an international expert opinion-based Delphi consensus study
Journal of Vascular Surgery ( IF 4.3 ) Pub Date : 2024-03-08 , DOI: 10.1016/j.jvs.2024.03.007 Giovanni Tinelli , Mario D’Oria , Simona Sica , Kevin Mani , Zoran Rancic , Timothy Andrew Resh , Flavia Beccia , Ali Azizzadeh , Marcelo Martins Da Volta Ferreira , Mauro Gargiulo , Sandro Lepidi , Yamume Tshomba , Gustavo S. Oderich , Stephan Haulon , Adam W. Beck , Adrien Hertault , Ajay Savlania , Alberto Froio , Alessia Giaquinta , Alexander Zimmermann , Anastasios Psyllas , Anders Wanhainen , Andrea Ascoli Marchetti , Andre Brito Queiroz , Andrea Kahlberg , Andrés Reyes-Valdivia , Andres Schanzer , Andrew Tambyraja Edinburgh Vascular , Antonio Freyrie , Antonio Lorido , Antoine Millon , Arnaldo Ippoliti , Babak Abai , Barend Mees , Benedikt Reutersberg , Blandine Maurel , Bosiers Michel , Carl Magnus Wahlgren , Carlo Cavazzini , Carlo Setacci , Cheong Jun Lee , Ciro Ferrer , Colin Bicknell , Coscas Raphaël , Daniel Clair , David L. Dawson , Dean J. Arnaoutakis , Dittmar Böckler , Drosos Kotelis , Edin Mujagic , Emiliano Chisci , Enrico Cieri , Enrico Gallitto , Enrico Maria Marone , Eric Ducasse , Fabio Verzini , Felice Pecoraro , Ferdinand Serracino-Inglott , Filippo Benedetto , Francesco Speziale , Francesco Stilo , Francisco Álvarez-Marcos , Gabriele Pagliariccio , Gabriele Piffaretti , Gaetano Lanza , Geisbüsch Philipp , George Geenberg , Georg Jung , Germano Melissano , Gian Franco Veraldi , Gianbattista Parlani , Gianluca Faggioli , Gianmarco de Donato , Gioele Simonte , Giovanni Colacchio , Giovanni De Caridi , Giovanni Pratesi , Giovanni Spinella , Giovanni Torsello , Glenn Wei Leong Tan , Gregory A. Magee , Hence Verhagen , Holden Andrew , Issam Koleilat , J Westley Ohman , J.P.P.M. de Vries , Jacob Budtz-Lilly , James Black , Jens Eldrup-Jorgensen , Joe Hockley , Jonathan Bath , Jonathan Sobocinski , Joost A. van Herwaarden , Kopp Reinhard , Kristine C. Orion , Kwame Amankwah , Luca Bertoglio , Luca di Marzo , Luca Garriboli , Luigi Rizzo , Maani Hakimi , Malachi Sheahan , Manar Khashram , Marc Schermerhorn , Mario Lescan , Mark Conrad , Mark G. Davies , Martin Czerny , Matteo Orrico , Matthew J. Eagleton , Matthew R. Smeds , Maurizio Taurino , Max Wohlauer , Mel J. Sharafuddin , Menges Anna-Leonie , Michel Reijnen , Michele Antonello , Michele Piazza , Nicla Settembre , Nicolas J. Mouawad , Nikolaos Tsilimparis , Nuno Dias , Ombretta Martinelli , Paolo Frigatti , Pasqualino Sirignano , Patrick Chong , Paul Bevis , Paul DiMuzio , Peter Henke , Philip Düppers , Peter Holt , Päivi Helmiö , Patrick Vriens , Raffaele Pulli , Raffaello Bellosta , Raimondo Micheli , Ravi Veeraswamy , Robert Cuff , Roberto Chiappa , Roberto Gattuso , Rodolfo Pini , Ronald L. Dalman , Ross Milner , Salvatore T. Scali , Sandeep Bahia , Sani Laukontaus , Santi Trimarchi , Sebastian Fernandez-Alonso , Sebastien Deglise , Sergi Bellmunt-Montoya , Simone Hofer , Syed W. Yusuf , Sonia Ronchey , Stefano Bartoli , Stefano Bonvini , Stefano Camparini , Stefano Fazzini , Stefano Pirrelli , Tal Hörer , Theodosios Bisdas , Thodur Vasudevan , Thomas Lattmann , Thomas Rudolf Wyss , Thomas Maldonado , Thomas Pfammatter , Tilo Kölbel , Tomasz Jakimowicz , Tommaso Donati , Margaret Tracci , Umberto Marcello Bracale , Valerio Stefano Tolva , Vincent Riambau , Vincenzo Palazzo , Vladimir Makaloski , Von Allmen Regula S , Walter Dorigo , Wassim Mansour , Wouter Van den Eynde
Journal of Vascular Surgery ( IF 4.3 ) Pub Date : 2024-03-08 , DOI: 10.1016/j.jvs.2024.03.007 Giovanni Tinelli , Mario D’Oria , Simona Sica , Kevin Mani , Zoran Rancic , Timothy Andrew Resh , Flavia Beccia , Ali Azizzadeh , Marcelo Martins Da Volta Ferreira , Mauro Gargiulo , Sandro Lepidi , Yamume Tshomba , Gustavo S. Oderich , Stephan Haulon , Adam W. Beck , Adrien Hertault , Ajay Savlania , Alberto Froio , Alessia Giaquinta , Alexander Zimmermann , Anastasios Psyllas , Anders Wanhainen , Andrea Ascoli Marchetti , Andre Brito Queiroz , Andrea Kahlberg , Andrés Reyes-Valdivia , Andres Schanzer , Andrew Tambyraja Edinburgh Vascular , Antonio Freyrie , Antonio Lorido , Antoine Millon , Arnaldo Ippoliti , Babak Abai , Barend Mees , Benedikt Reutersberg , Blandine Maurel , Bosiers Michel , Carl Magnus Wahlgren , Carlo Cavazzini , Carlo Setacci , Cheong Jun Lee , Ciro Ferrer , Colin Bicknell , Coscas Raphaël , Daniel Clair , David L. Dawson , Dean J. Arnaoutakis , Dittmar Böckler , Drosos Kotelis , Edin Mujagic , Emiliano Chisci , Enrico Cieri , Enrico Gallitto , Enrico Maria Marone , Eric Ducasse , Fabio Verzini , Felice Pecoraro , Ferdinand Serracino-Inglott , Filippo Benedetto , Francesco Speziale , Francesco Stilo , Francisco Álvarez-Marcos , Gabriele Pagliariccio , Gabriele Piffaretti , Gaetano Lanza , Geisbüsch Philipp , George Geenberg , Georg Jung , Germano Melissano , Gian Franco Veraldi , Gianbattista Parlani , Gianluca Faggioli , Gianmarco de Donato , Gioele Simonte , Giovanni Colacchio , Giovanni De Caridi , Giovanni Pratesi , Giovanni Spinella , Giovanni Torsello , Glenn Wei Leong Tan , Gregory A. Magee , Hence Verhagen , Holden Andrew , Issam Koleilat , J Westley Ohman , J.P.P.M. de Vries , Jacob Budtz-Lilly , James Black , Jens Eldrup-Jorgensen , Joe Hockley , Jonathan Bath , Jonathan Sobocinski , Joost A. van Herwaarden , Kopp Reinhard , Kristine C. Orion , Kwame Amankwah , Luca Bertoglio , Luca di Marzo , Luca Garriboli , Luigi Rizzo , Maani Hakimi , Malachi Sheahan , Manar Khashram , Marc Schermerhorn , Mario Lescan , Mark Conrad , Mark G. Davies , Martin Czerny , Matteo Orrico , Matthew J. Eagleton , Matthew R. Smeds , Maurizio Taurino , Max Wohlauer , Mel J. Sharafuddin , Menges Anna-Leonie , Michel Reijnen , Michele Antonello , Michele Piazza , Nicla Settembre , Nicolas J. Mouawad , Nikolaos Tsilimparis , Nuno Dias , Ombretta Martinelli , Paolo Frigatti , Pasqualino Sirignano , Patrick Chong , Paul Bevis , Paul DiMuzio , Peter Henke , Philip Düppers , Peter Holt , Päivi Helmiö , Patrick Vriens , Raffaele Pulli , Raffaello Bellosta , Raimondo Micheli , Ravi Veeraswamy , Robert Cuff , Roberto Chiappa , Roberto Gattuso , Rodolfo Pini , Ronald L. Dalman , Ross Milner , Salvatore T. Scali , Sandeep Bahia , Sani Laukontaus , Santi Trimarchi , Sebastian Fernandez-Alonso , Sebastien Deglise , Sergi Bellmunt-Montoya , Simone Hofer , Syed W. Yusuf , Sonia Ronchey , Stefano Bartoli , Stefano Bonvini , Stefano Camparini , Stefano Fazzini , Stefano Pirrelli , Tal Hörer , Theodosios Bisdas , Thodur Vasudevan , Thomas Lattmann , Thomas Rudolf Wyss , Thomas Maldonado , Thomas Pfammatter , Tilo Kölbel , Tomasz Jakimowicz , Tommaso Donati , Margaret Tracci , Umberto Marcello Bracale , Valerio Stefano Tolva , Vincent Riambau , Vincenzo Palazzo , Vladimir Makaloski , Von Allmen Regula S , Walter Dorigo , Wassim Mansour , Wouter Van den Eynde
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. 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. 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. 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.
中文翻译：
EVAR 后的囊进化成像随访：一项基于国际专家意见的德尔菲共识研究
主动脉腔内修复术 (EVAR) 后的后续方案管理在各个中心之间存在显着差异，并且没有根据囊回归进行标准化。通过设计基于国际专家的德尔菲共识，该研究旨在根据囊的演变提出 EVAR 后随访的建议。八位主持人就研究主题提出了适当的陈述，并由选定的国际专家小组使用三轮修改后的德尔菲共识流程，使用 4 点李克特量表进行投票。根据专家的答复，只有达到A级（完全同意≥75%）或B级（总体同意≥80%且完全不同意<5%）的陈述才纳入最终文件。最终分析纳入了一百七十四名参与者，每人投票了最初的 29 条与 sac 回归定义（Q1-Q9）、EVAR 随访（Q10-Q14）以及评估和作用相关的陈述随访期间囊回归（Q15-Q29）。流程结束时，2 个陈述（6.9%）被拒绝，9 个陈述（31%）获得 B 级共识强度，18 个陈述（62.1%）达到 A 级共识强度。在 27 份最终陈述中，有 15 份（55.6%）属于 I 级，12 份（44.4%）属于 II 级。专家们一致认为，囊回归应被视为 EVAR 成功的重要指标，并始终在 EVAR 后的随访期间进行评估。基于这一国际专家德尔菲共识的高强度和高一致性，大多数陈述可能会指导当前根据囊回归进行EVAR后随访的临床管理。需要进一步的研究来澄清有争议的问题。
更新日期：2024-03-08
中文翻译：
EVAR 后的囊进化成像随访：一项基于国际专家意见的德尔菲共识研究
主动脉腔内修复术 (EVAR) 后的后续方案管理在各个中心之间存在显着差异，并且没有根据囊回归进行标准化。通过设计基于国际专家的德尔菲共识，该研究旨在根据囊的演变提出 EVAR 后随访的建议。八位主持人就研究主题提出了适当的陈述，并由选定的国际专家小组使用三轮修改后的德尔菲共识流程，使用 4 点李克特量表进行投票。根据专家的答复，只有达到A级（完全同意≥75%）或B级（总体同意≥80%且完全不同意<5%）的陈述才纳入最终文件。最终分析纳入了一百七十四名参与者，每人投票了最初的 29 条与 sac 回归定义（Q1-Q9）、EVAR 随访（Q10-Q14）以及评估和作用相关的陈述随访期间囊回归（Q15-Q29）。流程结束时，2 个陈述（6.9%）被拒绝，9 个陈述（31%）获得 B 级共识强度，18 个陈述（62.1%）达到 A 级共识强度。在 27 份最终陈述中，有 15 份（55.6%）属于 I 级，12 份（44.4%）属于 II 级。专家们一致认为，囊回归应被视为 EVAR 成功的重要指标，并始终在 EVAR 后的随访期间进行评估。基于这一国际专家德尔菲共识的高强度和高一致性，大多数陈述可能会指导当前根据囊回归进行EVAR后随访的临床管理。需要进一步的研究来澄清有争议的问题。
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