METHODS: 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%.
RESULTS: 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.
CONCLUSIONS: 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 research in those areas.
方法:由44名专家就6个关于AAA管理的预先指定主题编写了三轮德尔菲共识文件。所有答案都是匿名提供的。每轮的反应率为100%。
结果:大多数参与者(44人中的42人;95.4%)同意,最小病例量/年对于中心提供开放/血管内AAA修复(EVAR)至关重要(或可能必不可少)。此外,44人中有33人(75.0%)认为AAA筛查程序(可能)仍然具有临床效果和成本效益。此外,大多数小组成员(44人中的36人;81.9%)投票认为EVAR后的监测应该是(或可能应该是)终身的。最后,44名参与者中有35名(79.7%)认为女性吸烟者应该(或可能/可能)考虑在65岁时进行筛查,与男性相似。对于降低接受EVAR的患者的AAA修复阈值和需要预防深静脉血栓形成,尚未达成共识。
结论:这份以专家为基础的Delphi共识文件为临床医生提供有关具体未解决问题的指导。在某些主题上无法达成共识,强调需要在这些领域进行进一步研究。