The sac evolution imaging follow-up after endovascular aortic repair: An international expert opinion-based Delphi consensus study.

Beck, Adam W.; Hertault, Adrien; Savlania, Ajay; Froio, Alberto; Giaquinta, Alessia; Zimmermann, Alexander; Psyllas, Anastasios; Wanhainen, Anders; Andrea Ascoli Marchetti,; Andre Brito Queiroz,; Kahlberg, Andrea; Reyes-Valdivia, Andrés; Schanzer, Andres; Tambyraja, Andrew; Freyrie, Antonio; Lorido, Antonio; Millon, Antoine; Ippoliti, Arnaldo; Abai, Babak; Mees, Barend; Benedikt Reutersberg MD,; Febvs,; Maurel, Blandine; Michel, Bosiers; Carl Magnus Wahlgren,; Cavazzini, Carlo; Setacci, Carlo; Cheong Jun Lee,; Ferrer, Ciro; Bicknell, Colin; Raphaël, Coscas; Clair, Daniel; Dawson, David L.; Arnaoutakis, Dean J.; Böckler, Dittmar; Kotelis, Drosos; Mujagic, Edin; Chisci, Emiliano; Cieri, Enrico; Gallitto, Enrico; Enrico Maria Marone,; 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; Gian Franco Veraldi,; Parlani, Gianbattista; Faggioli, Gianluca; Gianmarco de Donato,; Simonte, Gioele; Colacchio, Giovanni; Giovanni De Caridi,; Pratesi, Giovanni; Spinella, Giovanni; Torsello, Giovanni; Glenn Wei Leong Tan,; Magee, Gregory A.; Verhagen, Hence; Andrew, Holden; Koleilat, Issam; Westley Ohman, J.; de Vries, J. P. P. M.; Budtz-Lilly, Jacob; Black, James; Eldrup-Jorgensen, Jens; Hockley, Joe; Bath, Jonathan; Sobocinski, Jonathan; van Herwaarden, Joost A.; Reinhard, Kopp; Orion, Kristine C.; Amankwah, Kwame; Bertoglio, Luca; Luca di Marzo,; Garriboli, Luca; Rizzo, Luigi; Hakimi, Maani; Sheahan, Malachi; Khashram, Manar; Schermerhorn, Marc; Lescan, Mario; Conrad, Mark; Davies, Mark G.; Czerny, Martin; Orrico, Matteo; Eagleton, Matthew J.; Smeds, Matthew R.; Taurino, Maurizio; Wohlauer, Max; Sharafuddin, Mel J.; Anna-Leonie, Menges; Reijnen, Michel; Antonello, Michele; Piazza, Michele; Settembre, Nicla; Mouawad, Nicolas J.; 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; Dalman, Ronald L.; Milner, Ross; Scali, Salvatore T.; Bahia, Sandeep; Laukontaus, Sani; Trimarchi, Santi; Fernandez-Alonso, Sebastian; Deglise, Sebastien; Bellmunt-Montoya, Sergi; Hofer, Simone; Yusuf, Syed W.; Ronchey, Sonia; Bartoli, Stefano; Bonvini, Stefano; Camparini, Stefano; Fazzini, Stefano; Pirrelli, Stefano; Hörer, Tal; Bisdas, Theodosios; Vasudevan, Thodur; Lattmann, Thomas; Thomas Rudolf Wyss,; Maldonado, Thomas; Pfammatter, Thomas; Kölbel, Tilo; Jakimowicz, Tomasz; Donati, Tommaso; Tracci, Margaret; Umberto Marcello Bracale,; Valerio Stefano Tolva,; Riambau, Vincent; Palazzo, Vincenzo; Makaloski, Vladimir; Von Allmen, Regula S.; Dorigo, Walter; Mansour, Wassim; Wouter Van den Eynde,

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 / 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, Antonio Freyrie, Antonio Lorido, Antoine Millon, Arnaldo Ippoliti, Babak Abai, Barend Mees, Benedikt Reutersberg MD, FEBVS, 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, Regula S. Von Allmen, Walter Dorigo, Wassim Mansour, Wouter Van den Eynde. - In: JOURNAL OF VASCULAR SURGERY. - ISSN 0741-5214. - STAMPA. - (2024), pp. 937-945.