| Title: |
Transatlantic Delphi consensus on the common iliac artery sealing zone in endovascular aorto-iliac aneurysm repair (the DECIDE study) |
| Authors: |
Kooijman, Maria-Annette; D’Oria, Mario; Bertoglio, Luca; Van Herzeele, Isabelle; Milner, Ross; de Vries, Jean-Paul P.M.; Schuurmann, Richte C.L.; Agarwal, Gautam; Antonello, Michele; Goncalves, Frederico Bastos; Bath, Jonathan; Beck, Adam; Berard, Xavier; Bicknell, Colin; Black, James; Bosiers, Michel; Branzan, Daniela; Budtz-Lilly, Jacob; Caradu, Caroline; Cheng, Stephen; Czerny, Martin; DeMartino, Randall; Dias, Nuno; Eagleton, Matthew; van den Eynde, Wouter; Farber, Mark; Fazzini, Stefano; Ferrer, Ciro; Fioole, Bram; Forbes, Thomas; Freyrie, Antonio; Gargiulo, Mauro; Geelkerken, Bob; Haulon, Stephan; van Herwaarden, Joost; Heyligers, Jan; Hicks, Caitlin; Holden, Andrew; Hörer, Tal; Houthoofd, Sabrina; Jakimowicz, Tomasz; Kahlberg, Andrea; Khashram, Manar; Kölbel, Tilo; Kotelis, Drosos; Lundberg, Göran; Maldonado, Thomas; Mangialardi, Nicola; Mani, Kevin; Mastracci, Tara; Maurel, Blandine; McCaslin, James; Mendes, Bernardo; Ohman, Westley; Orrico, Matteo; Ouriel, Kenneth; Panneton, Jean; Parlani, Gianbattista; Piffaretti, Gabriele; Pulli, Raffaele; Reijnen, Michel MPJ; Resch, Timothy; Riambau, Vicente; Ronchey, Sonia; Ruffino, Maria Antonella; van Sambeek, Marc; Scali, Salvatore; Schanzer, Andres; Schurink, Geert Willem; Settembre, Nicla; Smeds, Matthew; Tan, Glenn Wei Leong; Tielliu, Ignace; Troisi, Nicola; Tshomba, Yamyme; Ullery, Brant W.; Ünlü, Çağdaş; Upchurch, Gilbert; Veraldi, Gian Franco; Verhagen, Hence; Verhoeven, Eric; Verzini, Fabio; Wanhainen, Anders; Zimmermann, Alexander; DECIDE Collaborative Study Grp, missing |
| Source: |
JOURNAL OF ENDOVASCULAR THERAPY ; ISSN: 1526-6028 ; ISSN: 1545-1550 |
| Publication Year: |
2025 |
| Collection: |
Ghent University Academic Bibliography |
| Subject Terms: |
Medicine and Health Sciences; abdominal aortic aneurysm; endovascular aneurysm repair; Delphi consensus; stents; iliac artery; guidelines; ABDOMINAL AORTIC-ANEURYSM; HIGH-RISK; EVAR; RECONSTRUCTION; CRITERIA; RUPTURE |
| Description: |
Objective: Knowledge of hostile factors and their influence on long-term seal in the iliac landing zone is limited. Currently endorsed clinical practice guidelines lack structural evidence on how the iliac landing zone should be assessed in the pre-, intra-, and postoperative phases. The goal of this study was to obtain an international, expert-based consensus on the definition of a hostile iliac landing zone, on how to size and plan stent-grafts to optimize sustainable distal seal, and on the postprocedural follow-up protocol. Methods: Delphi consensus methodology was used, involving a panel of international vascular surgeons experienced in endovascular aneurysm repair (EVAR). The first round consisted of open-ended and multiple-choice questions to explore current practices, with subsequent rounds refining statements through a 4-point Likert scale. Consensus was defined as >75% agreement or disagreement, and the analysis included stability testing and strength of consensus. Results: The study engaged 77 international vascular surgeons, reflecting diverse geographic locations and hospital affiliations. Consensus was achieved on critical preoperative planning elements for EVAR, including a clear definition for a hostile iliac landing zone. The importance of computed tomography angiography for postoperative follow-up imaging was emphasized, including evaluating distal seal length and recommending specific timing for follow-up computed tomography scans and intervention strategies for diminishing iliac seal. Conclusions: This international expert-based Delphi consensus establishes a comprehensive set of consensus-driven recommendations focused on the definition and management of hostile iliac landing zones in EVAR. The key recommendation of this study is the definition of a hostile iliac landing zone as short (24 mm), or conical (>10% diameter difference along the landing zone). Although consensus was achieved on several critical aspects, the study also reveals ongoing debates and ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://biblio.ugent.be/publication/01JKTFNG98W61Z72S8QY6HPADN; https://doi.org/10.1177/15266028241295919; https://biblio.ugent.be/publication/01JKTFNG98W61Z72S8QY6HPADN/file/01JKTFNKZV3JPB0WAS71K3YSD4 |
| DOI: |
10.1177/15266028241295919 |
| Availability: |
https://biblio.ugent.be/publication/01JKTFNG98W61Z72S8QY6HPADN; https://hdl.handle.net/1854/LU-01JKTFNG98W61Z72S8QY6HPADN; https://doi.org/10.1177/15266028241295919; https://biblio.ugent.be/publication/01JKTFNG98W61Z72S8QY6HPADN/file/01JKTFNKZV3JPB0WAS71K3YSD4 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.6BB61E83 |
| Database: |
BASE |