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An International Ex...
An International Expert-Based CONsensus on Indications and Techniques for aoRtic balloOn occLusion in the Management of Ruptured Abdominal Aortic Aneurysms (CONTROL-RAAA)
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- D'Oria, Mario (författare)
- Division of Vascular Surgery, Cardiovascular Department, University Hospital of Trieste Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy; Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
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- Lembo, Rosalba (författare)
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
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- Hörer, Tal M., 1971- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Vascular Surgery, Carmel Lady Davis Center, Technion Institute Medical Faculty, Haifa, Israel; Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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- Rasmussen, Todd (författare)
- Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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- Mani, Kevin (författare)
- Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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- Parlani, Gianbattista (författare)
- Vascular and Endovascular Surgery Unit, S. Maria Misericordia Hospital, University of Perugia, Perugia, Italy
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- Ierardi, Anna Maria (författare)
- Diagnostic and Interventional Radiology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
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- Veraldi, Gian Franco (författare)
- Department of Vascular Surgery, University Hospital and Trust of Verona, Verona, Italy
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- Melloni, Andrea (författare)
- Division of Vascular Surgery, Department of Experimental and Clinical Sciences, University of Brescia, Brescia, Italy
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- Bonardelli, Stefano (författare)
- Division of Vascular Surgery, Department of Experimental and Clinical Sciences, University of Brescia, Brescia, Italy
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- Lepidi, Sandro (författare)
- Division of Vascular Surgery, Cardiovascular Department, University Hospital of Trieste Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
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- Bertoglio, Luca (författare)
- Division of Vascular Surgery, Department of Experimental and Clinical Sciences, University of Brescia, Brescia, Italy
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Collaborative CONTROL-RAAA Study Group, - (bidragsgivare)
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(creator_code:org_t)
- 2023
- 2023
- Engelska.
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Ingår i: Journal of Endovascular Therapy. - : Sage Publications. - 1526-6028 .- 1545-1550.
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- OBJECTIVE: To report on the recommendations of an expert-based consensus on the indications, timing, and techniques of aortic balloon occlusion (ABO) in the management of ruptured abdominal aortic aneurysms (rAAA).METHODS: Eleven facilitators created appropriate statements regarding the study issues that were voted on using a 4-point Likert scale with open-comment fields, by a selected panel of international experts (vascular surgeons and interventional radiologists) using a 3-round modified Delphi consensus procedure (study period: January-April 2023). Based on the experts' responses, only the statements reaching grade A (full agreement ≥75%) or B (overall agreement ≥80% and full disagreement <5%) were included in the final study report. The consistency of each round's answers was also graded using Cohen's kappa, the intraclass correlation coefficient, and, in case of double resubmission, Fleiss kappa.RESULTS: Sixty-three experts were included in the final analysis and voted on 25 statements related to indication and timing (n=6), and techniques (n=19) of ABO in the setting of rAAA. Femoral sheath or ABO should be preferably placed in the operating room, via a percutaneous transfemoral access, on a stiff wire (grade B, consistency I), ABO placement should be suprarenal and last less than 30 minutes (grade B, consistency II), postoperative peripheral vascular status (grade A, consistency II) and laboratory testing every 6 to 12 hours (grade B, consistency) should be assessed to detect complications. Formal training for ABO should be implemented (grade B, consistency I). Most of the statements in this international expert-based Delphi consensus study might guide current choices for indications, timing, and techniques of ABO in the management of rAAA. Clinical practice guidelines should incorporate dedicated statements that can guide clinicians in decision-making.CONCLUSIONS: At arrival and during both open or endovascular procedures for rAAA, selective use of intra-aortic balloon occlusion is recommended, and it should be performed preferably by the treating physician in aortic pathology.CLINICAL IMPACT: This is the first consensus study of international vascular experts aimed at defining the indications, timing, and techniques of optimal use of ABO in the clinical setting of rAAA. Aortic occlusion by endovascular means (or ABO) is a quick procedure in properly trained hands that may play an important role as a temporizing measure until the definitive aortic repair is achieved, whether by endovascular or open means. Since data on its use in hemodynamically unstable patients are limited in the literature, owing to practical challenges in the performance of well-conducted prospective studies, understanding real-world use by experts is of importance in addressing critical issues and identifying main gaps in knowledge.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Delphi consensus
- aortic aneurysm
- balloon occlusion
- ruptured aneurysm
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- Av författaren/redakt...
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D'Oria, Mario
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Lembo, Rosalba
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Hörer, Tal M., 1 ...
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Rasmussen, Todd
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Mani, Kevin
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Parlani, Gianbat ...
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Ierardi, Anna Ma ...
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Veraldi, Gian Fr ...
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Melloni, Andrea
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Bonardelli, Stef ...
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Lepidi, Sandro
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Bertoglio, Luca
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Collaborative CO ...
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
- Artiklar i publikationen
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Journal of Endov ...
- Av lärosätet
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Örebro universitet
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Karolinska Institutet