TY - JOUR
T1 - Infective Native Aortic Aneurysm
T2 - a Delphi Consensus Document on Treatment, Follow Up, and Definition of Cure
AU - the Academic Research Consortium of Infective Native Aortic Aneurysm (ARC of INAA)
AU - Wyss, Thomas R.
AU - Giardini, Matteo
AU - Sörelius, Karl
AU - Adam, Donald
AU - Assadian, Ojan
AU - Beck, Adam W.
AU - Berard, Xavier
AU - Boutoille, David
AU - Budtz-Lilly, Jacob
AU - Chakfé, Nabil
AU - Clough, Rachel E.
AU - Czerny, Martin
AU - Dang, Michael
AU - D'Oria, Mario
AU - Eldrup, Nikolaj
AU - Fourneau, Inge
AU - Gheysens, Olivier
AU - Glaudemans, Andor W.J.M.
AU - Hasse, Barbara
AU - Heinola, Ivika
AU - Henckaerts, Liesbet
AU - Hosaka, Akihiro
AU - Huang, Yao Kuang
AU - Husmann, Lars
AU - Jutidamrongphan, Warissara
AU - Kakkos, Stavros
AU - Kan, Chung Dann
AU - Kölbel, Tilo
AU - Lau, Christopher
AU - Lauri, Chiara
AU - Lawaetz, Martin
AU - Ljungquist, Oskar
AU - Lyons, Oliver
AU - Maciej, Juszczak
AU - Mani, Kevin
AU - Moulakakis, Konstantinos
AU - Oderich, Gustavo S.
AU - Resch, Timothy
AU - Schmidli, Jürg
AU - Sedivy, Petr
AU - Senneville, Eric
AU - Shirasu, Takuro
AU - Skov, Rebecca Andrea Conradsen
AU - Slart, Riemer H.J.A.
AU - Szeberin, Zoltan
AU - Touma, Joseph
AU - van den Berg, Jos C.
AU - Veger, Hugo T.C.
AU - Wanhainen, Anders
AU - Weiss, Salome
N1 - Publisher Copyright:
© 2023 The Author(s)
PY - 2024/4
Y1 - 2024/4
N2 - Objective: Evidence is lacking to guide the management of infective native aortic aneurysm (INAA). The aim of this study was to establish expert consensus on surgical and antimicrobial treatment and follow up, and to define when an INAA is considered cured. Methods: Delphi methodology was used. The principal investigators invited 47 international experts (specialists in infectious diseases, radiology, nuclear medicine, and vascular and cardiothoracic surgery) via email. Four Delphi rounds were performed, three weeks each, using an online questionnaire with initially 28 statements. The panellists rated the statements on a five point Likert scale. Comments on statements were analysed, statements were revised and added or deleted, and the results were presented in the iterative rounds. Consensus was defined as ≥ 75% of the panel rating a statement as strongly agree or agree on the Likert scale, and consensus on the final assessment was defined as Cronbach's alpha > 0.80. Results: All 49 panellists completed all four rounds, resulting in 100% participation. One statement was added based on the results and comments of the panel, resulting in 29 final statements: three on need for consensus, 20 on treatment, five on follow up, and one on definition of cure. All 29 statements reached agreement of ≥ 86%. Cronbach's alpha increased for each consecutive round; round 1, 0.85; round 2, 0.90; round 3, 0.91; and round 4, 0.94. Thus, consensus was reached for all statements. Conclusion: INAAs are rare, and high level evidence to guide optimal management is lacking. This consensus document was established with the aim of helping clinicians manage these challenging patients, as a supplement to current guidelines. The presented consensus will need future amendments in accordance with newly acquired knowledge.
AB - Objective: Evidence is lacking to guide the management of infective native aortic aneurysm (INAA). The aim of this study was to establish expert consensus on surgical and antimicrobial treatment and follow up, and to define when an INAA is considered cured. Methods: Delphi methodology was used. The principal investigators invited 47 international experts (specialists in infectious diseases, radiology, nuclear medicine, and vascular and cardiothoracic surgery) via email. Four Delphi rounds were performed, three weeks each, using an online questionnaire with initially 28 statements. The panellists rated the statements on a five point Likert scale. Comments on statements were analysed, statements were revised and added or deleted, and the results were presented in the iterative rounds. Consensus was defined as ≥ 75% of the panel rating a statement as strongly agree or agree on the Likert scale, and consensus on the final assessment was defined as Cronbach's alpha > 0.80. Results: All 49 panellists completed all four rounds, resulting in 100% participation. One statement was added based on the results and comments of the panel, resulting in 29 final statements: three on need for consensus, 20 on treatment, five on follow up, and one on definition of cure. All 29 statements reached agreement of ≥ 86%. Cronbach's alpha increased for each consecutive round; round 1, 0.85; round 2, 0.90; round 3, 0.91; and round 4, 0.94. Thus, consensus was reached for all statements. Conclusion: INAAs are rare, and high level evidence to guide optimal management is lacking. This consensus document was established with the aim of helping clinicians manage these challenging patients, as a supplement to current guidelines. The presented consensus will need future amendments in accordance with newly acquired knowledge.
UR - http://www.scopus.com/inward/record.url?scp=85184754325&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85184754325&partnerID=8YFLogxK
U2 - 10.1016/j.ejvs.2023.12.008
DO - 10.1016/j.ejvs.2023.12.008
M3 - Article
C2 - 38097164
AN - SCOPUS:85184754325
SN - 1078-5884
VL - 67
SP - 654
EP - 661
JO - European Journal of Vascular and Endovascular Surgery
JF - European Journal of Vascular and Endovascular Surgery
IS - 4
ER -