An Expert Delphi Consensus on Risk Factors for Adverse Events After Endovascular Aortic Aneurysm Repair: Tier 1 Study...

Area of Science:

• Vascular Surgery
• Medical Device Technology
• Patient Safety

Background:

• Endovascular aneurysm repair (EVAR) is a common procedure for abdominal aortic aneurysms.
• Identifying risk factors for adverse events is crucial for improving patient outcomes.
• The International RIsk Stratification in EndoVascular Aneurysm Repair (IRIS-EVAR) project aims to address this need.

Purpose of the Study:

• To identify and stratify important risk factors for adverse events following EVAR using expert consensus.
• To establish a foundation for developing evidence-informed risk stratification and surveillance strategies.

Main Methods:

• A Delphi consensus methodology was employed, involving three rounds of online surveys.
• Thirty-five international EVAR experts participated, rating proposed risk factors on a 4-point Likert scale.
• Consensus was defined as >70% agreement or disagreement among panelists.

Main Results:

• 37 out of 64 assessed risk factors (58%) reached expert consensus.
• Risk factors were categorized into four domains: preoperative anatomy (14), aortic device (3), procedure performance (8), and postoperative surveillance (12).
• Key high-consensus factors included proximal aortic neck length (<15 mm and <10 mm post-implantation) and non-compliant anatomy.

Conclusions:

• Expert consensus identified significant risk factors for adverse events after EVAR.
• These factors, stratified into four domains, will guide the development of risk stratification and surveillance tools.
• The findings are expected to influence clinical decision-making and enhance post-EVAR patient management.