Ahamed Thawwab Mohideen, Ahmad Alhalawani, Shiva Dindyal, Devender Mittapalli
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引用次数: 0
Abstract
Objective: This survey aims to establish current post-EVAR surveillance practice across vascular centres in the United Kingdom (UK) and report variations in practice, including adherence to the latest European Society of Vascular Surgery (ESVS) clinical practice guidelines.
Methods: Cross-sectional web-based survey disseminated to 64 aortic centres in the UK, and data collected on use of imaging modalities (with the option to select one or multiple) at set time points after standard infrarenal and complex EVAR. Modalities included computed tomographic angiography (CTA), duplex ultrasound (DUS), contrast enhanced ultrasound (CEUS), magnetic resonance angiography (MRA) and abdominal x-ray (AXR).
Results: Response rate was 84.4% (54/64 centres). Early imaging was CTA at 44(81.5%), DUS at 22(40.7%) and AXR at 8 (14.8%) centres for standard EVAR and CTA at 37 (94.9%), DUS at 11 (28.2%) and AXR at 6 (15.4%) centres for complex EVAR, with variability in timing. One year imaging for standard EVAR was CTA at 21 (44.7%), DUS at 30 (63.8%) and AXR at 9 (19.1%) centres, and CTA at 26 (81.3%), DUS at 11 (34.4%) and AXR at 7 (21.9%) centres for complex EVAR. The predominant choice for annual surveillance after standard EVAR was DUS at 45 (83.3%) centres followed by CTA at 10 (18.5%) centres, with the dominant choice CTA at 22 (56.4%) centres and DUS at 21 (53.8%) centres after complex EVAR. Only one centre employed an extended interval after initial imaging until 5 years after EVAR.
Conclusions: This survey reveals the variation in surveillance practices after EVAR between vascular centres in the United Kingdom, with limited adherence to the ESVS clinical practice guidelines. There continues to be reliance on CTA for early post-EVAR surveillance, with ultrasound mostly used for long-term follow-up. Creation of nationally agreed consensus protocols under the stewardship of a recognized body would foster more homogeneous practice.
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Since its establishment in 2003, The Surgeon has established itself as one of the leading multidisciplinary surgical titles, both in print and online. The Surgeon is published for the worldwide surgical and dental communities. The goal of the Journal is to achieve wider national and international recognition, through a commitment to excellence in original research. In addition, both Colleges see the Journal as an important educational service, and consequently there is a particular focus on post-graduate development. Much of our educational role will continue to be achieved through publishing expanded review articles by leaders in their field.
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