Washington University School of Medicine, St. Louis, MO (S.V.).
Mayo Clinic, Rochester, MN (P.G.).
Circ Cardiovasc Interv. 2023 Jul;16(7):e012894. doi: 10.1161/CIRCINTERVENTIONS.123.012894. Epub 2023 Jun 21.
Acute iliofemoral deep vein thrombosis and chronic iliofemoral venous obstruction cause substantial patient harm and are increasingly managed with endovascular venous interventions, including percutaneous mechanical thrombectomy and stent placement. However, studies of these treatment elements have not been designed and reported with sufficient rigor to support confident conclusions about their clinical utility. In this project, the Trustworthy consensus-based statement approach was utilized to develop, via a structured process, consensus-based statements to guide future investigators of venous interventions. Thirty statements were drafted to encompass major topics relevant to venous study description and design, safety outcome assessment, efficacy outcome assessment, and topics specific to evaluating percutaneous venous thrombectomy and stent placement. Using modified Delphi techniques for consensus achievement, a panel of physician experts in vascular disease voted on the statements and succeeded in reaching the predefined threshold of >80% consensus (agreement or strong agreement) on all 30 statements. It is hoped that the guidance from these statements will improve standardization, objectivity, and patient-centered relevance in the reporting of clinical outcomes of endovascular interventions for acute iliofemoral deep venous thrombosis and chronic iliofemoral venous obstruction in clinical studies and thereby enhance venous patient care.
急性髂股深静脉血栓形成和慢性髂股静脉阻塞会给患者带来严重的伤害,目前越来越多地采用血管内静脉介入治疗,包括经皮机械血栓切除术和支架置入术。然而,这些治疗方法的研究并没有经过充分的设计和报告,因此无法得出关于其临床应用的可靠结论。在本项目中,采用值得信赖的共识声明方法,通过一个结构化的过程,制定了共识声明来指导未来的静脉介入研究。共起草了 30 条声明,涵盖了与静脉研究描述和设计、安全性结果评估、疗效结果评估以及专门评估经皮静脉血栓切除术和支架置入术相关的主要主题。通过改良德尔菲技术达成共识,一组血管疾病的医师专家对这些声明进行了投票,成功地达到了所有 30 条声明 >80%的共识(同意或强烈同意)的预定阈值。希望这些声明的指导能在临床研究中提高急性髂股深静脉血栓形成和慢性髂股静脉阻塞的血管内介入治疗的临床结果报告的标准化、客观性和以患者为中心的相关性,从而改善静脉患者的护理。