Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists · 2026
International European Expert Consensus on the Use of Shockwave Intravascular Lithotripsy in Iliac Arteries: A Modified Delphi Study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Saratzis Athanasios, Fazzini Stefano
Аннотация
PURPOSE: To establish pan-European expert consensus on the use of Shockwave intravascular lithotripsy (IVL) for endovascular treatment of calcified iliac steno-occlusive disease and to develop a pragmatic, expert-derived treatment algorithm.
MATERIALS AND METHODS: A modified Delphi process comprised an initial workshop, 2 anonymous online surveys and a final workshop. Experts were purposively identified through professional networks using prespecified procedural-volume and IVL-experience criteria. Round 1 combined closed questions with unrestricted free text; thematic and framework analysis informed refinement, separation or removal of candidate items for round 2. Agreement was reported as the proportion supporting each statement, with consensus defined a priori as ≥70%.
RESULTS: Twenty-six experts completed round 1 and 17 completed round 2 (65% retention); reasons for non-participation in round 2 were not collected. Vascular surgeons comprised 65% of the round 1 panel, and approximately 65% of participants practised in Italy. Sixteen final statements achieved 73% to 100% agreement. Key items supported computed tomographic angiography with duplex ultrasound (100%), planned rather than bailout IVL use (100%), calcium burden as the principal determinant (93%), and selective rather than routine intravascular imaging (93%). The final workshop approved the algorithm; item-level agreement is displayed within it.
CONCLUSION: This modified Delphi study provides a structured expert consensus and algorithm for Shockwave IVL in iliac arteries. It is an expert-opinion framework that should complement, not replace, patient-specific clinical judgement, device instructions for use and local guidance, and it requires prospective external validation.Clinical ImpactThis pan-European modified Delphi study reports expert-agreed statements on planned Shockwave IVL use, imaging, technique, adjunctive treatment and follow-up in calcified iliac disease. The algorithm displays the agreement strength for each recommendation and can support structured multidisciplinary decision-making where comparative evidence is limited. It represents expert opinion rather than a guideline. The algorithm should be applied alongside clinical judgement and device instructions for use. The consensus identified calcium definition, comparative IVL effectiveness assessment, and research priorities in this area.
MATERIALS AND METHODS: A modified Delphi process comprised an initial workshop, 2 anonymous online surveys and a final workshop. Experts were purposively identified through professional networks using prespecified procedural-volume and IVL-experience criteria. Round 1 combined closed questions with unrestricted free text; thematic and framework analysis informed refinement, separation or removal of candidate items for round 2. Agreement was reported as the proportion supporting each statement, with consensus defined a priori as ≥70%.
RESULTS: Twenty-six experts completed round 1 and 17 completed round 2 (65% retention); reasons for non-participation in round 2 were not collected. Vascular surgeons comprised 65% of the round 1 panel, and approximately 65% of participants practised in Italy. Sixteen final statements achieved 73% to 100% agreement. Key items supported computed tomographic angiography with duplex ultrasound (100%), planned rather than bailout IVL use (100%), calcium burden as the principal determinant (93%), and selective rather than routine intravascular imaging (93%). The final workshop approved the algorithm; item-level agreement is displayed within it.
CONCLUSION: This modified Delphi study provides a structured expert consensus and algorithm for Shockwave IVL in iliac arteries. It is an expert-opinion framework that should complement, not replace, patient-specific clinical judgement, device instructions for use and local guidance, and it requires prospective external validation.Clinical ImpactThis pan-European modified Delphi study reports expert-agreed statements on planned Shockwave IVL use, imaging, technique, adjunctive treatment and follow-up in calcified iliac disease. The algorithm displays the agreement strength for each recommendation and can support structured multidisciplinary decision-making where comparative evidence is limited. It represents expert opinion rather than a guideline. The algorithm should be applied alongside clinical judgement and device instructions for use. The consensus identified calcium definition, comparative IVL effectiveness assessment, and research priorities in this area.