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VAM Sessions Highlight Clinical Practice Guidelines
New Global Guidelines on CLI to Be Introduced
This year’s Vascular Annual Meeting (May 31 to June 3 in San Diego, with plenaries and exhibits June 1 to 3) offers a wealth of opportunities to learn about new practice procedures. Case in point: the Friday Concurrent Session (C9) from 3:30–5 p.m. organized by the Document Oversight Committee. Through a series of writing groups, the committee suggests, develops and reviews clinical practice guidelines – one of the tools the SVS provides to help members deliver evidence-based care.
Presentations Plus Open Dialogue
"We want members across practice settings to know more about our work. We also want to hear their views. We need their ideas to uphold the SVS mission of exemplary patient care," said committee Chair Thomas Forbes, MD.
New SVS Guidelines
Session participants will learn about three new guidelines that Dr. Forbes described as relevant, exciting and topical. Writing group chairs will present on behalf of their teams:
- Hospital privileges for vascular and endovascular surgery, including considerations for negotiating contracts, an update to the 2008 document, Dr. Keith Calligaro;
- Post-procedure patient follow-up, Dr. R. Eugene Zierler, RPVI;
- Care of abdominal aortic aneurysms, an update of guidelines issued in 2009, Dr. Elliot Chaikof, PhD.
New Global Guidelines
New global guidelines for the treatment of chronic limb-threatening ischemia also will be reviewed. These guidelines call for clinical decision-making based on individual risk factors. In addition, treatment would be informed by a new anatomical classification system for the leg, similar to staging systems used for cancer patients.
Three co-leaders head this initiative: Drs. Michael Conte, for the SVS; Andrew Bradbury, for the World Federation of Vascular Societies; and Philippe Kolh, PhD, for the European Society for Vascular Surgery. Through a nine-member steering committee they oversee a writing group of 60 stakeholder specialists in more than a dozen time zones.
"It’s a little like birthing a whale, but well worth it," Dr. Conte said. "Patients with CLI represent a significant portion of the people we care for around the world, and they are at serious risk for life and limb. With a more consistent vernacular and more individualized care, many limbs (that now are) lost could still be saved."
The guidelines required a strong foundation, so the team commissioned the Mayo Decision Support Group to provide an exhaustive evidence review and also create a nimble "re-review" system to facilitate expeditious updates as new research findings emerge.
The complete guidelines, now in the final stage of development, will be presented at the September ESVS meeting and will be posted on a public website for an open-comment period. For 30 days, the full range of stakeholders – individual practitioners, societies, industry, policymakers and regulators – will have an opportunity to weigh in.
Dr. Conte said the committee plans to publish final guidelines by year-end. They will be the first such guidelines since SVS, ESVS and WFVS agreed to move away from the TransAtlantic Inter-Society Consensus (TASC) system. "The process now is truly international, multidisciplinary and entirely insulated from industry influence and conflicts." Dr. Conte said.
Dr. Forbes agreed. "Our process for both SVS and global guidelines has evolved, including our approach to forming work groups. Our goal is guidelines that reflect consensus thinking of world-class experts in relevant fields so that we can offer the best possible care. With the help of our members we’re able to contribute to better care in all practice environments."