An education session set to take place in the afternoon of Wednesday, June 19 (3:15–4:45 p.m. in the West Building, Level 1), will examine discrepancies between Society for Vascular Surgery (SVS) and European Society for Vascular Surgery (ESVS) clinical practice guidelines.
The session centers around the fact that, with the exception of the 2019 Global Vascular Guidelines on the management of chronic limb-threatening ischemia (CLTI), the production and release of clinical practice guidelines by the respective journals of the SVS and ESVS are not coordinated or managed between these societies. Furthermore, recommendations between societal guidelines often differ, leave gaps or content areas unaddressed, or unilaterally define new content areas unique to a specific society.
Against this backdrop, the VAM 2024 session has four key aims: to highlight differences between the SVS and ESVS guidelines and how they play out in day-to-day clinical practice; to examine the scientific, cultural, societal and personal reason(s) behind these respective differences; to gain insight into the guideline development processes between the SVS and ESVS; and to consider future publication upgrades between the respective societies to harmonize recommendations or contextualize differences when apparent, in order to enhance understanding and adaptation when appropriate.
Moderating the session will be Firas Mussa, MD, of the University of Texas Health Science Center at Houston, Texas; Ronald Dalman, MD, of Stanford University in Stanford, California; Ian Loftus, MD, of St. George’s University Hospitals NHS Foundation Trust in London, England; and Thomas Forbes, MD, of the University of Toronto, Canada.
Speaking to VS@VAM, Mussa underscores what attendees can expect. “The session is meant to highlight where the SVS and ESVS might agree or disagree on clinical practice patterns. […] Furthermore, it is meant to touch on the drivers of patient care in the U.S. as compared to Europe,” he says.
Dalman notes that “there are a few important differences in guideline recommendations between those outlined by the SVS and the ESVS” and that SVS members and VAM attendees “will be interested to learn the rationale and evidence behind these differences—and make up their own minds regarding how to manage patients with these challenging conditions based on the explanations provided.”
Dalman anticipates the debate-format session will be “lively and highly engaging” and is one VAM attendees “won’t want to miss.”
Loftus remarks that international clinical guidelines are “important tools to guide patient pathways and decision-making for individual patients,” and that each set of guidelines from the SVS and the ESVS “take many months of intense collaboration between key opinion leaders in the field.” He continues, “While [society guidelines] undoubtedly advance the care of patients with vascular disease, there are often differences between individual recommendations made either side of the Atlantic, which stimulate debate and occasional controversy. It is important that guidelines reflect different healthcare systems, disease patterns and expectations of clinicians and patients alike.
“In this exciting session, we will highlight and debate some of the key differences in our important guidelines, and how they have influenced decision-making with real case examples,” Loftus says.
Forbes notes that the editors of the Journal of Vascular Surgery and the European Journal of Vascular and Endovascular Surgery have brought together an international panel to discuss the guidelines. “We’re looking forward to this session and what should be a robust discussion around these clinically relevant practice recommendations, as well as to explore opportunities to harmonize these efforts in the future,” he tells VS@VAM.
The session will cover four guideline topics, namely the management of aortic graft infection, asymptomatic carotid stenosis, intermittent claudication and the management of incompetent perforators in venous disease. Due to speak on the latter, Maarit Venermo, MD, PhD, of Helsinki University Hospital in Helsinki, Finland, highlights that the recommendations on invasive treatment of perforator veins are very different between SVS and ESVS, with the key variance being that the ESVS “is much more conservative when it comes to the invasive treatment of perforators.” These differences will be discussed in this session around a patient case, with Venermo noting that patient cases will feature throughout the session.
