Highlights from new guidelines, and a chance to weigh in

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Though the Society for Vascular Surgery has long published clinical practice guidelines, its 2017 annual meeting marks the first seminar dedicated to guidelines in progress, allowing for more interaction, debate, and feedback across the vascular community before these guidelines become final.

At Friday afternoon’s update on SVS clinical practice guidelines, speakers will present on four that are in advanced development, including new global vascular guidelines.

Dr. Thomas Forbes

Dr. Thomas Forbes

Session moderator Thomas Forbes, MD, chair of vascular surgery at the University of Toronto, heads the SVS’s document oversight committee, which is responsible for guideline development. “It’s important to remember that guidelines are a work in progress,“ Dr. Forbes said, calling the session “an opportunity to get some direct verbal feedback close to the final time of completion of these guidelines and to try and engage the membership in the process a bit more.”

All too often, Dr. Forbes said, the guideline process can seem opaque, or top-town or cumbersome in soliciting and incorporating feedback – problems that this kind of interactive seminar can help rectify. “We don’t want to be Moses with the tablet from the mountain, handing them down and asking everybody to follow them without question,” he said.

Keith D. Calligaro, MD, who practices in Philadelphia, starts the seminar off with highlights from new guidelines on hospital privileges across practice settings, an update of SVS guidelines from 2008. The new guidelines “describe specific procedure-related training requirements that would then lead to privileges in a hospital setting. This is especially relevant in some of the practice environments in the U.S.,” Dr. Forbes said.

R. Eugene Zierler, MD, of the University of Washington in Seattle, will present broad-reaching new advice on the follow-up of patients after vascular procedures. These guidelines cover patients who’ve undergone a wide variety of procedures, “all the way from carotid to abdominal aortic aneurysm repairs to venous surgery – and offers specific, evidence-based recommendations for how patients should be followed up, how often they should undergo imaging, bloodwork, and other follow-up modalities,” Dr. Forbes said.

And Elliot Chaikof, MD, of Beth Israel Deaconess Medical Center in Boston, will discuss new guidelines on the care of patients with abdominal aortic aneurysms that incorporates “what we know today about the different therapeutic options: from medical management to endovascular and open repair to different treatment strategies for men and women – all this based on advances from the last couple years,” Dr. Forbes said.

Finally, in separate talks, two presenters will describe different elements of a new global vascular guideline developed jointly by the SVS, the European Society for Vascular Surgery, and the World Federation of Vascular Societies.

Andrew W. Bradbury, MD, of the University of Birmingham in the U.K. and Michael S. Conte of the University of California San Francisco will speak on some issues the guidelines are tackling, all with an aim to reflect a more inclusive, worldwide picture of vascular practice.

“This is the first time we’re going to hear what these recommendations are,” Dr. Forbes said. One highlight is likely to be a new global classification system for peripheral arterial disease. “This is a new and novel concept in vascular disease, and that is similar to the classification systems used for cancer,” Dr. Forbes said.

Dr. Forbes said that he hopes that a seminar focused on guidelines in progress will become a regular feature of the annual meeting, and that this year’s seminar will help shape the society’s approach to future guidelines as well.

“Members may know of areas of vascular surgery where there’s a real need for guidelines, or some evidence-based recommendations that we don’t have, and we’d love them to come forward and propose those topics,” he said. “We need practitioners in academic centers and community practitioners alike, to represent the breath of the work being done out there.”

Friday, June 2

3:30 p.m. – 5:00 p.m., SDCC, Room 4

C9: Update on Society for Vascular Surgery Clinical Practice Guidelines

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