J Vasc Interv Radiol. 2026 Jan 9:107993. doi: 10.1016/j.jvir.2026.107993. Online ahead of print.
ABSTRACT
PURPOSE: To provide recommendations for the most appropriate endovascular intervention of femoropopliteal (FP) arterial disease based on plaque characterization.
MATERIAL AND METHOD: A panel of 22 physicians from multiple disciplines participated in a modified-Delphi consensus, leveraging the RAND/UCLA Appropriateness Method. Panelists engaged in two rounds of voting, following a literature review, with an in-person discussion prior to the second round of voting. A rigorous statistical approach was utilized to analyze the points of agreement and disagreement. Consensus-based recommendations on the most appropriate endovascular approaches for treating patients with FP lesions, stratified by lesion morphology, were generated.
RESULTS: Overall, 490 individual items were included in the voting, 458 (93%) of which achieved consensus and 32 (7%) were non-consensus items, based on a priori criteria under the following categories: (1) recommendations on method for determining plaque morphology; (2) preferred endovascular devices for vessel preparation and definitive treatment stratified by (a) plaque morphology and (b) Tosaka classification of in-stent restenosis; and (3) vessel preparation device safety-related considerations.
CONCLUSION: This international, multidisciplinary consensus provides evidence- and expert-informed recommendations for vessel preparation and definitive treatment of FP arterial disease, tailored to plaque morphology. These consensus recommendations aim to support clinical decision-making and promote best interventional practices by serving as an expert-opinion supplement to existing guideline-based care pathways.
PMID:41520819 | DOI:10.1016/j.jvir.2026.107993