Endofibrosis Flow Limitations in the Iliac Artery (FLIA)
Conditions
Interventions
Results of the e-Delphi study
Sponsors
Máxima MC
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Patient representatives (Track A)Track A will include former or current endurance athletes who have undergone surgery for FLIA. Eligible participants must be adults, able to read and respond in English, and willing to reflect on their rehabilitation and RTS experiences. Patients will be recruited via participating centres, existing patient networks, and professional contacts within elite sport environments.?Patient representatives will be invited as partners providing structured, experience-based input rather than as subjects of a clinical intervention. Their contributions will focus on perceived barriers and facilitators during rehabilitation, psychosocial impact, and views on the feasibility and acceptability of proposed recommendations.?We will collect sport type (e.g., cycling, speed skating, multi-sport), competition level (elite / semielite / recreational), age at surgery, time since surgery, and whether rehabilitation was coordinated by a multidisciplinary team. These variables enable exploration of differences in acceptability/feasibility across patient subgroups.Expert panel (Track B)Track B will comprise an international panel of clinicians and subject-matter experts with demonstrable experience in the diagnosis, surgical management, and/or rehabilitation of FLIA. Targeted disciplines include vascular surgery, sports medicine, high-performance or sports physiotherapy, and other professionals with recognised expertise in FLIA (e.g., specialised radiologists or performance physicians).The initial identification of potential panel members will be conducted through a structured search of MEDLINE (PubMed) using the following keywords: “flow limitation iliac artery”, “iliac endofibrosis”, “endofibrosis”, “exercise-induced iliac artery stenosis”, and related terms. No additional filters will be applied to maximise inclusivity. Furthermore, experts will be approached via professional networks, relevant scientific societies (e.g., vascular surgery and sports medicine associations), and existing FLIA research collaborations. Purposive snowball sampling will be employed, whereby recruited panel members may nominate other qualified individuals outside their own research groups.Eligibility criteria will include a minimum threshold of FLIA cases treated or supervised within recent years, or equivalent recognised expertise evidenced by peer-reviewed publications, guideline contributions, or invited conference presentations. Efforts will be made to ensure a balanced representation across disciplines and geographic regions to enhance the generalisability of the final consensus recommendations.
Exclusion criteria
Exclusion criteria: Track A Exclusion criteria include: age <18 years, insufficient command of the English language, no history of surgical treatment for FLIA, and inability or unwillingness to provide informed consent or to complete the questionnaire independently. Track B Exclusion criteria include: lack of demonstrable clinical or scientific expertise in FLIA, no recent involvement in the diagnosis, treatment, or rehabilitation of FLIA, and inability to understand and complete the questionnaire in English.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome of Track A is a set of themes describing patient-reported experiences, barriers, facilitators, and acceptability of proposed recommendations. Qualitative data from open-ended responses will be analysed using thematic analysis by at least two researchers independently, with discrepancies resolved through discussion. Where possible, brief illustrative summaries (not verbatim quotes) will be reported in anonymised form to preserve confidentiality while conveying key insights.?The primary outcome of Track B is a set of consensus-based recommendations on postoperative care and RTS after FLIA surgery, including concrete milestones, monitoring suggestions, and criteria for progression. For each item, consensus will be quantified using predefined thresholds based on the distribution of Likert-scale responses (for example proportion of ratings in the “agree”/“strongly agree” range and measures of dispersion).?An integration step will link expert consensus items with patient-reported themes to classify each recommendation, for example as “expert consensus and patient-aligned” or “expert consensus with patient-identified concerns”. Items without expert consensus but strongly supported by patient experience will also be flagged for future empirical research or further discussion.? | — |
Secondary
| Measure | Time frame |
|---|---|
| - | — |
Countries
Afghanistan, Albania, Algeria, Andorra, Angola, Antarctica, Antigua and Barbuda, Argentina, Armenia, Aruba, Australia, Austria, Azerbaijan, Bahrain, Bangladesh, Barbados, Belarus, Belgium, Belize, Benin, Bhutan, Bolivia, Bosnia and Herzegovina, Botswana, Brazil, Brunei, Bulgaria, Burkina Faso, Burundi, Cambodia, Cameroon, Canada, Cape Verde, Central African Republic, Chad, Chile, China, Colombia, Comoros, Congo-Brazzaville, Cook Islands, Costa Rica, Croatia, Cuba, Curaçao, Cyprus, Czech Republic, Democratic Republic of the Congo, Denmark, Djibouti, Dominica, Dominican Republic, East-Timor, Ecuador, Egypt, El Salvador, Equatorial Guinea, Eritrea, Estonia, Eswatini, Ethiopia, Fiji, Finland, France, Gabon, Gambia, Georgia, Germany, Ghana, Greece, Grenada, Guatemala, Guinea, Guinea-Bissau, Guyana, Haiti, Honduras, Hungary, Iceland, India, Indonesia, Iran, Iraq, Ireland, Israel, Italy, Ivory Coast, Jamaica, Japan, Jordan, Kazakhstan, Kenya, Kiribati, Kosovo, Kuwait, Kyrgyzstan, Laos, Latvia, Lebanon, Lesotho, Liberia, Libya, Liechtenstein, Lithuania, Luxembourg, Macedonia, Madagascar, Malawi, Malaysia, Maledives, Mali, Malta, Marchall Islands, Mauritania, Mauritius, Mexico, Micronesia, Moldova, Monaco, Mongolia, Montenegro, Morocco, Mozambique, Myanmar, Namibia, Nauru, Nepal, Netherlands, New Zealand, Nicaragua, Niger, Nigeria, Niue, North-Korea, Norway, Oman, Pakistan, Palau, Palestinian Territories, Panama, Papua New Guinea, Paraguay, Peru, Philippines, Poland, Portugal, Qatar, Romania, Russian Federation, Rwanda, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Samoa, San Marino, São Tomé and Príncipe, Saudi Arabia, Senegal, Serbia, Seychelles, Sierra Leone, Singapore, Slovakia, Slovenia, Solomon Islands, Somalia, South Africa, South Korea, South Sudan, Spain, Sri Lanka, Sudan, Suriname, Sweden, Switzerland, Syria, Taiwan, Tajikistan, Tanzania, Thailand, The Bahamas, Togo, Tonga, Trinidad and Tobago, Tunisia, Turkey, Turkmenistan, Tuvalu, Uganda, Ukraine, United Arab Emirates, United Kingdom, United States, Uruguay, Uzbekistan, Vanuatu, Vatican City, Venezuela, Vietnam, Yemen, Zambia, Zimbabwe
Contacts
Public ContactM. van Hooff
Máxima MC
Outcome results
None listed