Controversies in vascular imaging and intervention: A panel discussion

Purpose: To express for educational purposes, different and often opposing views on controversial topics of current interest in vascular radiology. And to explore whether or not consensus can be reached on any of these controversial issues. Method: Panel discussion among experts in the field. With the help of a moderator, controversial topics were introduced for discussion. For each topic the moderator underscored the principal issue and asked relevant questions. All panelists were asked to express their views on all issues. The following issues were discussed: Atherectomy vs balloon angioplasty; Balloon angioplasty vs stents; Digital vs analog Imaging; TIPS as an emergency procedure; Regional thrombolysis; MRA vs conventional angiography; Laser angioplasty; Carbon dioxide angiography; Lymphangiography vs CT; The training of surgeons in angiography. The panelists were urged to avoid extensive references to the literature but rather to express their own personal opinions based on experience and practice. For each topic an attempt was made to arrive at consensus. Results: Ten issues were presented for debate and discussion. Despite divergent opinions it was possible and relatively painless to reach consensus on seven controversies. On the remaining issues the panelists agreed to disagree. However even when there was disagreement certain trends became apparent. Local considerations and resource availability accounted for varied approaches to the solution of certain controversies. Conclusions: A panel discussion among experts may be a useful way to address controversies for educational purposes. Despite divergence of opinions consensus may be reached, or in absence of consensus general trends may become apparent.