Temporal Changes in Reintervention Rate and the Impact after EVAR. V1
Research type
Research Study
Full title
Temporal changes in reintervention rate and the impact of reinterventions after endovascular aortic repair (EVAR)
IRAS ID
247111
Contact name
Bijan Modarai
Contact email
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Endovascular aortic repair (EVAR) has been a vital intervention in the treatment of aortic diseases such as aneurysm and dissection. Research has been extensive in assessment of the procedure however, little is understood of the longer term impact on patients. Aortic diseases lead to deterioration in patient condition and death if left untreated. Morbidity and mortality are currently used as markers of operative success though, with the need to lifelong surveillance and reinterventions, may no longer be effective independent measures. Increasing experience, availability of adjuncts and refinement in peri-operative care have reduced operative mortality and complication. Patients and financial authorities demand data on whether aortic repair is likely to improve and prolong life. We suggest patient reported outcome measures (PROMs) may provide additional information not captured by morbidity and mortality data, and propose to conduct new research which includes QOL measures in patients undergoing EVAR and focus on the effect of re-interventions on QOL.
Investigation 1: Retrospective study setting
We will undertake a retrospective analysis of EVARs undertaken at St Thomas’ Hospital, investigating re-interventions as outlined above. Using routinely collected information on more than 2000 EVARs, we will extract data including co-morbidities, technical aspects related to stent graft repair, re-interventions, complications and survival. Data will be cleaned and prepared for multiple regression modelling to determine factors associated with reintervention and impact on survival.Investigation 2: Prospective Study setting
A prospective observational study, recruiting patients scheduled for aortic repair over a 20 month period, to investigate contemporary EVAR and reinterventions, capturing a rich set of baseline data to allow appropriate longitudinal analyses. This prospective element of the project will enable capture of QOL data on all patients, and will address questions about quality of life pre, immediately post and after aortic repair and re-intervention, as well as the impact of re-intervention on QOL and long term survival. We will use the SF-36 QOL measures.REC name
London - Brighton & Sussex Research Ethics Committee
REC reference
18/LO/1473
Date of REC Opinion
24 Aug 2018
REC opinion
Favourable Opinion