The ETTAA study protocol: a UK-wide observational study of 'Effective Treatments for Thoracic Aortic Aneurysm'. Issue 6 (2nd June 2015)

• Record Type: Journal Article
• Authors: Sastry, Priya; Hughes, Victoria; Hayes, Paul; Vallabhaneni, Srinivasa; Sharples, Linda; Thompson, Matt; Catarino, Pedro; Moorjani, Narain; Vale, Luke; Gray, Joanne; Cook, Andrew; Elefteriades, John A; Large, Stephen R
• Other Names: author non-byline.; Rajakaruna Cha author non-byline.; Chetter Ian author non-byline.; Bicknell Colin author non-byline.; Spyt Tomas author non-byline.; Oo Aung author non-byline.; Dayer Mark author non-byline.; Freeman Leisa author non-byline.; Unsworth—White Jonathon author non-byline.; Quarmby John author non-byline.; Vallabhaneni Srinivasa R author non-byline.; Cooper Graham author non-byline.; Tsang Geoffrey author non-byline.; Loftus Ian author non-byline.; McCollum Charles author non-byline.; Thompson Andrew author non-byline.; Elefteriades JA author non-byline.
• Is Part Of: BMJ open. Volume 5:Issue 6(2015)
• Publication Date: 2015-06-02
• Subjects: VASCULAR MEDICINE; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2015-008147
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Introduction: Chronic thoracic aortic aneurysm (CTAA) affecting the arch or descending aorta is an indolent but life-threatening condition with a rising prevalence as the UK population ages. Treatment may be in the form of open surgical repair (OSR) surgery, endovascular stent grafting (ESG) or best medical therapy (BMT). Currently, there is no consensus on the best management strategy, and no UK-specific economic studies that assess outcomes beyond the chosen procedure, but this is required in the context of greater demand for treatment and limited National Health Service (NHS) resources. Methods and analysis: This is a prospective, multicentre observational study with statistical and economic modelling of patients with CTAA affecting the arch or descending aorta. We aim to gain an understanding of how treatments are currently chosen, and to determine the clinical effectiveness and cost-effectiveness of the three available treatment strategies (BMT, ESG and OSR). This will be achieved by: (1) following consecutive patients who are referred to the teams collaborating in this proposal and collecting data regarding quality of life (QoL), medical events and hospital stays over a maximum of 5 years; (2) statistical analysis of the comparative effectiveness of the three treatments; and (3) economic modelling of the comparative cost-effectiveness of the three treatments. Primary study outcomes are: aneurysm growth, QoL, freedom from reintervention, freedom from death or permanent neurological injury, incremental cost per quality-adjusted life year gained. Ethics and dissemination: The study will generate an evidence base to guide patients and clinicians to determine the indications and timing of treatment, as well as informing healthcare decision-makers about which treatments the NHS should provide. The study has achieved ethical approval and will be disseminated primarily in the form of a Health Technology Assessment monograph at its completion. Trial registration number: ISRCTN04044627.