UK-COMPASS

@Matt_J_Bown @Penn @damrauer @UoLCVS @uniofleicester @LeicResearch Congratulations Matt!! Well done 👏

Great time with Scott Damrauer and his excellent team at @Penn this week, culminating in the honour of delivering the D. Hayes Agnew Grand Round lecture this morning where I was honoured to receive the Agnew medal! @damrauer @UoLCVS @uniofleicester @LeicResearch

Don't miss this #EJVESVA of the 'UK- COMPASS Study: Perioperative and Midterm Outcomes' @ComplexAAAStudy @VallabhaneniRao @Jonnyboyle1 @JoseeRijn @petarz_91 #aortaed doi.org/10.1016/j.ejvs…

@smholder92 Sophie and Alastair: absolute pillars of the study along with Shaneel and Richard! And of course the full team!

Comparison of Open Surgery and Endovascular Techniques for Juxtarenal and Complex Neck Aortic Aneurysms: The UK COMPlex AneurySm Study (UK-COMPASS) – Perioperative and Midterm Outcomes - European J of Vascular and Endovascular Surgery ejves.com/article/S1078-…

UK-COMPASS mid term results e-published in EJVES. Pre-proof available on open access. Print PDF will be available soon.

@ResearchWales @davebosanquet Congratulations! Well deserved!!

This year’s Rising Research Star award goes to… David Bosanquet   @DaveBosanquet has progressed research in his field of vascular surgery. His leadership and collaboration with the research community and the public has resulted in real benefits to patients.   #ResearchWales23

A privilege to interview Dr Frank Veith about his memoir. Here he gives advice to the next generation of #vascular surgeons on how to survive in the medical jungle. ⁦@VEITHsymposium⁩

@KevinMani7 @TimResch2 @BudtzJacob @UppsalaC @AorticDissect Congratulations and all the best!

SUNDAY trial PI meeting (Scandinavian Trial of Uncomplicated Aortic Dissection Therapy) - poised to get this long-awaited trial on role of TEVAR in uncomplicated type B dissection going!

ASPIRE 8 will be held on 23/24 March 2023 in Liverpool. Can any ST8 or equivalent Vascular Trainee please DM me if interested in attending. @VSGBI @RouleauxClub @paulmoxey @GarnhamAndy @mrdavid_russell

@profawbradbury @farazhmughal Very soon - shall keep in touch.

@ComplexAAAStudy @farazhmughal Very happy to engage, of course. I congratulate you and your fellow investigtors on your study. Look forward to the papers / report. When can we expect these please? Best wishes

We are asked by our colleagues at COMPASS to accept their view that there is something about complex EVAR that, unlike any other area of cardiovascular practice, makes it uniquely impossible, and also unecessary, to test its clinical and cost-effectivness by means of RCTs

@profawbradbury @farazhmughal Thanks for engaging Andrew - a debate is very much necessary. For the record, at the study design workshop in Glasgow 2014 every FEVAR centre in the U.K. was present and not a single centre was prepared to randomise!

@ComplexAAAStudy @farazhmughal Thank you. I look forward to seeing manuscript and the HTA report. No doubt I and many other colleagues will want to further debate this with you then. Best wishes

@profawbradbury @farazhmughal We pointed out to the guidelines committee to note that an NIHR funded study, UK-COMPASS was in progress when making research recommendations. The committee chose to ignore that and recommended an RCT anyway.

@farazhmughal Neither do I and many of my colleagues. However, UK COMPASS have asked me and others to defer any further comment until the study has been published. But looking at the outcomes presented last week, it may be that they will conclude there is no longer any equipoise?

@profawbradbury @farazhmughal Andrew, the main reason for UK-COMPASS not being an RCT was a complete lack of equipoise - your centre was at our workshop in Glasgow 2014 unequivocally un-equipoised.

Reflecting of very successful #VSASM2022 in #Brighton , thank you ⁦@rebellvascular⁩ and @VSGBI for the slightly less flashy bling! Also big thanks to overseas and invited lecture speakers ⁦@AWBeckMD⁩ ⁦@KevinMani7⁩ ⁦@IanLoftus2⁩ ⁦@FLareyre⁩

@IanLoftus2 @doctorhammond @NICEComms @BSIR_News @VSGBI @cirsesociety @SIRspecialists @NIHRresearch Absolutely. Absolutely. Absolutely. More analyses coming out on this question from UK-COMPASS. Also an important strand in our design of Personalised Decision Making in AAA research.

@doctorhammond @ComplexAAAStudy @NICEComms @BSIR_News @VSGBI @cirsesociety @SIRspecialists @NIHRresearch I think we need to move away from the ‘one is better than the other’ mantra and accept these as complimentary therapies. The key surely is who benefits most from which (or conservative) treatment? Perhaps COMPASS will actually show our current selection pathways are working.

@profawbradbury @doctorhammond @NICEComms @BSIR_News @VSGBI @cirsesociety @SIRspecialists @NIHRresearch Nothing unique. Issues are methodological, practical, feasibility in a timely manner - basic elements to consider to deliver & have impact. There is little attraction in starting a study that can’t recruit or complete a study that is then ignored. Await manuscripts.

@ComplexAAAStudy @doctorhammond @NICEComms @BSIR_News @VSGBI @cirsesociety @SIRspecialists @NIHRresearch We are asked by our colleagues at COMPASS to accept their view that there is something about complex EVAR that, unlike any other area of cardiovascular practice, makes it uniquely impossible, and also unecessary, to test its clinical and cost-effectivness by means of RCTs

@profawbradbury @doctorhammond @NICEComms @BSIR_News @VSGBI @cirsesociety @SIRspecialists @NIHRresearch Reasons were presented at VSGBI. Nothing to be astonished about. Straight forward methodological issued and practicability.

@ComplexAAAStudy @doctorhammond @NICEComms @BSIR_News @VSGBI @cirsesociety @SIRspecialists @NIHRresearch Truly astonishing claim to say that an RCT is no longer needed, and is not feasible. What exactly makes AAA intervention different from every other field of medicine and surgery?

@IanLoftus2 @doctorhammond @NICEComms @BSIR_News @VSGBI @cirsesociety @SIRspecialists @NIHRresearch Results pattern is the same as in RCTs of Open V Endo. The divergence is muted when risk adjusted but still there. Agree not the same as RCT, but no RCT was powered beyond peri-op death. Caution always necessary, but there are few surprises here.

@ComplexAAAStudy @doctorhammond @NICEComms @BSIR_News @VSGBI @cirsesociety @SIRspecialists @NIHRresearch Let’s be cautious there. There is probably no way to appropriately risk adjust these groups for long term outcomes. They will be different patient groups. These data, as seen so far, are not enough to start shouting down endo yet again, and denying patients treatment.

@ComplexAAAStudy @DevinZarkowsky @doctorhammond @NICEComms @BSIR_News @VSGBI @cirsesociety @SIRspecialists @NIHRresearch @BEST_CLI In this case I see general agreement across studies. One treatment is safer but demonstrably less effective over time. With improvements the gap will close . The reality today in the US is rampant off IFU use even in good risk pts