Feasibility of a proposed randomized trial in patients with uncomplicated descending thoracic aortic dissection: Results of worldwide survey.
The trial we propose will be the first multicenter, randomized, trial investigating the role of thoracic endovascular aortic repair (TEVAR) of uncomplicated type B aortic dissection (TBAD) compared to conservative (medical) management. To document the current management approaches for uncomplicated TBAD, we performed an international survey in 130 centers (in US and worldwide), of whom 114 (89%) responded. Sixty-three (54.8%) respondents do not routinely stent uncomplicated TBAD, and 43 (37.4%) perform TEVAR based on various imaging criteria. One hundred and one respondents (88.6%) agreed that equipoise was present. Almost all respondents agreed that demonstrating an improvement in major aortic complication-free survival with TBAD would lead to change in practice. The results of the survey demonstrate that a major randomized trial to determine the optimal management strategy for uncomplicated TBAD is warranted.
Department of Surgery, Columbia University Medical Center, New York, NY. Electronic address: ffm2110@cumc.columbia.edu.
Firas F
FF
Mussa
Division of Cardiothoracic Surgery, Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
Joseph S
JS
Coselli
Department of Internal Medicine, Division of Cardiology, University of Michigan Medical Center, Ann Arbor, MI.
Kim A
KA
Eagle
D000784:Aortic Dissection / Q000628:therapy*; D017545:Aortic Aneurysm, Thoracic / Q000628:therapy*; D000072700:Conservative Treatment / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic; D015607:Stents; D011795:Surveys and Questionnaires; D014481:United States