OBJECTIVE: The aim of this survey was to determine Canadian vascular surgeons' experience with elective endovascular aortic repair (EVAR) and traditional open repair and their interest in participating in an expertise- based randomized controlled trial (RCT) as opposed to a conventional RCT comparing these 2 procedures. METHODS: A single-page questionnaire was developed and sent by fax, email or post to all vascular surgeons in Canada. Nonresponders were recontacted on 2 additional occasions to improve the response rate. The questionnaire had 2 sections. The first inquired about current and past practice patterns, including experience in both open and endovascular techniques. The second investigated the surgeons' belief in the value of open as opposed to endovascular repair and the value of expertise-based RCT methodology; it also canvassed their interest in participating in a future trial. Definitions of expertise in open and endovascular repair were drawn from the published literature. Criteria to determine the feasibility of conducting an expertise-based RCT were established a priori. RESULTS: The questionnaire was sent to 259 surgeons who appeared in multiple vascular surgery databases, and the overall response rate was 56% (95% confidence interval [CI] 50%-62%). The mean career experience was 406 cases (standard deviation [SD] 359) for conventional open abdominal aortic aneurysm (AAA) repair and 24 cases (SD 48) for endovascular repair. Of the responding surgeons, 51% (95% CI 41%-60%) ranked conventional open repair as "probably superior." Respondents were equally interested in participating in an RCT using either expertise-based methodology (54%, 95% CI 44%-63%) or conventional design (51%, 95% CI 41%-60%). CONCLUSION: Uncertainty exists among vascular surgeons in Canada as to the role of endovascular surgery in the repair of AAA. A national RCT comparing open with endovascular repair in the elective setting is potentially feasible with either expertise-based or conventional design. Increases in the number of surgeons who are willing to participate and have expertise in EVAR, in addition to high recruitment rates among eligible patients, will be necessary to make such a trial feasible in Canada.
OBJECTIVE: The aim of this survey was to determine Canadian vascular surgeons' experience with elective endovascular aortic repair (EVAR) and traditional open repair and their interest in participating in an expertise- based randomized controlled trial (RCT) as opposed to a conventional RCT comparing these 2 procedures. METHODS: A single-page questionnaire was developed and sent by fax, email or post to all vascular surgeons in Canada. Nonresponders were recontacted on 2 additional occasions to improve the response rate. The questionnaire had 2 sections. The first inquired about current and past practice patterns, including experience in both open and endovascular techniques. The second investigated the surgeons' belief in the value of open as opposed to endovascular repair and the value of expertise-based RCT methodology; it also canvassed their interest in participating in a future trial. Definitions of expertise in open and endovascular repair were drawn from the published literature. Criteria to determine the feasibility of conducting an expertise-based RCT were established a priori. RESULTS: The questionnaire was sent to 259 surgeons who appeared in multiple vascular surgery databases, and the overall response rate was 56% (95% confidence interval [CI] 50%-62%). The mean career experience was 406 cases (standard deviation [SD] 359) for conventional open abdominal aortic aneurysm (AAA) repair and 24 cases (SD 48) for endovascular repair. Of the responding surgeons, 51% (95% CI 41%-60%) ranked conventional open repair as "probably superior." Respondents were equally interested in participating in an RCT using either expertise-based methodology (54%, 95% CI 44%-63%) or conventional design (51%, 95% CI 41%-60%). CONCLUSION: Uncertainty exists among vascular surgeons in Canada as to the role of endovascular surgery in the repair of AAA. A national RCT comparing open with endovascular repair in the elective setting is potentially feasible with either expertise-based or conventional design. Increases in the number of surgeons who are willing to participate and have expertise in EVAR, in addition to high recruitment rates among eligible patients, will be necessary to make such a trial feasible in Canada.
Authors: P J Devereaux; Mohit Bhandari; Mike Clarke; Victor M Montori; Deborah J Cook; Salim Yusuf; David L Sackett; Claudio S Cinà; S D Walter; Brian Haynes; Holger J Schünemann; Geoffrey R Norman; Gordon H Guyatt Journal: BMJ Date: 2005-01-08
Authors: J A Heller; A Weinberg; R Arons; K V Krishnasastry; R T Lyon; J S Deitch; A H Schulick; H L Bush; K C Kent Journal: J Vasc Surg Date: 2000-12 Impact factor: 4.268
Authors: Jan D Blankensteijn; Sjors E C A de Jong; Monique Prinssen; Arie C van der Ham; Jaap Buth; Steven M M van Sterkenburg; Hence J M Verhagen; Erik Buskens; Diederick E Grobbee Journal: N Engl J Med Date: 2005-06-09 Impact factor: 91.245
Authors: T S Huber; J G Wang; A E Derrow; D A Dame; C K Ozaki; G B Zelenock; T C Flynn; J M Seeger Journal: J Vasc Surg Date: 2001-02 Impact factor: 4.268
Authors: Jonathan A Cook; Andrew Elders; Charles Boachie; Ted Bassinga; Cynthia Fraser; Doug G Altman; Isabelle Boutron; Craig R Ramsay; Graeme S MacLennan Journal: Trials Date: 2015-05-30 Impact factor: 2.279
Authors: Alain Bernard; Michel Vaneau; Isabelle Fournel; Hubert Galmiche; Patrice Nony; Jean Michel Dubernard Journal: Med Devices (Auckl) Date: 2014-09-23