Vascular Surgery - Major Trials

Major Trials

- Edinburgh Artery Study. *Highwire results for Edinburgh Artery Study

- Netherland Vascular Study.

- Framingham heart study. Highwire results for Framingham heart Study

- MASS Trial. – the Multicentre Aneurysm Screening Study (MASS) trial. Four centres (about 7000 men); screening (and treatment) vs. control group. AAA-related mortality in the screening arm reduced by about 40%; emergency ruptured AAA reducted by about 70%; disruption to elective work was reduced; and better management of risk factors and ITU/HDU beds. The overall survival benefits remain difficult to estimate, nevertheless, screening for AAA is recommended .

- UK Small Aneurysm Trial: 1090 patients; AAA 4-5.5 cm; Immediate surgery vs. ultrasound surveillance (and treatment for rapid expansion or AAA >5.5); 30-day mortality after elective AAA repair is 5.8%. No difference in survival.

- ADAM VA Cooperative Group Trial. 73451 VA patients screened with no known hx of aneurysm; Age 50-79; AAA 4.0-5.4 cm; similar conclusion to Uk Small Aneurysm Trial.

- Joint Vascular Research Group Trial. 284 patients; Study the relationship between intraoperative intravenous heparinisation, blood loss during surgery and thrombotic complications. Conclusion: Intraoperative heparin, given before aortic cross clamping, is an important prophylaxic against perioperative MI in aortic aneurysm surgery.

- HOPE (Heart Outcomes Prevention Evaluation) study - 4046 patients with PAD. In this subgroup, there was a 22% risk reduction in patients randomized to ramipril compared with placebo,which was independent of lowering of blood pressure.

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