Aortic Dissection Research
The Aortic Dissection Charitable Trust Research Advisory Group (RAG) supports and actively promotes research in the field of aortic dissection. Aiming to save lives and improve the quality of life for those suffering from the condition, now and in the future.
The group consists of established researchers, patients and trainees chosen to represent research interests across the whole patient pathway for aortic dissection. The Research Advisory Group functions independently to advise the Trustees of the Charity on research strategy, research governance and all operational research issues.
The Aortic Dissection Research Advisory Group aims to:
- Influence and advise the national research agenda to support research in aortic dissection
- Develop and implement a research strategy and research network to support aortic dissection research in the UK and Ireland
- Review applications for support of research projects and advise on their suitability for support
- Engaging with the Aortic Dissection Charitable Trust patient panel for research project development and participation
Aortic Dissection Research Advisory Group
On September 15th 2021 the RAG, along with special guests Dr Dianna Milewicz, Dr Sandip Nandhra and Dr Jim Zhong, set out the research objectives for the charity.
World-leading aortic dissection genetics expert Dianna Milewicz, Division Director of Medical Genetics at the University of Texas Medical School and Director of the John Ritter Research Program in Aortic and Vascular Diseases, gave a perspective from the genomics work carried out in the US so far.
Aortic Dissection Research Grants
Details of the current aortic dissection research grant recipients.
Join the research panel
Do you want to help define the future of aortic research in order to enhance patient survival? Your experience and perspective are critical as a survivor, relative, or family member who has lost a loved one to AD.
AD Research Leadership
Dr Colin Bicknell BM MD FRCS
Consultant Vascular Surgeon and Head of Specialty at the Imperial Vascular Unit, London. Colin trained at Southampton and Imperial where he was awarded Bachelor of Medicine and Doctor of Medicine degrees. He is a Fellow of the Royal College of Surgeons of England and a member of the Vascular Surgical Society of Great Britain and Ireland, the British Society of Endovascular Therapy, the Royal Society of Medicine and the European Society of Vascular Surgery.
Colin is President of the British Society of Endovascular Therapy; Co-Chair of the Research Priority Setting Partnership group for the Vascular Society of Great Britain and Ireland and the James Lind Alliance; member of the Vascular Society Research Committee and Section of Surgery Committee of the Royal Society of Medicine.
He is a Clinical Reader in the Department of Surgery and Cancer, Imperial College London. He directs a translational aortic clinical research programme involving the application of technology, the generation of high performing teams and clinical treatments for aortic disease. He is the Course Director of the Imperial Health Policy MSc and has overseen the graduation of over 250 students.
Prof. Julie Sanders RGN BSc (Hon) MSc PhD FESC
Director of Clinical Research at St Bartholomew’s Hospital, Barts Health NHS Trust and Clinical Professor of Cardiovascular Nursing at the William Harvey Research Institute at Queen Mary University of London, developing research and clinical academic career opportunities for nurses and allied health professionals in cardiovascular care. Julie has a special interest in outcomes after cardiothoracic surgery, including quality of life and psychosocial recovery, and increasing nursing and allied professional research in these areas.
Julie is also the European Society of Cardiology Association of Cardiovascular Nursing and Allied Professionals (ACNAP) Secretary-Treasurer and ACNAP Science Committee Chair and Co-Founder of the Cardiac Surgery International Nursing and Allied Professional Research Network (CONNECT).
Prof. Mark Field
Honorary Associate Clinical Professor at the University of Liverpool, Consultant Aortic and Cardiac Surgery and Clinical Lead for Aortic Surgery, focusing on thoracic aortic surgery. His research interests include quality outcome measures in aortic surgery, health economics as well as all aspects of aortopathy including genomics, proteomics, metabolomics and bioengineering.
Mark is a member of the Society for Cardiothoracic Surgery, the Royal College of Surgeons Edinburgh and has several collaborations with the University Liverpool and Imperial College, London through the Institute of Cardiovascular Medicine and Science.
Prof. Aung Oo
Professor of Cardiovascular Surgery Clinical Lead for Aortovascular Surgery at The Barts Heart Centre, Barts Health NHS Trust and the NIHR Biomedical Research Centre at Barts, William Harvey Research Institute, Queen Mary University of London, St Bartholomews Hospital. Aung is one of the leading aortic surgeons in the UK with extensive experience in the surgical management of thoracoab-dominal aneurysms.
He has been the course director of the Biennial Liverpool Aortic Symposium for the last 12 years. He is NIHR CRN North Thames Cardiothoracic Surgical Subspecialty lead for research. His specific interests include clinical outcomes research in cardiac and aortic surgery and organ protection in aortic surgery.
Aung is also a highly sought-after professor, with academic and teaching responsibilities at Barts Heart Centre, the University of Liverpool, and the University of Medicine in Yangon, Myanmar.
Lived Experience Leadership
Kirsty Lawie
Kirsty became an active fundraiser for TADCT and a member of the charity’s Research Advisory Group following the sudden and unexpected death of her husband, Keith, to an aortic dissection in 2021. Having attended hospital with chest pains and been discharged with a misdiagnosis of a muscle spasm as a result of weight lifting, Keith succumbed to the condition a week later.
Kirsty is keen to do all she can to raise awareness, improve education, and support research into this survivable condition so that others like her husband can be saved.
Richard Bonella
Richard was an RAF engineer officer, then a physics teacher. He is now an AD patient, after surviving a Type A dissection in 2020. He attributes his survival to earlier cardiac surgery by New Cross Hospital in Wolverhampton, a swift diagnosis of his AD at Royal Shrewsbury Hospital and some skilled surgery at Royal Stoke University Hospital. Not to forget a lot of patient care, Covid-notwithstanding, and a daily upload of multi-coloured medications.
He hopes to make a small contribution to work on this “not common, but not rare” condition, and to cardio-vascular medicine in general. To foster the impression that he is not just a pensioner, he also volunteers with the Physics Partners charity and as a guide at the newly-renovated Shrewsbury Flaxmill Maltings.
Maggie Weber
Maggie’s husband, diagnosed with an aortic dissection, suffered a fatal ischemic stroke after surgery. His passing has made Maggie reflect on the patient journey, particularly the importance of accurate diagnosis and appropriate medical management. As a former researcher in education and health education, she’s well-equipped to apply her analytical skills to our cause.
Her unique insights into a patient’s journey and her firsthand experience with the healthcare system are invaluable. We believe Maggie’s contribution to the RAG plays a pivotal role in our pursuit to improve patient care, expedite diagnosis and increase survival rates for aortic dissection patients.
Nick Betts
Nick, an aortic dissection survivor, whose successful operation at St Barts has inspired him to give back. He has since dedicated himself to increasing awareness of aortic dissection and its early detection.
The owner of a television production company and a former MD of drama and comedy production at BBC Studios, Nick managed a department of over 500 people, producing vast amounts of television and radio content annually. His experience in handling complex information and thinking strategically aligns perfectly with the goals of our research advisory group.
Barbara Emanuel MBA
Barbara’s personal journey with aortic dissection, involving an aortic operation in the past and a more recent aortic graft, has led her to channel her experience into assisting others facing similar situations.
Barbara comes with a strong academic and professional background. A retired Learning and Development professional, she holds a degree, an MBA and a Level 8 qualification in research and leadership from Worcester University. In her role, she has demonstrated her research proficiency, working with healthcare professionals, research statisticians, and patients. Her skills in communication, project evaluation and research methodology are valuable assets to the RAG.
AD Research Leadership
Prof. Matt Reed
An esteemed figure in the field of Emergency Medicine, Prof. Reed is currently an Honorary Professor of Emergency Medicine at the University of Edinburgh and the immediate past Royal College of Emergency Medicine Professor. In addition, he is a Consultant and NRS Fellow at the Royal Infirmary of Edinburgh and serves as the Research Director of EMERGE, the Emergency Medicine Research Group Edinburgh.
Matt’s research work spans a variety of challenging areas in acute care, including aortic dissection. With over 130 published papers and more than £8.4 million personally awarded in research grants, his contributions to the field are significant.
Dr Jill Madine
As a Senior Lecturer in Biochemistry at the University of Liverpool and as a founding member of the Liverpool Aortic Biomechanics and Biochemistry Research Group (LABB), Dr Madine has been involved in aortic disease research for over a decade.
Her work encompasses a broad range of areas, including enhancing the understanding of aortic diseases, identifying future development in diagnostics and prognostic prediction, and investigating point-of-care testing and future treatments.
Jill’s experiences navigating the challenges of aortic disease research are invaluable in identifying potential issues in proposals and providing guidance on future projects.
Dr Vikas Kapil
Director of Clinical Research at St Bartholomew’s Hospital, Barts Health NHS Trust and Clinical Professor of Cardiovascular Nursing at the William Harvey Research Institute at Queen Mary University of London, developing research and clinical academic career opportunities for nurses and allied health professionals in cardiovascular care. Julie has a special interest in outcomes after cardiothoracic surgery, including quality of life and psychosocial recovery, and increasing nursing and allied professional research in these areas.
Julie is also the European Society of Cardiology Association of Cardiovascular Nursing and Allied Professionals (ACNAP) Secretary-Treasurer and ACNAP Science Committee Chair and Co-Founder of the Cardiac Surgery International Nursing and Allied Professional Research Network (CONNECT).
Dr George Krasopoulos
A renowned cardiac surgeon with a subspecialty interest in aortic surgery, Dr Krasopoulos is affiliated with multiple universities and involved in various research projects at local, national, and international levels, bringing a diverse and rich viewpoint to the team.
Currently serving as a Consultant Cardiac Surgeon at Oxford Heart Centre and an Honorary Professor in Cardiac Surgery, his invaluable expertise and unique insights significantly contributes to further research understanding and treatment of aortic dissection. George’s commitment to exploring modern treatment options, integrating services, evolving therapies, and simplifying processes undoubtedly helps us achieve our goals to enhance research efforts.
Jack Hall BEng (Hons) MSc
A medical statistician working in clinical trials at the Birmingham Clinical Trials Unit, Jack’s interest in aortic dissection research is both professional and deeply personal after losing his best friend to a ruptured dissection.
With his expertise in clinical trials and statistical analysis, Jack provides valuable insights and guidance as we delve into the intricacies of aortic dissection research. We believe his invaluable skills and personal drive will greatly contribute to the future of aortic dissection research.
Supported Research Projects
The ASES study: Aortic Syndrome Evidence Synthesis
Steve Goodacre, Professor of Emergency Medicine, The University of Sheffield
The ASES project is funded by the NIHR: National Institute for Health and Care Research, to discover how we could utilise clinical scores and blood tests to determine which patients in the emergency department require a CT aortogram. Experts in emergency medicine, surgery, imaging, statistics, and health economics are among those on the research team, as are two public representatives from the Aortic Dissection Charitable Trust.
The initiative will examine all existing research on clinical scores and blood tests to see how well they detect acute aortic syndrome. Following that, a computer model will be created to mimic how doctors would manage a population of patients with symptoms suggestive of acute aortic syndrome if alternative diagnostic procedures were applied. To select patients for a CT aortogram, the strategies will employ a clinical score and/or a blood test. The model will predict the outcomes for patients and the costs to the NHS of various solutions.
As a result, emergency medicine will be able to select the technique that achieves the optimal balance of preventing misdiagnosis while not requiring too many CT scans. This initiative will also highlight gaps in current knowledge that require additional investigation.
The Royal College of Emergency Medicine has made the diagnosis of acute aortic syndrome one of its top ten research priorities. The ASES study will ensure we make the most of the current evidence to help diagnose acute aortic syndrome and determine where future research is best focused.
The DAShED study: Diagnosis of Acute Aortic Syndrome in the Emergency Department
Matt Reed, Professor of Emergency Medicine, University of Edinburgh
The DAShED research is an observational cohort study funded by the Royal College of Emergency Medicine (RCEM) of patients visiting the ED with symptoms consistent with Acute Aortic Syndrome (AAS).
Previous research has identified several strategies for ruling out AAS that combine clinical probability scoring with blood tests (such as D-Dimer), but when these strategies are applied to a large population, such as those presenting to the ED, with a relatively low number of actual cases, they result in a high rate of computed tomographic angiography (CTA) scanning. Overtesting has a substantial economic and resource impact, as well as higher radiation risks leading to later cancer development, delays in CT scanning for patients with other conditions, and the detection of ‘incidentalomas,’ or the discovery of anomalies whose relevance is unknown.
The DAShED project will examine the features of ED visits with potential AAS and assess the service implications of various diagnostic techniques. DAShed will guide future research which we hope ultimately will lead to a standardised universal ED diagnosis route for all patients presenting to the ED with suspected AAS.
DAShED accepted its first patient on September 26, 2022, and will continue to accept patients until November 30, 2022. As of November 21st, nearly 3000 people had been enrolled on the study, which is taking place in the emergency departments of 27 hospitals across the UK. Follow-up will be complete by the end of 2022 and study results will be revealed in Spring 2023. Detailed information on this project including the clinical poster, patient information and protocol is available at EMERGE; the Emergency Medicine Research Group of Edinburgh.
DAShED is the first study attempting to really understand the broad presentation of patients to Emergency Departments who may have symptoms of Aortic Dissection.
DAShED is set to understand how ED clinicians currently chose to investigate for this time critical, potentially catastrophic condition which can be so difficult to detect amongst the myriad other potential diagnoses, and how we can standardise this in future to reduce the currently unacceptable rate of misdiagnosis.
EARNEST: Early Aortic Repair in patients Needing Endovascular Surgery for Type B Aortic Dissection
Colin Bicknell, Consultant Vascular Surgeon, Imperial College London
Approximately seven out of ten patients with type B aortic dissection have uncomplicated aortic disease with no immediate life-threatening complications. They are typically treated with the best medical treatments, including rigorous blood pressure monitoring, high blood pressure medication, and yearly aorta scans. However, one in every three individuals develops an aortic aneurysm, which must be corrected or there is a considerable risk of rupture and internal haemorrhage. This procedure is difficult and dangerous, with a high chance of death.
An earlier treatment known as thoracic endovascular aortic repair (TEVAR) may be preferable. Surgeons reline the aorta with a stent graft by a keyhole method a few months after the dissection. The treatment enables the aorta to heal while preventing it from expanding and rupturing.
This project is in the final round of competition for funding by the NIHR: National Institute for Health and Care Research, to determine if early thoracic aortic stenting in patients with uncomplicated type B aortic dissection is clinically and economically beneficial.
All participants will be evaluated for a period of five years. The most common outcome is death from aortic disease, major stroke, paralysis, or serious heart and lung illness. The experiment will investigate whether this composite result is lower in the TEVAR group compared to the normal care group, who may require a complex aortic repair at a later date, and whether this method is good value for money in the NHS.
If this experiment demonstrates a benefit to early TEVAR, thousands of patients worldwide could have their aorta relined at an early stage, avoiding complex aortic surgeries if there is late aortic deterioration.
This is a unique opportunity to run this trial in the UK. Definitive evidence regarding the clinical and cost effectiveness of early TEVAR for uncomplicated type B aortic dissection is badly needed.
If this trial shows a benefit to early TEVAR, across the world, each year, thousands of patients may have their aorta relined at an early stage and not have to undergo complex aortic operations when there is late degeneration of the aorta.
CAASP: A multi-centre service evaluation project to understand current acute aortic syndrome (AAS) pathways
Dr Jim Zhong , Interventional Radiology Fellow, Leeds Teaching Hospitals NHS Trust
Mr Sandip Nandhra, Clinical Lecturer, Newcastle University & President of the Vascular and Endovascular Research Network
Aortic dissection is not recognised or considered as a possibility in the diagnosis of acute aortic syndrome (AAS), and one in every five patients dies before reaching the hospital. To avoid life-threatening complications, early hospital admission and rigorous blood pressure control are essential. Only 2 out of every 10 patients will survive if the aorta bursts.
A quick diagnosis is essential to start the appropriate treatment. However, because dissection is uncommon in comparison to other more prevalent medical issues that can present similarly and resemble AD, such as a heart attack, bone or joint pain, or a blood clot in the lung, there may be delays in identifying AD. Because aortic dissection care is time-sensitive, these delays might have a negative impact on patients’ outcomes. Diagnosis is almost usually detected on a CT scan, which is sometimes conducted for other reasons (i.e. not looking for an aortic dissection).
This Collaborative Acute Aortic Syndrome Project will examine all individuals who had a CT scan in their local hospital (with symptoms presumably caused by an AAS) to determine how many actually had an aortic dissection. The study will then focus more thoroughly on those patients who have a fresh aortic dissection to examine if the diagnosis (and subsequent management) was made on time and, if not, why the delays occurred. We will also look at how these delays affected their outcomes six months following the initial diagnosis in terms of survival and the number of aortic surgeries.
The Collaborative Acute Aortic Syndrome Project is a research partnership with the Vascular and Endovascular Research Network (VERN), British Society of Interventional Radiology (BSIR), British Society of Endovascular Therapy (BSET), Vascular Society of Great Britain and Ireland (VSGBI), Circulation Foundation, Cardiothoracic Interdisciplinary Research Network (CIRN) and TADCT.
Join the research panel
We would appreciate it if you could contribute to any of these projects. Your experience and perspective are key as a survivor, relative, or family member who has lost a loved one to aortic dissection.
In Collaboration With
The Aortic Dissection Charitable Trust
Registered charity in the UK No. 1191420
Registered charity in Scotland No. SC051517
PO Box 812, Hope Valley, Chesterfield S40 9QY
© 2023 All Rights Reserved
This website and its content is licensed under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 International License.
The information and materials on this site are for general information purposes only. This site is not designed to provide individual medical advice, diagnosis or treatment. If you have any concerns, please speak to your GP. If you believe you have a medical emergency, call 999 immediately.
The information and materials on this site are for general information purposes only. This site is not designed to provide individual medical advice, diagnosis or treatment. If you have any concerns, please speak to your GP. If you believe you have a medical emergency, call 999 immediately.
The Aortic Dissection Charitable Trust
Registered charity in the UK No. 1191420
Registered charity in Scotland No. SC051517
PO Box 812, Hope Valley, Chesterfield S40 9QY
©
2023
All Rights Reserved
This website and its content is licensed under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 International License.
