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Mr Stuart Grant

Mr Stuart Grant

Research Fellow in Academic Surgery

The development of an algorithm to calculate in individual patients with abdominal aortic aneurysm when elective repair is indicated to improve survival.

Stuart W Grant, Prof Charles McCollum, Academic Surgery Unit UHSM.

An abdominal aortic aneurysm (AAA) is a weakening and ballooning of the main artery supplying high pressure blood from the heart to the body. It may continue to stretch until it bursts (ruptures), which is usually fatal killing 9000 people a year in the UK.

Early detection, allowing elective repair is important and the National AAA Screening programme was launched this year in Manchester. Currently surgery is indicated when the aneurysm grows to 5.5cms in men or 5.0cms in women. This clearly can not be best practice for young fit people and elderly unfit people where the risk of death following surgery is higher and life expectancy lower. The indication for surgery should ideally be based on each patientsí individual risk of rupture and of surgery.

Our objective is to develop a computer algorithm to calculate for each individual patient with AAA when elective surgery is indicated to improve their health adjusted life expectancy. This will be done using the Vascular Governance North West (VGNW) and National Vascular Databases (NVD), which contain data on over 8000 patients who have had AAA repairs. Information on aneurysm growth and risk of rupture will be produced by a re-analysis of previous studies; this will be validated using data on 1020 patients undergoing AAA surveillance at UHSM.

This project is a collaboration between Academic Surgery at UHSM, the MRC Biostatistics Unit in Cambridge and the Vascular Society of Great Britain. The project meets the CLAHR objectives by providing an evidence based change to the care pathway of people with vascular disease. Funding from the CLAHRC has allowed us to conduct pilot studies and to complete a full application to the NIHR HTA.