Aortic Top 10 Priorities (priority setting in association with the JLA)

A workshop was held on 13th April 2021 to bring together patients and healthcare professionals to jointly agree a priority list for vascular aortic research.  The results were as follows:

  1. What is the optimal management of patients with aortic aneurysm disease using individualised risk benefit ratios?
  2. What causes aneurysms to grow and/or rupture?
  3. Can we develop a test that could diagnose patients at risk of aortic aneurysm/dissection?
  4. How do surgeons decide which treatment is best for aneurysms and are these decisions based on the latest evidence available?
  5. What is the optimum medical therapy for patients with AAA to minimise expansion / rupture?
  6. What causes an aneurysm or is associated with aneurysm formation and how can we prevent one developing?
  7. What is the best way to monitor people after treatments to repair aneurysms to make sure they don't develop problems with their repair?
  8. How do we make aneurysm surgery safer and reduce the risk of complications?
  9. How do we reduce the time it takes to recover from aortic operations?
  10. Should siblings be screened for AAA when there is a family history of aneurysm?

The following questions were also discussed and put in order of priority at the workshop:

  1. What methods, including digital technology, can be used to ensure that people with acute aortic conditions such as aneurysm rupture or dissection are diagnosed quickly and treated without delay?
  2. Aneurysms behave differently in women compared to men but both men and women are treated the same way. Should we develop sex-specific pathways to care for people with aneurysms?
  3. When should people with aneurysms be offered an operation to repair their aneurysm and how quickly should this be done if this is required?
  4. How can the risk of another aneurysm or other long term aortic complications after aneurysm repair be minimised?
  5. What is the best treatment option for "complex" AAA (e.g. those not suitable for standard stent grafts or low risk standard operations – eg short neck, iliac pathologies, juxtarenal)
  6. What is the rate of aneurysm growth or aortic growth after dissection?
  7. Can keyhole techniques and robotics make operations to repair aneurysms safer?
  8. Does having an aneurysm affect life expectancy, how can any effect of having an aneurysm be minimised and how can the patient and doctor achieve this?