O-030 - PERCEPTION AND ACCEPTABILITY OF OPEN VS ENDOVASCULAR TREATMENT OF COMMON FEMORAL ARTERY DISEASE: BARRIERS AND FACILITATORS FOR RANDOMISED CONTROLLED TRIALS

TOPIC:
Peripheral Occlusive Arterial Disease
AUTHORS:
Kaneta G. (Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom ~ London ~ United Kingdom) , Saratzis A. (Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom ~ Leicester ~ United Kingdom) , Zayed H. (Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom ~ London ~ United Kingdom)
Introduction:
The Common Femoral Artery (CFA) is often affected by atherosclerosis in patients with Peripheral Arterial Disease (PAD), requiring revascularisation. CFA Endarterectomy (CFAE) remains the standard of care in this context; however, there have been multiple recent advances in endovascular CFA therapies. Randomised Controlled Trials (RCTs) comparing CFA treatments, though, have suffered from multiple pitfalls. This research assessed barriers and enablers of delivering high-quality RCTs in this context, from a healthcare professionals' point-of-view.
Methods:
A mixed-methods qualitative study was performed, including a structured online survey and a face-to-face semi-structured interviews with healthcare professionals. Survey content and interview topic guides were developed following a literature review to identify ongoing and completed RCTs comparing CFA treatments. Results were analysed using thematic analysis.
Results:
A total of 121 participants completed the online survey, including vascular surgeons (75, 62%) and interventional radiologists (22, 18%), mostly from the United Kingdom (92, 76%). A total of 61 participants (51%) would be willing to take part in a RCT comparing open vs. endovascular CFA revascularisation. The majority (89, 74%) believed that such an RCT is urgently needed. A total of 15 participants were interviewed face-to-face. Five main themes emerged regarding barriers and facilitators for a high-quality RCT in this context: factors directly limiting patient recruitment; clinicians' attitudes towards equipoise between treatments; clinicians' attitudes towards endovascular therapies; attitudes towards outcomes examined in a potential RCT; factors facilitating patient recruitment. From these, 10 subthemes were identified. Figure 1 shows a thematic map of the views of healthcare professionals.
Conclusion:
This study showed that the majority of the surveyed healthcare professionals believe that an RCT comparing cost- and clinical- effectiveness of surgery vs. endovascular treatments for CFA disease is necessary and the vast majority would not object to taking part in this trial. It has also identified potential barriers and enablers which should be taken into consideration when designing and delivering such a trial.
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