Research within the Vascular & Aneurysm Research Group is divided into three broad themes:
Health service outcome analysis,
Endovascular procedures; and
Mechanisms of aneurysm formation.
Health services outcome analysis in our unit has provided a wealth of evidence defining the relationship between the outcomes of vascular surgical procedures and service attributes of provider units.
This evidence has been used extensively in regional health service reconfigurations designed to provide equity of access to high quality (vascular) services – one of the cornerstones of NHS policy. At present, vascular services have been reconfigured in London as a direct result of outcomes research from our unit.
Patient outcomes are improved by the cost effective use of new technology. Our research has been instrumental in developing (BHF programme grant) and evaluating such treatments with considerable improvement in patient outcomes.
Professor Matt Thompson is a lead investigator in a randomized controlled trial (RCT) of endovascular therapy for ruptured aneurysms (IMPROVE trial – UK multi centre HTA funded) and also in the VIRTUE study (multi-centre European study of aortic dissection).
Basic science investigations have been undertaken with widespread European collaboration (EU FP7 grant) to define potential medical treatments for aneurysms. Successful experimental studies have now suggested a strategy for reducing the need for surgery in these patients. A clinical trial will start in 2011, evaluating the use of mast cell inhibition in AAA.
The focus of the Marfan Unit is to improve the diagnosis and management of Marfan syndrome and other types of genetic types of ascending aortic aneurysm.
We also aim to explore the role of fibrillin-1 in associated disorders of eye, heart and skeleton, and to define genetic causes of inherited ectopia lentis, glaucoma, scoliosis, lymphoedema, lipoedema, mitral valve prolapse and abdominal aortic aneurysm.
Our research is focused on understanding molecular mechanisms of degenerative vascular diseases, primarily unstable atherosclerotic plaque and abdominal aortic aneurysm (AAA).
The overall aim of our research is to improve evaluation of disease prognosis, management of treatment and assist in the development of new pharmacological treatments of AAA stabilisation. The research strategy may be divided into the following two components:
[I ] Defining new targets of disease.
* In collaboration with international research groups, we are part of a genome wide association study (GWAS) to determine links between specific genes and AAAs.
* To define which genes are differentially expressed in response to diseases and disease processes, we are measuring the differential transcriptional profile of human tissue biopsies from atherosclerotic plaques and AAAs.
[II] Testing new therapies and investigating their mechanisms of action.
* Using in vitro and in vivo models we test the ‘proof of principle’ of pre-clinical efficacy of new therapies.
* Finally, to assess the clinical application of our discoveries, we collaborate with our clinical colleagues to conduct clinical pilot studies and trials to establish the efficacy of new therapies.
St George’s Healthcare Vascular Institute is a specialist unit providing diagnosis and surgical treatment of disorders of the blood vessels. This includes varicose veins, blood clots, aneurysms and atherosclerosis.
It is home to a team of specialists including vascular surgeons, physicians, specialised nurses and radiologists.
The Department is the hub of the South West Thames Vascular Network which provides emergency and elective services to people living across southwest London and Surrey. The ‘spoke’ hospitals are Epsom, East Surrey, Kingston, and Mayday. The Network was set up in 1999, one of the first in the country, and has developed to be one of the biggest in the UK.
The service continues to develop and new initiatives include laser treatment of varicose veins and treats patients from across south east England for thoracic aneurysms, lymphoedema and arterio-venous malformations. The Institute has a well developed research programme.