Professor Bradbury’s research falls into three main areas:
- The HTA-funded Bypass Versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial.
- Basic science work looking at changes in inflammatory cytokines and haemostasis following interventions for abdominal aortic aneurysm (AAA).
- Ultrasound guided foam sclerotherapy (UGFS) for the treatment of lower limb venous disease.
BASIL trial and other research into lower limb peripheral arterial disease (PAD)
The BASIL trial was a randomised controlled trial (RCT) of surgical versus endovascular revascularisation for critical limb ischaemia (CLI) conducted over almost 10 years in 452 patients from 27 UK hospitals. The interim results were published in the Lancet in 2005 and the main final results in 2010 in a:
HTA monograph (http://www.hta.ac.uk/execsumm/summ1414.shtml)
Dedicated supplement of Journal of Vascular Surgery which contains five original papers as well as commentaries (please see Publications section below).
Professor Bradbury has been invited to present the results of the BASIL trial at many national and international conferences (Europe, North and South America, Middle East, Far East, South Africa, Australia).
Professor Bradbury is a full (and the only non-US) member of the US Society of Vascular Surgery (SVS) Critical Limb Ischaemia (CLI ) working group.
The US Society of Vascular Surgery CLI group, in collaboration with the US Food and Drug Administration (FDA), have used the BASIL (and other RCT) trial data to inform the development of Objective Performance Goals that can be used in the regulatory approval of new technologies and devices for the treatment of critical limb ischaemia in the US (for further information, please see 2009 publication on OPG, listed below).
Professor Bradbury is an Expert Adviser on the National Institute of Clinical and Health Excellence (NICE) Guideline Development Group for Lower Limb Peripheral Arterial Disease (PAD). This NICE GDG has relied heavily on the BASIL data when formulating recommendations on clinically and cost-effective treatment strategies for CLI.
Analysis of the BASIL data set continues, particularly with respect to the health economics data.
Professor Bradbury is also involved in novel health economic modelling studies as part of the NICE PAD GDG Health Economics Sub-group.
Basic science AAA research
Professor Bradbury is undertaking basic science research with Professor Gerard Nash and Dr Ed Rainger at the University of Birmingham looking at novel biomarkers in patients with vascular disease that might predict disease progression and so help better select patients for vascular and endovascular interventions.
As part of this work Professor Bradbury’s group has secured a patent (“Interleukin (IL)-1a as Biomarker for AAA”, US patent application US12/778230) (IP and Licensing, Alta Innovations, Birmingham Research Park, B15 2SQ) for Interleukin (IL)-1a as a novel biomarker for AAA.
Clinical AAA research
Professor Bradbury is Chairman of the Trial Steering Committee for the HTA funded (HTA Project 09/91/39) “The development of an algorithm to calculate in individual patients with abdominal aortic aneurysm (AAA) when repair is indicated to improve survival”.
This is a collaboration lead by Professor Charles McCollum at the University of Manchester (Surgery, Biostatistics and Health Economics) that also involves the School of Health and Related Research (ScHARR) at the University of Sheffield, MRC Biostatistics Unit in Cambridge, Vascular Governance North West (VGNW) database, and the Vascular Society of Great Britain and Ireland.
Ultrasound guided foam sclerotherapy (UGFS)
Professor Bradbury started the UGFS programme at HEFT in 2001 as part of the Varisolve European Trial and a member of the Varisolve® European Phase III Investigators Group.
Full details at http://phleb.rsmjournals.com/content/21/4/180.abstract.
Since then, Professor Bradbury has been the senior author on a number of papers in peer-reviewed surgical journals describing outcomes from this novel technique.
At HEFT, UGFS is now the preferred alternative to surgery for over 90% of patients presenting with lower limb venous disease to the academic vascular surgery unit.
Professor Bradbury has been invited to speak on, and demonstrate, UGFS at many national and international (Europe, North and South America, Middle East, Far East, South Africa, Australia) meetings, workshops and clinics.
Other venous research and academic activity
Professor Bradbury is a Founding Member and current Board Member of the European Venous Forum (EVF) and in that capacity has been part of the Faculty organizing the First (2010) and Second (October 2011) EVF Workshops.
Full details available at http://www.europeanvenousforum.org/meetings.htm.
The Second EVF Workshop was held in Vienna in October 2011 and attracted over 100 vascular specialists from 36 countries (Europe, Middle East, Far East, Africa, Australasia, South and North America). The Third EVF Workshop will be held in Cyprus in November 2012 and continues to enjoy strong industry support.
Professor Bradbury’s expertise in venous disease and, in particular UGFS, has led NICE to appoint him as an Expert Adviser to their Guideline Development Group on Varicose Veins and Chronic venous Insufficiency. The Guidelines are due to be published in 2014 and will have a major impact upon the commissioning of services for lower limb venous disease in the UK.
Professor Bradbury has been appointed by the Union Internationale de Phlebologie to the Faculty of an International Consensus Group on Venous Haemodynamics.
Professor Bradbury is also currently President of the UK Venous Forum of the Royal Society of Medicine (RSM) (2010-2012).
- Continues to publish regularly peer-reviewed papers in high impact scientific journals (list of recent publications below).
- Is currently co-editing the new (6th Edition) of Principles and Practice of Surgery (UK and International Editions). This is a very popular text among medical students (it is the preferred text for MBChB students at University of Birmingham) and young surgeons embarking upon their post-graduate surgical training.
Co-authors a number of chapters in under- and post-graduate text-books. For example, Professor Bradbury is currently working on chapters for new Editions of Davidson’s Principles and Practice of Medicine and MacLeods Clinical Examination.