Scandinavian trial of Uncomplicated Aortic Dissection Therapy (Sunday Trial)

Dissection of the descending thoracic aorta (type B aortic dissection, TBAD) is an acute, potentially lethal disease.

The majority of TBAD are uncomplicated in the acute setting, but 50% of these upcomplicated dissections (uTBAD) develop aortic dilatation which may result in fatal complications over time. Traditionally patients with uTBAD receive medical treatment (MT) with tight pulse and blood pressure control.

Minimally invasive thoracic endovascular aortic repair (TEVAR) has however raised the question on whether patients with uTBAD would benefit from early TEVAR intervention to avoid late aortic death.

Currently, there is no consensus on the role of TEVAR in uTBAD, and practice varies widely between centers.In the Scandinavian Trial of Uncomplicated Aortic Dissection Therapy (Sunday Trial) patients with uTBAD are randomized to intervention during the subacute phase of the dissection (2-12 weeks after onset) with TEVAR + MT or control with MT alone.

The primary outcome is 5-year survival, while secondary outcomes include aortic events, readmissions, quality of life and health economic evaluation.

The study design is a 1:1 randomized, open label, clinical trial with parallel assignment of patients in centers in Sweden, Denmark, Norway, Finland and Iceland.The uniform single-payor health care systems in Scandinavia, and registry-based evlauation of outcomes with minimal loss to follow-up, offers a unique possibility to perform this study with adequate population base.