Leadership and governance

IUAT leadership, sponsor, proposed collaborative structure and governance model.

Team

Professor Tufail Ahmed F.M. Patankar is the proposed Chief Investigator for IUAT. He is Clinical Director and Consultant Diagnostic and Interventional Neuroradiologist at Barking, Havering and Redbridge University Hospitals NHS Trust, Professor of Radiology at the University of Bolton and Honorary Professor at the University of Manchester. He has extensive experience in complex neurovascular intervention, including aneurysm coiling, flow diversion and intrasaccular technologies.

Professor Andrew Molyneux is a consultant neuroradiologist and senior clinical research fellow at the University of Oxford, and was Co-Principal Investigator of the landmark International Subarachnoid Aneurysm Trial (ISAT). ISAT transformed the management of ruptured intracranial aneurysms by establishing the role of endovascular coiling in appropriate patients, with major results published in The Lancet.

Dr Adam Dmytriw is an interventional and diagnostic neuroradiologist with a clinical and academic focus in neurointervention, endovascular neurosurgery, cerebrovascular disease, neuroimmunology and multicentre clinical research. He trained in medicine at Dalhousie University, completed postgraduate study at the University of Oxford and Harvard University, and undertook neuroradiology and neurointervention work across the University of Toronto, Brigham and Women’s Hospital, Massachusetts General Hospital and Harvard Medical School.

Dr Jeremy Lynch is a London-based Consultant Interventional Neuroradiologist at King’s College Hospital NHS Foundation Trust and Barking, Havering and Redbridge University Hospitals NHS Trust. He graduated in medicine from the University of Bristol in 2007, completed surgical training with Membership of the Royal College of Surgeons, and specialised in interventional radiology and neuroradiology at leading London centres before undertaking an international fellowship in Toronto.

Dr Mohd Shariq is a Consultant Interventional and General Neuroradiologist at Barking, Havering and Redbridge University Hospitals NHS Trust, based at Queen’s Hospital, Romford. He contributes expertise in diagnostic neuroradiology and endovascular neurovascular care within a high-volume centre.

A high-volume cerebrovascular neurosurgical Co-Chief Investigator is in development. This role is intended to provide senior neurosurgical leadership, high-volume operative cerebrovascular expertise and balance across endovascular and microsurgical perspectives within the IUAT investigator group.

Sponsor and trial delivery

The proposed sponsor is Barking, Havering and Redbridge University Hospitals NHS Trust.

The current proposal has been prepared for discussion with Oxford Clinical Trials Unit. The partnership request includes protocol development, statistical support, regulatory and ethics work, eCRF and randomisation infrastructure, site management, health economics and imaging core lab development.

Proposed governance structure

The planned structure includes:

• Trial Steering Committee
• independent Data Safety Monitoring Committee
• independent Clinical Events Committee
• independent imaging core laboratory
• patient and public involvement through Headway Brain Aneurysm Support
• CTU statistical and trial coordination support

Academic framing

IUAT is positioned as the unruptured aneurysm counterpart to ISAT. The message is not that the answer is known; it is that the question is now ready for a definitive, contemporary trial.