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	ASTRAL — the story so far
	DOI: 10.1102/1473-1827.2003.0001
	K Wheatley
	Clinical trials unit
	Birmingham
	UK
	Corresponding address:		Keith Wheatley, Professor of Medical Statistics, Deputy Directory, University of Birmingham Clinical Trials Unit, Park Grange, 1 Somerset Road, Edgbaston, Birmingham B1 2RR, UK.
			E-mail: k.wheatley@bham.ac.uk
	Abstract
	Atherosclerotic renovascular disease (ARVD) is a relatively common and serious condition. Revascularisation is already widely used to open up the renal artery, despite the lack of evidence of any benefit on kidney function. To determine reliably whether or not there is any worthwhile benefit, large randomised trials are needed. Thus, the ASTRAL trial has been designed to compare revascularisation with medical management alone. Funded jointly by government, charity and industry, ASTRAL was fully launched in 2001 with the aim of randomising up to 1000 patients. ASTRAL is already by far the largest randomised trial in ARVD, with 225 patients by the end of 2002. To make participation easy, ASTRAL is a simple, pragmatic trial, with minimum paperwork and no extra clinic visits or tests.With widespread collaboration, ASTRAL will determine the role of revascularisation in the treatment of ARVD, enabling future patients to be offered the most appropriate therapy.
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