Though so many specialties touch on PEs, they’re still relatively understudied, Dr. Sista said. There is a paucity of data and previous studies have either lacked randomization or provided insufficient hard clinical outcomes data. PE-TRACT is designed to not only meet rigorous scientific standards, but also to answer larger questions within the disease space.
“The second goal of PE-TRACT is to really understand the natural history of PE through a rigorous trial and to see if something we as IRs do relatively frequently can improve quality of life and functional capacity and exercise tolerance in the year following PE,” said Dr. Sista.
Applications, which can be 450 pages long, require the work of 20–30 people, building a team within your institution, as well as advocating for the research to outside communities. Trials of this level also benefit from insight into current trends in industry.
Designing an NIH-funded trial Dr. Sista compared the potential impact of PE-TRACT to that of the ATTRACT trial, led by Suresh Vedantham, MD, FSIR, which provided substantial data on the nature of deep vein thrombosis, as well as patient selection for endovascular therapies.
The comparison is natural, as Dr. Sista worked closely with Dr. Vedantham on the ATTRACT trial. After designing an initial clinical trial protocol for investigating CDT for PE during a Radiological Society of North America workshop in 2014, Dr. Sista reached out to Dr. Vedantham for aid.
Akhi Sista, MD, FSIR
Suresh Vedantham, MD, FSIR
“Dr. Vedantham offered to bring the ATTRACT group together to consider the project,” Dr. Sista said, which he calls the “genesis” of the PE-TRACT trial. From there, Dr. Sista and fellow investigators applied to the NHLBI four times for funding before successfully obtaining a grant in summer 2022.
“Suresh told me to count on it being a longer project than expected,” Dr. Sista said. “I didn’t initially believe him. But once you’re down the path, you see that there’s another step ahead, something can be improved. There’s always an opportunity to continue the process, and by continuing you are striving for something that is so important for your specialty.”
The process was difficult, Dr. Sista said. Applications, which can be 450 pages long, require the work of 20–30 people, building a team within your institution, as well as advocating for the research to outside communities. Trials of this level also benefit from insight into current trends in industry. “You put together a research strategy,” Dr. Sista said, “then you develop a budget, a trial management plan and a steering committee. Then you ensure that committee is informed and actually believes you can pull it off.”
That’s where Dr. Vedantham’s mentorship was crucial, as well as his faith in Dr. Sista’s abilities. Dr. Vedantham has secured NIH funding before, so he was able to guide Dr. Sista through the process—and potential pitfalls.
“There’s a common misconception that if you write a perfect grant, you’ll get
the funding,” Dr. Vedantham said. “You do need a perfect grant, but there’s a lot more beyond that. You have to think about the way in which you as a principal investigator interact with the NIH.”
According to Dr. Vedantham, within each institute of the NIH, like the NHLBI, project officers are tasked with reaching out to the community of physicians and scientists to find opportunities for the advancement of health. There are many ways in which they perform this outreach, but according to Dr. Vedantham, establishing yourself as a resource and leader in a space and connecting it to the work the NIH does may increase your likelihood of funding.
“I don’t believe Akhi would have been funded if the NIH didn’t appreciate, outside of his grant submission, that he had put in the requisite scholarship and had the kinds of accomplishments and experiences that demonstrate he has enough insight to run a multicenter study and understand the arena and the stakeholders,” Dr. Vedantham said.
Advocating for IR A crucial takeaway, Dr. Vedantham said, is that the success of the PE-TRACT grant shows this kind of support is possible for interventional radiology.
“We don’t come up through training in the scientific knowledge of a particular disease process, so the way we get to NIH funding is different,” Dr. Vedantham said. “But my hope is that this trial may also provide insight into the ways in which an IR can become a research scientist and begin
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