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Maria Kokozidou (DVM, MSc, PhD)
Actual Trends in Applied Medicine
Clinic of Vascular Surgery European Vascular Centre Aachen-Maastricht RWTH Aachen, Germany [email protected]
A bit of History …
2005 – decision by the RWTH in Aachen to institute the Clinic for vascular surgery within the University Clinics
Professor Michael Jacobs Head of the Surgical Clinics, AZM in Maastricht, Netherlands is invited to lead the new Clinic
01.12.2006 – certification of the European Vascular Centre Aachen-Maastricht as the first cross-national Vascular centre ever
500 inpatients/year, 800 surgical operations/year, 2000 operative procedures/year
Performance characteristic of the clinic: the neurophysiological monitoring via internet, in real time from Maastricht in thoracic / thoraco-abdominal Aorta interventions
Signalling events of the end of the 20th century
Aging population, increase in population’s mean and median ages especially in Asia and Europe
Increase of the aging diseases: renal, metabolical, cardiovascular
Increased requirement of innovative therapeutic applications
1990-2003: completion of the Human Genome Project, 20.000-25.000 genes available for further biological study plus parallel studies in selected model organisms (E. coli, mouse)
Need of animal models that will simulate the closest possible, human disease
Everyday routine in the European Vascular Centre Aachen-Maastricht
The example of chronic renal disease
In the US the dialysis patients nr. raises from 340 000 in 1999 to 651 000 in 2010
Fistula failure
NIH Calcification
Remodelling
The clinical Problem 1 J. patency rate in autologous fistula
63 %
Need for research strategies
Endovascular and peri vascular therapies Reliable animal models
Langer NDT 2009 Langer, Kokozidou, Koeppel, Magn Res 2010 (in press) Langer, Kokozidou, Koeppel, Kidney Int 2010 (in press)
Tailor made to patient medicine
Information on gene expression
Industrial and academic R & D
Application in in vitro and in vivo models
Human trial/application
na#ve Caro#s TE Caro#s
Transec(on and elimina(on of the na(ve artery
Replacement of the caro(c artery by a (ssue engineered gra9
Anastomosis was made by means of a con(nous suture
Implanted and perfused gra9 a9er opening the clamps
1
2
3
4
Courtesy of Dr. S. Jockenhoevel
Tissue engineering Department, RWTH Aachen
Implantation of tissue engineered grafts / vessels
Biomaterials 2010
GoreTex Gra9
Courtesy of Dr. S. Jockenhoevel
Tissue engineering Department, RWTH Aachen
Questions arising for tailor made to patient medicine
Cost effectiveness of R & D to application?
Insurance cost effectiveness to patient’s service?
Limits of application: age, clinical condition, economics?
Greater need than ever for cross-national instututions?
