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  • 1. Actual Trends in Applied Medicine Maria Kokozidou (DVM, MSc, PhD) Clinic of Vascular Surgery European Vascular Centre Aachen-Maastricht RWTH Aachen, Germany mkokozidou@ukaachen.de
  • 2. 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
  • 3. 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
  • 4. Everyday routine in the European Vascular Centre Aachen-Maastricht
  • 5. The example of chronic renal disease In the US the dialysis patients nr. raises from 340 000 in 1999 to 651 000 in 2010 Remodelling Fistula failure NIH Calcification The clinical Problem 1 J. patency rate in autologous fistula 63 %
  • 6. 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)
  • 7. 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
  • 8. Implantation of tissue engineered grafts / vessels Replacement  of  the  caro(c   Anastomosis  was  made  by  means   artery  by  a  (ssue  engineered   of  a  con(nous  suture     gra9   1   TE  Caro#s   3   na#ve  Caro#s   Transec(on  and  elimina(on  of  the   Implanted  and  perfused  gra9  a9er  opening   na(ve  artery   the  clamps   2   4   Courtesy of Dr. S. Jockenhoevel Tissue engineering Department, RWTH Aachen
  • 9. GoreTex   Gra9   Courtesy of Dr. S. Jockenhoevel Tissue engineering Department, RWTH Aachen Biomaterials  2010  
  • 10. 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?