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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
mkokozidou@ukaachen.de
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?
Actual trends in applied science

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Actual trends in applied science

  • 1. Maria Kokozidou (DVM, MSc, PhD) Actual Trends in Applied Medicine 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 Fistula failure NIH Calcification Remodelling 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. 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
  • 9. Biomaterials  2010   GoreTex   Gra9   Courtesy of Dr. S. Jockenhoevel Tissue engineering Department, RWTH Aachen
  • 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?