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
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?
