Measuring the Efficacy of Endovascular Treatment of AAA

测量 AAA 血管内治疗的疗效

• 批准号: 6605386
• 负责人: PETER L FARIES
• 金额: $ 12.73万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-04-08 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6605386
• 关键词: aorta aneurysm; blood pressure; blood vessel prosthesis; cardiovascular disorder prevention; cardiovascular surgery; cinematography; dogs; magnetic resonance imaging; medical implant science; nonhuman therapy evaluation; perfusion

DESCRIPTION (provided by applicant): This proposal describes a five year training program for the development of an academic career in Vascular Surgery for the Principal Investigator, who has completed a structured residency in Vascular Surgery at the Beth Israel Deaconess Medical Center / Harvard Medical School and is currently an Assistant Professor of Surgery in the tenure track at the Mount Sinai School of Medicine. The Mentored Scientist Clinical Development Award will support the development of the Principal Investigator, a vascular surgeon who is trained in experimental methods, into an independent investigator. The program will allow him to expand his expertise in vascular surgery research to develop, coordinate and translate laboratory findings into practical clinical applications for the endovascular treatment of patients with abdominal aortic aneurysms. The program will be performed under the mentorship of Valentin Fuster, M.D., Ph.D.. He is the past-president of the American Heart Association, Chairman of the Fellowship Training Directors Program of the American College of Cardiology and Director of the Cardiovascular Institute at the Mount Sinai Medical Center and a Professor of Medicine at the Mount Sinai School of Medicine. He has trained 38 research fellows, many of whom now direct independent laboratories. Juan Badimon, Ph.D., Professor of Medicine, will provide further supervision and training in the areas of thrombus formation and organization. Michael Marin, M.D., Professor of Surgery, a leading pioneer of endovascular stent graft treatment of abdominal aortic aneurysms will enhance the clinical applicability of the hypotheses to be tested. The focus of the research will be measuring the efficacy of endovascular stent graft treatments of abdominal aortic aneurysms. Abdominal aortic aneurysms are a leading cause of death due to aneurysm rupture. Although surgery is the only effective treatment, endovascular surgical techniques utilizing stent grafts have reduced the morbidity of repairing abdominal aortic aneurysms considerably. Endovascular treatments are designed to eliminate arterial perfusion of the aneurysm and thereby eliminate the risk of aneurysm rupture. Although significant advances have been made, the effectiveness of endovascular treatments in eliminating pressure within the aneurysm has not been definitively demonstrated. In addition, no non-invasive means of confirming successful and ongoing elimination of pressure from the aneurysm has been developed. The study will use an experimental model of abdominal aortic aneurysm with an implanted pressure transducer, developed in the principal investigator's laboratory. The effect of retrograde perfusion of the aneurysm sac on intra-aneurysmal pressure after treatment with an endovascular stent graft will be evaluated. The impact of stent graft porosity on the transmission of pressure to the aneurysm will also be studied. Pressure within the aneurysm sac will be correlated with the change in the cross-sectional area and volume of the aneurysm during systole and diastole using cine magnetic resonance imaging. This information may provide a non-invasive means of confirming the success of endovascular stent graft treatment in eliminating pressure from the aneurysm. The rich academic environment provided by the Mount Sinai School of Medicine and the Departments of Surgery and Medicine / Cardiology with the diverse resources and enthusiasm for promoting scientific research will maximize the potential for the principal investigator to establish an academic career as a clinician scientist.

描述（由申请人提供）： 本提案描述了一项为期五年的培训计划，旨在为主要研究者发展血管外科学术生涯，主要研究者已在Beth Israel Deaconess Medical Center /哈佛医学院完成了血管外科的结构化住院医师培训，目前是西奈山医学院终身职位的外科助理教授。 指导科学家临床开发奖将支持主要研究者（一名接受过实验方法培训的血管外科医生）发展为独立研究者。 该计划将使他能够扩展他在血管外科研究方面的专业知识，以开发，协调和将实验室发现转化为腹主动脉瘤患者血管内治疗的实际临床应用。 该计划将在医学博士瓦伦丁·福斯特的指导下进行，博士他是美国心脏协会的前任主席，美国心脏病学院奖学金培训主任项目主席，西奈山医学中心心血管研究所主任，西奈山医学院医学教授。 药 他培养了38名研究员，其中许多人现在领导独立实验室。Juan Badimon博士，医学教授，将提供进一步的监督和培训领域的血栓形成和组织。 迈克尔·马林，医学博士，外科教授是腹主动脉瘤血管内覆膜支架治疗的领先先驱，他将增强待检验假设的临床适用性。 研究的重点将是测量腹主动脉瘤血管内覆膜支架治疗的有效性。 腹主动脉瘤是由于动脉瘤破裂导致死亡的主要原因。 虽然手术是唯一有效的治疗方法， 利用支架移植物显著降低了修复腹主动脉瘤的发病率。 血管内治疗旨在消除动脉瘤的动脉灌注，从而消除动脉瘤破裂的风险。 尽管已经取得了显著的进展，但血管内治疗在消除血管内压力方面的有效性仍然有待进一步研究。 动脉瘤还没有被明确证实。 此外，还没有开发出确认成功和持续消除动脉瘤压力的非侵入性方法。 本研究将使用在主要研究者实验室开发的带有植入式压力传感器的腹主动脉瘤实验模型。 的 将评价血管内覆膜支架治疗后动脉瘤囊逆行灌注对动脉瘤内压的影响。 还将研究覆膜支架孔隙率对压力传递至动脉瘤的影响。 使用电影磁共振成像，动脉瘤囊内的压力将与动脉瘤在收缩期和舒张期的横截面积和体积变化相关。 该信息可提供一种非侵入性方法，确认血管内覆膜支架治疗在消除动脉瘤压力方面的成功。 西奈山医学院和外科和医学/心脏病学部门提供的丰富的学术环境，以及促进科学研究的多样化资源和热情，将最大限度地发挥主要研究者作为临床科学家建立学术生涯的潜力。