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Arts Klinisch Onderzoeker (AKO)
- Vascular disease
- Venous thrombosis
About Our Client
Het Maastricht UMC+ onderscheidt zich (inter)nationaal door de focus op preventie. Dus niet alleen gezondheidsherstel, maar ook gezondheidsbehoud én gezondheidsbevordering. Kerntaken zijn - naast topklinische en topreferente patiëntenzorg - wetenschappelijk onderzoek en onderwijs/opleiding. Het Maastricht UMC+ kenmerkt zich daarbij door de multidisciplinaire en probleemgestuurde aanpak. Het Maastricht UMC+ heeft 715 bedden, circa 7.000 medewerkers en 4.000 studenten. Maastricht UMC+ is aangesloten bij de Nederlandse Federatie van Universitair Medische Centra.
Preventing complications of venous thrombosis and treat deep venous disease.
Venous vascular disease spans a spectrum of medical conditions including superficial venous diseases e.g.: venous insufficiency, superficial venous thrombosis, varicosities, venous ulcers as well as deep venous diseases including deep venous thrombosis, insufficiency and obstruction. Many of these very common pathologies have potentially serious consequences, including death due to pulmonary embolism and post-thrombotic syndrome (PTS). In order to better address this spectrum of disease, we established a program combining invasive and non-invasive studies. This program spans different expertise's and techniques and establishes a close collaboration between internists, pathologists, epidemiologists and radiologists.
The pathogenesis of DVD and PTS are poorly understood. In addition to limited small animal studies, human studies are essentially lacking. To address this void, we will do a prospective study in which the onset and progression of venous thrombosis is studied in patients with acute deep venous thrombosis (DVT). By directly targeting the proximal thrombus with a transcutaneous biopsy, we will explore the pathophysiological events that determine thrombus resolution and vessel wall damage, precipitating PTS. These data will be used to select the optimal animal model to further investigate treatment options.
Furthermore, new evidence with improved MRI imaging suggests that in a significant fraction of patients with "idiopathic" DVT has one or more venous anomaly that may impose an increased risk of thrombosis. With our combined expertise, the further evaluation of such anomalies in relation to thrombosis risk (biochemically analyzed) and outcome (risk of PTS and recurrent thrombosis) will be addressed.
In a randomized trial the efficacy and safety of early thrombus resolution by catheter guided thrombolysis is being studied (CAVA multicenter trial) as compared to conventional therapy with anticoagulation alone. Further studies of optimized combinations of invasive (mechanical thrombectomy, accelerated lysis, stenting) and non-invasive therapies (NOACs, new selective anticoagulants, anti-inflammatory agents) for management of DVT will be undertaken. In part, new techniques will rely on testing in large animal models which will be executed in collaboration with Aachen.
Related to deep venous disease studies will be performed to improve outcome.
We will perform studies to improve comparable outcome measures to quantify disease burden. This is done by optimizing disease specific QoL questionnaires (AVVQ, Vein QoL/Sym, CIVIC) and clinical scoring systems (CEAP, VCSS, Villalta).
Improvement of non-invasive diagnostic measures is also one of our goals (MRV, CTV, Duplex). Basic pathophysiology is also addressed by flow and pressure measurements before and after treatments to search for measures that predict treatment success and clinical outcome. Especially pathophysiology related to incompetent perforating veins and deep vein obstruction will be our focus.
We also conduct several studies to analyze new treatment modalities and to compare different existing treatment modalities. And closely related to this we will develop improved the tools and implants to positively influence outcome in close collaboration with industry (Stents, AV fistulae, implants, Geko).
Compression, as a cornerstone of conservative venous disease treatments, are researched with objective tools to measure compliance in patients with different venous disorders (PTS, post DVT, varicose veins, post-treatment).
We will, in the near future, setup registries according to the optimal QoL en clinical scoring systems to evaluate quality and cost-effectiveness of different treatment options.
The Successful Applicant
We are searching research fellows and PhD students for several projects.
What's on Offer
For AKO students several options can be created to do research in the last year or the training program, together with extensive clinical work at the ward, or/and outpatient clinic. There are also several PhD tracts available, each for a 4 year period.