Aims - Radboudumc

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Aims

We improve personalised treatment for patients with PAD and AAA. We aim to improve treatment for patients with peripheral arterial disease (PAD) and abdominal aortic aneurysms (AAA) by developing personalised treatment strategies. By combining clinical research, translational science and patient-specific risk assessment, we seek to select the most appropriate treatment for each individual patient and improve long-term outcomes.
- Personalized Antithrombotic Therapy in PAD:
  ntithrombotic therapy in PAD patients can be optimized by tailoring treatment based on genetic markers. CYP2C19-guided therapy helps to select the most effective and safest antithrombotic regimen, reducing the risk of thrombotic and bleeding complications.
  - GENPAD study (NCT04619927): "Genotype-Guided Antithrombotic Therapy in Peripheral Artery Disease" - Evaluating CYP2C19-guided therapy and individualized antithrombotic regimens.
  - Thrombo-inflammation research: Studying post-COVID vascular dysfunction and inflammatory-driven thrombosis. This research aims to improve our understanding of disease mechanisms in other vascular conditions, potentially leading to novel therapeutic targets.
- Microrobotics for Vascular Interventions:
  Magnetic microrobots are remotely controlled using external magnetic fields, allowing for precise navigation through blood vessels without the need for tethered systems. These small-scale robots offer novel solutions for minimally invasive vascular interventions, including clot retrieval, targeted radiation, and localized drug delivery.
  - WCR (Wireless Clot Retriever): Magnetic control for thrombus retrieval.
  - RUMAR (Radioactive Untethered Magnetic Robot): Targeted radiation therapy in vascular lesions.
  - UMR (Untethered Magnetic Robot): Biodegradable microrobots for local drug delivery.
- Conservative Management of Aortic Aneurysms:
  Not all patients with aortic aneurysms require immediate surgical intervention. Conservative management focuses on risk assessment, lifestyle modifications, and medical therapy to slow aneurysm progression and improve patient outcomes.
  - Optimizing patient selection: Risk stratification for complex aortic repair.
  - CATCH study: Conservative Aortic aneurysm Treatment and Comprehensive Health program (CATCH) in patients with small abdominal aortic aneurysms.
We develop next-generation technologies for minimally invasive clot removal. We aim to improve the treatment of vascular occlusions by developing innovative technologies for minimally invasive clot removal. Together with engineers, imaging specialists and industry partners, we work on image-guided and robotic solutions that enable more precise treatment and facilitate future clinical implementation.
We optimise perioperative care for laparoscopic/robot assisted surgery. We improve perioperative care by optimising neuromuscular management, enhancing intraoperative safety and promoting the use of low-pressure pneumoperitoneum. Through clinical and implementation research, we support the integration of these evidence-based strategies into routine surgical practice.
- Low-Pressure Pneumoperitoneum in Laparoscopic Surgery:
  Since 2011, our research group has conducted multiple RCTs (LEOPARD, RECOVER studies) on evaluated low-pressure pneumoperitoneum. Our recent systematic review and meta-analysis confirmed its benefits in improving postoperative outcomes after laparoscopic surgery. We recently published a systematic review and meta-analysis demonstrating that low-pressure pneumoperitoneum improves patient outcomes after laparoscopic surgery.
  - Key-paper: Reijnders-Boerboom GTJA, Albers KI, Jacobs LMC, Helden EV, Rosman C, Díaz-Cambronero O, Mazzinari G, Scheffer GJ, Keijzer C, Warlé MC. Low intra-abdominal pressure in laparoscopic surgery: a systematic review and meta-analysis. Int J Surg. 2023 May 1;109(5):1400-1411. doi: 10.1097/JS9.0000000000000289. PMID: 37026807; PMCID: PMC10389627.
- Deep Neuromuscular Blockade:
  We conducted the RELAX and EURO-RELAX studies to assess the impact of deep neuromuscular blockade on surgical conditions and intraoperative safety in laparoscopic surgery. These studies explore how optimized neuromuscular blockade can improve visibility, reduce intraoperative complications, and enhance postoperative recovery. The results of the EURO-RELAX study will be published soon.
- Innate Immune Function and Postoperative Infections:
  Multiple clinical studies have investigated the innate immune response, with a focus on the role of monocytes. Postoperative innate immune dysregulation is studied in relation to infectious complications, with the potential to identify new therapeutic targets.

Research Research groups Translational vascular surgery

About Translational vascular surgery

We aim to improve patient outcomes, with a primary focus on vascular surgery, through translational research that integrates molecular and immunological studies, large-scale clinical trials, and the development of innovative technologies.

Research group leader

prof. dr. Michiel Warlé

Aims

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Publications

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Publications

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Internationally we are also known as

Surgical Translational Science

Profile page

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Alumni

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Alumni

Dr. Veerle Bijkerk, Radboudumc
Dr. Piet Krijtenburg, Radboudumc
Dr. Kim Albers-Warlé, Radboudumc
Dr. Loes Willems, Helios Klinikum, Berlin
Dr. Esmee van Helden, CWZ
Dr. Gabby Reijnders-Boerboom, Radboudumc
Dr. Thijs Landman, general practitioner

Research programs

Programs that are connected to this research group.

Our members

Rozemarijn van der Vijver chirurg
Laszlo Groh postdoc Heelkunde
Roger Lomme researchanalist
Mark Dirven chirurg

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