Prof. dr. em. Andrew Maas (MD, PhD)
Prof. dr. Tomas Menovsky (MD, PhD)
UZA staff member
Dr. Niels Kamerling (MD)
Traumatic Brain Injury
Treatment of cerebral aneurysms: development of Bioactive Implantable Polymers based on UreidoPyrimidinone
CENTER-TBI: Collaborative European Neuro-Trauma Effectiveness Research in TBI
The annual incidence of Traumatic Brain Injury (TBI) is estimated to be up to 500/100 000 in the US and Europe. Country based incidence estimates for hospitalizations following TBI range from 100-330 new cases per 100 000 population per year. TBI constitutes a major cause of death and disability, particularly amongst young individuals, leading to great personal suffering to victims and relatives, and huge direct and indirect costs to society.
TBI is considered "the most complex disease in our most complex organ". It is characterized by great heterogeneity in terms of etiology, mechanisms, pathology, severity, and treatment, with widely varying outcomes. Falls and high velocity road traffic incidents cause different types of injury. TBI may consist of diffuse damage, contusional brain damage (bruises) or intracerebral hematoma. Structural abnormalities may or may not be visible on imaging. The clinical severity ranges from minor (minimal complaints, no visible structural damage) to virtually unsurvivable. We have found large differences in outcome between centers with up to a six fold higher risk in "poorer" vs. "better" centers after adjustment for chance effects and case mix. We now also recognize that TBI is not just an acute event, but can trigger a chronic process, with progressive injury over hours, days, weeks, months, and even years.
CENTER-TBI is a large European project that aims to
Better characterize TBI as a disease, and describe it in a European context
Identify the most effective clinical interventions for managing TBI
It forms part of the larger global initiative InTBIR: International Initiative for Traumatic Brain Injury Research with projects currently ongoing in Europe, the US and Canada.
CENTER-TBI brings the newest technologies and many of the world's leading TBI experts together in a much needed effort to tackle the silent epidemic of TBI. International and multidisciplinary collaboration are key elements to the project in which past dogmas will be left behind and innovative approaches undertaken. As Coordinators of CENTER-TBI we are proud to lead this generationally unique project.
We anticipate that CENTER-TBI will revolutionize our view of leading TBI to more effective and efficient therapy, improved health care at both individual and population based levels, and better outcomes at lower costs.
Treatment of cerebral aneurysms: development of Bioactive Implantable Polymers based on UreidoPyrimidinone (BIP-UPy):
Intracranial aneurysms are life-threatening bulges of the brain’s blood vessels. It is estimated that between 1 and 6% of the population may present them, and the associated mortality reaches 50%”. At present, the endovascular treatment of cerebral aneurysms is mainly based on platinum coils. Coils are used to fill the aneurysm sack in a manner that it creates a solid barrier that prevents further leakage or widening of the potential rupture site. However, current treatments involve high risks for the patient and high costs for the hospital.
Biomedical implants based on polymer technologies have become an indispensable part of effective modern medicine. They represent one of the most stable markets for polymers in terms of growth. The goal of the BIP-UPy project is to develop a new type of coil that would present clear advantages to the current available coils. To this purpose a method has been developed to obtain implantable polymers with bio-activity. The aim is to produce bio-active coils for the closure of intracranial aneurysma. This project will partner with the development of biodegradable meshes with improved in-situ tissue regeneration for pelvic floor repair.
Pelvic organ prolaps (POP) and stress urinary incontinence (SUI) are common disorders affecting millions of women worldwide. The estimated lifetime risk of POP is 30-50% and of SUI 20–40%. The lifetime risk to undergo surgery for POP or SUI is 11%. It is most frequently seen in women who have had children and/or hysterectomies and it may be a progressive condition that worsens over time. The current used techniques have been causing high complication rates.
Bioactive BIP-UPy implants aim at improving quality of life of people suffering from intracranial aneurysms and women with pelvic organ prolapse (POP) and stress urinary incontinence (SUI). The improved functionality and optimized compatibility with the body of these new implants will lead to improved patient outcome, reducing hospitalization time and other treatment-related risks. Hence, this will ultimately result in better health and a healthcare costs reduction.
The clinical specific objectives targeted with the new improved bioactive biomaterials are:
In the treatment of intracranial aneurysms:
reduce patient follow-up costs follow-up costs by more than 50%
minimize time of exposure to radiation from 1-3 hours to 10 minutes
decrease aneurysm recurrence from 17-33% to below 5%
For surgically treated POP and SUI:
reduce the rate of serious complications from 10% to below 3%