• This is the CVA laboratory

    Discover our research projects

  • The CVA lab Mission

    To find, develop and apply new therapies for the treatment of vascular diseases.

     

    Vascular diseases are the leading cause of death and disability in the western world. In order to prevent disease development and develop preventive strategies, a complete understanding of basic cellular and molecular mechanisms is necessary.

    Our research group is at the center of the vascular surgery department, which belongs to the DCV (Département Cœur Vaisseau) of the CHUV (Centre Hospitalier Universitaire Vaudois).

     

    Our group has put in place a translational platform with advanced cell- and molecular biology, animal models in combination with patient-centered research.

    The close proximity between clinical vascular surgery and research creates a unique platform for the resolution of issues of immediate concern for clinical care as well as breeding of future clinical academic leadership.

    Our goal is to better understand the processes associated with peripheral vascular diseases such as Peripheral artery disease (PAD) and Abdominal aortic aneurysm (AAA) associated with inflammation and vascular repair.

    We are also developing new research related to kidney transplantation, which constitutes a major part of our clinical activity.

    In the past few years, our laboratory has published many original peer-review articles in both clinical and fundamental research.

  • cross section artery vs vein

    Atherosclerosis frequently causes arterial occlusive disease, which most commonly affects the lower limbs and is referred to as PAD. This chronic disease affects about 20% of the population over 65 years old. It is characterized by the narrowing or occlusion of an artery of the lower limbs, which causes poor irrigation (ischemia) of tissues.

    Atherosclerosis is the primary cause of arterial occlusion due to the development of large plaques. We are more interest in the processes leading to secondary arterial occlusion. Following vascular surgery, the trauma to the operated arteries triggers complex remodeling and healing processes, which results in the development of intimal hyperplasia (IH).

  • What is intimal hyperplasia (IH) ?

    Intimal hyperplasia (IH) is the universal response of a vessel to injury. This process leads to the progressive occlusion of vessels following vascular surgery. The occurrence of restenosis due to intimal hyperplasia (IH) remains the bane of all vascular surgery as it is the first cause of late graft failure, both in vein and synthetic vascular grafts.

    Normal vessel

    Before the injury

    Inflammation phase

    immediately post surgery

    IH starts as a physiologic healing response to injury to the blood vessel wall. The injury and dysfunction of endothelial cells (EC) lining the inner part of the vessels triggers the recruitment and inflammatory response

    VSMC dedifferenciation and proliferation

    early IH

    The inflammation promotes fibrosis and ECM remodeling, and vascular smooth muscle cells (VSMC) proliferation and migration from the media to a neo-intima layer over the site of injury.

    neointima growth

    a continuous process

    The neointima layer continues to grow. the tissue becomes ever-more fibrotic and the lumen of the vessels reduces until occlusion occurs.

  • The only treatment for patients with end-stage renal disease remains kidney transplantation

    By BruceBlaus - Own work, CC BY-SA 4.0,  Kidney transplant procedure

    The kidney transplantation procedure is inevitably associated with Ischemia/reperfusion injury (IRI) to the kidney.

    In most cases, the dysfunctioning kidneys are not removed, as removal has been shown to increase the rates of surgical morbidity.
    The transplanted kidney is placed lower in the abdomen and connected to the external iliac artery and vein. The donor ureter is then anastomosed with the recipient's bladder.

     

    The lack of blood supply to kidneys during procurement and transplantation, followed by restoration of blood flow and re-oxygenation result in a complex trauma, referred to as Ischemia/reperfusion injury (IRI).
    IRI contributes to a pathological condition called acute kidney injury (AKI), which leads to rapid kidney dysfunction with high mortality rates. The pathophysiology of IRI is very complex and incompletely understood.

  • AAA scheme

    The aorta is the largest artery in the body. It starts from the heart and goes down through the chest to the abdomen where it irrigates the digestive and urinary organs. Finally, it splits in two to form the iliac arteries that irrigate the legs. It is divided into two segments, the thoracic aorta, and the abdominal aorta.

    Over time, the wall of the aorta can become brittle and dilate. The aorta becomes aneurysmal. From a certain diameter, its wall becomes so thin that it may rupture under the effect of arterial pressure.

     

    The use of EVAR and EVAS for the endovascular treatment of AAA has allowed ever improving management of this pathology. However the complications associated with the use of prosthetic material warrant the need for additional research to better understand the pathology of AAA, and in particular hemodynamics of AAA before and after reconstructive surgery.