Cook + Togni Group
Acute coronary syndromes (ACS) are life-threatening conditions of utmost clinical importance that - despite recent progress in the field-are still associated with high morbidity and mortality. ACS results from a rupture or erosion of one vulnerable atherosclerotic plaque with secondary platelet activation and thrombus formation, which leads to partial or complete luminal obstruction of the coronary artery.
Current pre-clinical research
During the last decade, scientific evidence shows that, at time of ACS, several non-culprit plaques are in a “vulnerable” state. Moreover, it has been consistently demonstrated that the vascular wall was a very active medium with healing ability. Based on these evidences, it has been suggested that therapies stimulating healing and carried out at time of percutaneous coronary intervention for ACS could help stabilizing atherosclerotic plaque at risk and decrease the risk of ACS recurrence.
From the introduction of angioplasty, its founding father, Dr. Andreas Grüntzig, envisaged balloon angioplasty of vulnerable plaque to induce healing. The concept of "balloon sealing" was born.
- In analogy to cardiac electrophysiology and dermatology, and in collaboration with the Optics Laboratory at the EPFL (Prof. Demetri Psaltis) on the one hand and with the Medical Photonics Group at the EPFL (PD Dr. Georges Wagnières), the School of Pharmaceutical Sciences at University of Geneva (Prof. Norbert Lange) and the balloon manufacturer Acrostak in Winterthur (Erwin Berger/Mathieu de Kalbermatten), we develop several strategies for plaque stabilization. This project is partly supported by Swiss National Science Foundation (SNSF) - CR32I3_150271 / 1.
- In collaboration with the Institute for Printing (iPrint) of the College of Engineering and Architecture of Fribourg (Prof. Fritz Bircher), we develop bioresorbable vascular scaffolds designed to replace the current coronary stents.
Current clinical research
We conduct an independent clinical research to test the harm reduction after percutaneous coronary intervention (PCI):
- Safety and efficacy of the newest drug-eluting stents and bioresorbable vascular scaffolds in acute coronary syndromes. EverBio-2 compares the efficacy of the bioresorbable vascular scaffolds with new generation drug-eluting stents in all-comers. The SWEET registry (in collaboration with Inselspital-Bern and Clinique la Tour, Meyrin) and BIOSCIENCE study (in collaboration with Inselspital-Bern) focuse on the efficacy and safety of newest generation drug-eluting stents in all-comer patients. The DAPT-STEMI (in collaboration with Maasstad Hospital, the Netherlands) investigates a reduced duration of dual antiplatelet therapy after PCI for ongoing myocardial infarction. The SENIOR trial tests a reduced duration of dual antiplatelet therapy after PCI in elderly patients (>75 y.o.). The MOVES trial focuses on the vessel healing after implantation of new generation drug-eluting stent versus bioresorbable vascular scaffold. The CABRAL registry (together with Luzern, Mainz and Frankfurt) interrogates the causes of scaffold thrombosis.
- AMIS plus registry (in collaboration with UniZurich) reports the clinical outcomes of patients suffering from acute coronary syndromes. EvalFAST reports the initial management and clinical outcomes after primary PCI for for ongoing myocardial infarction at Fribourg hospital.
- HAPPY and NAP wonder about the psychological consequences of myocardial infarction and possible prevention strategies.
- How to reduce radiation exposure during percutaneous coronary procedures.