In recent years, endovascular aortic therapy has replaced or been performed to complement lengthy, complicated surgical procedures. Although interventional aortic procedures are quicker and have fewer unwanted side effects, surgery of the aorta is still done in many areas.
In order to give patients access to all their treatment options, without bias, we interventional radiologists work closely with the departments of general surgery, cardiac surgery, and anaesthesia. Such interdisciplinary interactions has put our department on the same level with the largest centers around the world. This has been a very productive time for us, as the field of endovascular aortic therapy has made tremendous strides in the last years, including both new devices and new implantation methods.
As a research group of endovascular aortic therapy in a tertiary medical center, not only are we a key player for aortic treatment in Austria, but also in the entire European community. In single- and multi-center studies, we have monitored endovascular therapy, identifying problem areas. Our national and international ties continue to grow so that we are able to offer coveted postgraduate clinical and research positions.
Section Head
Assoc. Prof. Univ. Doz. Dr. Martin Funovics, EBIR, FCIRSE
Team
Dr. Sven Hauck
Dr. Maximilian Kern
Dr.in Catharina Klausenitz
Dr.in Theresa-Marie Dachs
Dr. Funovics has performed over 15,000 Interventional procedures, involving all areas of the body. His scientific focus is endovascular treatment of aortic diseases, a rapidly growing field. Since 2010, Dr. Funovics has been responsible for the program on treating complex endovascular aortic diseases that derive from branched and fenestrated stents. Dr. Funovics collaborates with one of the biggest agents in the industry, as well as with other large academic hospitals. He has published a technique that he developed, and also an entirely new treatment concept which he created here, at the Department of Biomedical Imaging and Image-guided Therapy.
In the General Hospital in Vienna a new stent for the ascending aorta, was developed, a stent for the aortic arch first implanted, and a multi-center international study established to evaluate these new devices. We have now developed additional stents, e.g., a bridging stent connects the main aortic stent to a visceral artery, which we can assess and modify, as necessary, in our own Austrian databank. We have expanded the available therapeutic endovascular devices for the aortic arch, and developed an unprecedented endovascular graft that can be combined with an endovascular aortic valve. In collaboration with Prof. Bruno Podesser, in the Department of Biomedical Research, this implant will be tested in an animal model. Lastly, we focus on improving follow-up of these stents after placement, using the state-of-the-art photon-counting CT.
In recent years, endovascular aortic therapy has grown significantly, becoming the first-line treatment for various conditions. Nonetheless, for acute conditions of the ascending aorta, surgery remains the gold standard. Our Team has a new approach to evaluating and refining potential endovascular therapy for Type A aortic dissection, whereby fenestrated or branched aortic prostheses are extended up to and integrated into the aortic valve, overcoming the exclusion criteria. We are using animal models to improve this implant technique.
The therapeutic options for Interventional Radiology treatment of vascular diseases, especially in the aorta, have grown enormously in the last decades. Our research group is not only involved in the technical aspects of endovascular therapy, but also in the development of the complex devices, such as fenestrated and branched prostheses. Moreover, using the most modern equipment available, e.g., photon-counting CT, we aim to recognize potentially dangerous vascular diseases and/or post-treatment sequelae earlier and earlier. Above all, we remain dedicated to satisfying the wishes of our patients and to improving their quality of life.
The goal of our previous work was to summarize our available fenestrated and branched abdominal vascular stents. Our current research evaluates the reliability of Photon Counting CT imaging for the non invasive diagnosis of stent re-stenosis in phantoms and in the coronary and peripheral arteries.
Publications
Endovascular repair of penetrating thoracic aortic ulcers using tubular stent grafts versus stent grafts with a proximal scallop
Kupferthaler A, Hauck SR, Schwarz M, Kern M, Deinsberger J, Dachs TM, Neumayer C, Stelzmueller ME, Ehrlich M, Loewe C, Funovics MA
Journal of Endovascular Therapy 2022, in press
Applicability of endovascular branched and fenestrated aortic arch repair devices to treat residual type A dissection after ascending replacement.
Hauck SR, Kern M, Dachs TM, Haider L, Stelzmueller ME, Ehrlich M, Loewe C, Funovics MA.
J Vasc Surg. 2022 Aug 23:S0741-5214(22)02207-8.
[Endovascular aortic repair of endoleaks : Diagnosis, treatment, and outcomes].
Hauck SR, Schernthaner R, Dachs TM, Kern M, Funovics M.
Radiologie (Heidelb). 2022 Jul;62(7):592-600.
[Fenestrated and branched endovascular aortic prostheses : An update].
Dachs TM, Hauck SR, Kern M, Klausenitz C, Funovics MA.
Radiologie (Heidelb). 2022 Jul;62(7):586-591.
Branched versus fenestrated thoracic endovascular aortic repair in the aortic arch: A multicenter comparison.
Hauck SR, Kupferthaler A, Kern M, Rousseau H, Ferrer C, Iwakoshi S, Sakaguchi S, Stelzmueller ME, Ehrlich M, Loewe C, Funovics MA.
J Thorac Cardiovasc Surg. 2022 Apr 6:S0022-5223(22)00374-9.
Use of a Steerable Sheath for Completely Femoral Access in Branched Endovascular Aortic Repair Compared to Upper Extremity Access.
Hauck SR, Eilenberg W, Kupferthaler A, Kern M, Dachs TM, Wressnegger A, Neumayer C, Loewe C, Funovics MA.
Cardiovasc Intervent Radiol. 2022 Jun;45(6):744-751.
Structural failure in bridging stentgrafts for branched endovascular aneurysm repair: a case-control study.
Hauck SR, Kupferthaler A, Freund MC, Pichler P, Stelzmueller ME, Burghuber C, Ehrlich M, Teufelsbauer H, Loewe C, Funovics MA.
Insights Imaging. 2022 Mar 28;13(1):62.
Endovascular Stent-Graft Repair of the Ascending Aorta: Assessment of a Specific Novel Stent-Graft Design in Phantom, Cadaveric, and Clinical Application.
Hauck SR, Kupferthaler A, Stelzmüller M, Eilenberg W, Ehrlich M, Neumayer C, Wolf F, Loewe C, Funovics MA.
Cardiovasc Intervent Radiol. 2021 Jun 27.
Self-expanding nitinol stents of high versus low chronic outward force in de novo femoropopliteal occlusive arterial lesions (BIOFLEX-COF trial): study protocol for a randomized controlled trial.
Wressnegger A, Kaider A, Funovics MA.
Trials. 2017 Dec 14;18(1):594.
Successful Treatment of a Ruptured Extracranial Vertebral Artery Aneurysm with Onyx Instillation.
Kollmann D, Kinstner C, Teleky K, Wressnegger A, Koppensteiner R, Huk I, Neumayer C, Funovics M.
Ann Vasc Surg. 2016 Oct;36:290.e7-290.e10.
Treatment of the aorto-iliac segment in complex lower extremity arterial occlusive disease.
Wressnegger A, Kinstner C, Funovics M.
J Cardiovasc Surg (Torino). 2015 Feb;56(1):73-9. Epub 2014 Dec 5.
Endovascular repair of thoracoabdominal aortic aneurysms with a novel multibranch stent-graft design: preliminary experience.
Kinstner C, Teufelsbauer H, Neumayer C, Domenig C, Wressnegger A, Wolf F, Funovics M.
J Cardiovasc Surg (Torino). 2014 Aug;55(4):543-50.
Ongoing research
- “Early experience with the iCover stent as bridging stentgraft in fenestrated endovascular aortic repair” Hauck, Funovics
- “Imaging follow-up of fenestrated and branched endovascular repair with photon-counting computed tomography” Hauck, Funovics
- “Detection of early failure signs in bridging stentgrafts in photon-counting computed tomography evaluated in an in vitro model” Kern, Funovics
- “In-stent restenosis in peripheral arterial disease: photon counting versus 256 slice multi-detector CT phantom study in seven different stent types” Dachs, Funovics
- “In-stent restenosis in coronary artery disease: photon counting versus 256 slice multi-detector CT phantom study in XX different stent types” Dachs, Funovics
- “Force, friction and pushability of various commercially available bridging stentgrafts in different sheaths” Kern, Funovics
- “Last endovascular aortic frontier - the endobentall with a newly developed stent-TAVI combination applied in a swine model” Hauck, Funovics
- "The Faith of Endoleaks after Thoracic Endovascular Repair (TEVAR) in Type B Acute Dissection" Klausenitz, Funovics
- "Effects of Complex Thoracic Endovascular Repair (TEVAR) on Haemodynamics of the Upper Extremities" Dunne, Klausenitz, Funovics
- "Long-Term-Quality of Life in Patients after Thoracic Endovascular Repair (TEVAR)" Klausenitz, Funovics
- "Thrombus characterization for prediction of aneurysmal growth in abdominal aortic aneurysm (AAA) with Photon Counting Computed Tomography (PC- CT) at multiple energy levels" Klausenitz, Wielandner
- "Evaluation Of Internal Carotid Artery Stenosis And Plaque Composition Using Photon Counting Computed Tomography" Klausenitz, Loewe