- Timothy A.M. Chuter, MD
- Robert L. Raffai, PhD
- Joseph H. Rapp, MD
- Rajabrata Sarkar, MD, PhD
- Darren B. Schneider, MD
- Rong Wang, PhD
Timothy A.M. Chuter, MD, Associate Professor of Surgery, UCSF, is developing and advancing new, minimally invasive surgical techniques that use stent grafts to repair and eliminate aneurysms in patients who, because of age or medical problems, are at high risk of complications from open surgical repair. Using this new technique, potentially fatal aneurysms are repaired through the use of a stent graft within the abdominal aorta. Access to an abdominal aortic aneurysm is through the femoral artery, a major artery in the thigh that feeds to the legs.
A world renowned leader in this area, Dr. Chuter's research supports the use of multi-branched stent-graft implantation to treat a TAAA (thoraco-abdominal aortic aneurysm). He recently was presented with the Society for Vascular Surgery Medal for Innovation in Vascular Surgery for developing the first bifurcated endovascular stent-graft. Learn more...
In addition, Dr. Chuter is concerned with the after-effects of this surgery. A high percentage of stent graft recipients have a variety of after surgery outcomes ranging from partial paralysis to trauma to systems within the body. Death is rarely an outcome, but trauma and some residual effects are problematic and expensive. With an increasing number of stents grafts being placed in the body each year, there is reason for concern. Dr. Chuter believes he knows the reasons for these complications and is setting up a research project which will determine the causes and optimize the outcomes in the coming years.
“FAVR can be credited with the foresight to recognize the potential of the whole catheter-based endovascular approach and to support long-term studies of novel techniques in a wide range of conditions.” Dr. Timothy Chuter
Robert L. Raffai, PhD, Assistant Adjunct Professor, Department of Surgery at UCSF and Principal Investigator at the Veterans Administration Medical Center, is studying how to control and reverse atherosclerosis. This is a serious disease caused by the accumulation of cholesterol and fat in the artery wall, resulting in progressive narrowing and “hardening” of the arteries, blocking blood flow. Dr. Raffai is internationally recognized for his ground-breaking work in developing genetically engineered mouse models of atherosclerosis and cardiovascular disease. Dr. Raffai's research team is studying these mice to discover how to reverse atherosclerosis (called atherosclerosis regression) in order to prevent heart attacks and peripheral arterial disease (PAD). In addition, their research is exploring how high blood sugar can promote PAD and cause problems such as stroke, critical limb ischemia and heart failure. Results of Dr. Raffai's research may one-day lead to effective non-surgical treatments for severe PAD.
“Our research has the potential of providing clues to better understand why diabetic people are at such high risk of developing PAD. We will also gain insights on how to promote the reversal of the PAD in the setting of diabetes. Funding from FAVR significantly improves our ability to complete our goals in a timely manner.” Dr. Robert Raffai
Photo by Chris Goodfellow of the Gladstone Institute
Joseph Rapp, MD, Professor of Surgery at UCSF, focuses his research on stroke, or "brain attack," the number three killer of Americans. A stroke can result from plaque build-up in one of the two carotid arteries located in the neck. When plaque is sufficiently advanced or ruptures, it can reduce or stop blood flow to the brain and a person either dies or is severely disabled. The most common methods of preventing stroke are to remove the plaque from the carotid artery by surgery or angioplasty and stenting. However, in doing so, tiny plaque particles can break loose and actually cause the very stroke one is trying to avoid. Dr. Rapps's research studies the reaction of the brain to these fragments. His goal is to refine current treatments to increase safety and minimize risks.
“If we know certain fragment types are dangerous, and we can examine the composition of a patient's carotid artery plaque before surgery or anioplasty with high-resolution magnetic resonance scanning, we may be able to recommend either surgery or angioplasty based on the patient's plaque composition, and thereby help improve the safety of these treatments and reduce death and disability from stroke.” Dr. Joseph Rapp
Rajabrata Sarkar, MD, Ph.D., Associate Professor of Surgery, UCSF and FAVR’s 2005 Wylie Scholar, is leading a research team to identify genes important in the development or resolution of vascular disease. This includes genes that play a role in the progression of a blockage in an artery or vein, or genes that potentially can be used to accelerate the beneficial response of the body to a blockage in a blood vessel. Currently, Dr. Sarkar can increase or decrease the levels of key proteins (matrix metalloproteinases) within specific parts of the vasculature, which may allow them to help grow new blood vessels or rapidly clear a blockage within an artery or vein.
In addition to funds from FAVR, Dr. Sarkar receives funding from the Department of Defense. These funds are being used to test a gene therapy in arterial injury that may impact injuries incurred by our soldiers in combat. By increasing the levels of proteins (matrix metalloproteinases) known to be important to blood vessel growth, Dr. Sarkar and his team hope to develop a way to treat damaged tissue and prevent limb loss.
“Vascular disease is one of the most misdiagnosed and misunderstood diseases today. Although we are experiencing an exploding number of breakthroughs in our research, the complexity of this amazing and intricate network of arteries, veins and capillaries doesn’t relinquish its secrets easily.” Dr. Rajabrata Sarkar
Darren B. Schneider, MD, Assistant Professor of Surgery and Radiology in Residence at UCSF, is a vascular surgeon with a clinical focus in minimally invasive treatment of vascular disease. He has a special interest in the treatment of aortic aneurysms and aortic dissections with endovascular stent-grafts. Dr. Schneider is the principle investigator in several clinical studies concerning endovascular treatment of aortic aneurysms.
Dr. Schneider’s current research interest involves developing stem cell therapies to treat patients with critical limb ischemia, a severe obstruction of the arteries associated with peripheral vascular disease. Critical limb ischemia seriously decreases blood flow to the hands, feet and legs and can progress to the point of severe pain and skin ulcers or sores.
“We are focused on developing cell-based therapies for the treatment of critical limb ischemia. One day, hopefully soon, these new therapies will relieve the suffering of patients who have this very painful, often debilitating disease.” Dr. Darren Schneider
Rong Wang, Ph.D. is the Director of the Laboratory for Accelerated Vascular Research. Previously, Dr. Wang had the distinction of being a post-doctoral fellow in the laboratory of Michael Bishop, MD, a winner of the Nobel Prize in Medicine and Chancellor of UCSF. Dr. Wang's team is engaged in state-of-the-art research involving key proteins necessary for blood vessel growth (angiogenesis) and arterial growth (arteriogenesis). They have found that the “Notch 4” protein can cause dramatic blood vessel enlargement in adult animals and that the protein called “focal adhesion kinase” is essential for maintaining existing blood vessel structure. The ability to encourage the growth of blood vessels can increase healing in traumatic wounds, promote recovery from strokes and heart attacks, or generate the growth of new pathways around blocked arteries in the lower limbs to reduce the potential of gangrene and possible amputation.
“Our goal is to become international experts on angiogenesis (blood vessel growth) and arteriogenesis (arterial growth), and to conduct research at the limits of existing knowledge.” Dr. Rong Wang