University Hospital for Vascular Surgery

3616

acute lower limb ischemia, aortic aneurysm, Aortic disease, carotid artery disease, diabetes-associated limb loss, hybrid aortic repair, mitochondrial function, peripheral arterial disease, simulator training, spinal cord ischemia, vascular biobank, and vascular trauma

Basic science – Vascular biobank, Cell stretching, Mitochondrial Oxygenation

Translational research – evaluation of new haemostyptic agents in a large animal model; visceral perfusion assessment using fluorescent imaging; haemorrhagic shock model; in-vivo perfusion; spinal cord ischemia; in-vivo graft evaluation, biomechanical stress mapping in CTA using finite element method (FEM)

Aortic disease – prognosis, treatment, outcome; hybrid aortic repair; spinal cord ischemia; rupture risk evaluation; aortic database and biobank

Carotid disease – prognosis, treatment, outcome; cerebral perfusion (MRI)

Peripheral arterial disease – prognosis, diagnosis, outcome and treatment; mitochondrial dysfunction; limb loss and its prevention

Acute lower limb ischemia – coordination of an international, multicentre, prospective study on outcome of acute limb ischemia

Diabetes-associated limb loss – regional analysis, predictors and outcome, patient-reported outcome measurement

Vascular trauma – aorta and upper / lower limb; outcome, prognosis, treatment;

Simulation-based training in vascular surgery and vascular interventions

Basics Science – in May 2022, the Laboratory of Experimental Vascular Surgery of the Department of Vascular Surgery was inaugurated. Special research interests include mitochondrial dysfunction in peripheral disease, cellular pathomechanisms in aortic disease, spinal cord ischemia, visceral and spinal cord perfusion, aortic rupture risk evaluation and cell stretching. Additionally, a vascular biobank was established.

Sabine Wipper, Juliana Heidler, Daniela Lobenwein, Michaela Kluckner, Kristina Grassl, Florian Enzmann

Clinical research covers all main topics of vascular surgery with focus on diagnosis, treatment, prognosis and outcome of vascular diseases: aortic disease (prospective data collection), peripheral arterial disease (retrospective analysis of treatment & outcome), vascular trauma (retrospective analysis of treatment & outcome) and acute as well as chronic limb ischemia (coordination of an international prospective study) including the loss of a limb due to arterial and diabetic disease.

Florian Enzmann, David Wippel, Kristina Grassl, Josef Klocker, Laura Schönherr, Bernhard Winder, Ingrid Gruber, Michaela Kluckner, Sabine Wipper

Translational research – Special research interests include new haemostyptic agent, haemorrhagic shock model with visceral and spinal cord perfusion, in-vivo graft evaluation; simulator training on endovascular techniques with medical students; integration of computational wall stress analysis with clinical data to predict the likelihood of wall and tissue failure, enabling personalised diagnostics and treatment strategies.

Sabine Wipper, David Wippel, Daniela Lobenwein, Kristina Grassl

Vascular Biobank

A vascular biobank with local and international collaboration partners was established by the end of 2022 with ongoing sample collection.

Name/Names of Researcher: Daniela Lobenwein, Juliana Heidler, Sabine Wipper, Kristina Grassl, David Wippel, Michaela Kluckner, Laura Schönherr

Aortic disease

Aortic disease includes aortic aneurysms as well as aortic dissection with different treatment modalities for these clinical entities.

• Clinical studies: We have established a prospective database to further evaluate incidences, prognosis and outcome of different treatment options.

In addition, our institution is part of a multicentre registry data collection evaluating the outcome of specific endovascular grafts.

For further investigation of patients´ outcome suffering from aortic dissection, a retrospective database was established including all patients having been treated at our institution over the last 20 years.

We performed a retrospective analysis to evaluate the early prediction of abdominal aortic aneurysm rupture risk using numerical biomechanical analysis. Based on this groundwork, we will conduct a prospective study to further assess rupture risk and validate the predictive capability of the biomechanical modelling approach. Furthermore, an international database was established for the Thoracoflo® graft for thoracoabdominal hybrid repair.

Names of Researcher: Florian Enzmann, Kristina Grassl, David Wippel, Werner Westreicher, Michaela Kluckner, Laura Schönherr, Sabine Wipper

• Thoracoflo®: Based on the Thoraflex® hybrid-graft (Vascutek ltd., Glasgow, UK), a new hybrid graft, the Thoracoflo® hybrid-graft (Vascutek ltd., Glasgow, UK), was developed as a new hybrid device for the repair of a thoracoabdominal aortic aneurysm (TAAA). The new graft for thoracoabdominal hybrid aortic repair to avoid thoracotomy and extracorporeal circulation was developed in extensive translational research projects between 2010 and 2020 (in Hamburg). Since 2021, a total of 52 patients was treated worldwide. Implantation is supervised by the proctoring of Prof. Sabine Wipper (Austria, Germany, Switzerland, UK, Norway, US, Asia) or Prof. E. Sebastian Debus (Europe) or Prof. Aung Oo (Australia). The database is supervised by Dr. David Wippel.

Names of Researcher: Sabine Wipper, Florian Enzmann, David Wippel

• Basic science: To further investigate cellular pathomechanisms relevant in the development of aortic diseases, a model including mechanical stress, simulating blood flow within an aneurysm, is established in the basic science laboratory. Additionally, using patient sample collection of the established vascular biobank, further insights on cellular and molecular alterations in aortic diseases are yet to be defined.

Name/Names of Researcher: Juliana Heidler, Kristina Grassl, Florian Enzmann, Daniela Lobenwein, David Wippel, Sabine Wipper

Translational research:

• Evaluation of new haemostyptic agents (polyphosphate) in a large animal model of haemorrhagic shock was performed and compared to Combat Gaze. The animal experiments are complete, data are analysed and the manuscript is under preparation.

Name/Names of Researcher: Daniela Lobenwein, Juliana Heidler, Sabine Wipper

• Acute mesenteric ischemia requires acute treatment to achieve reperfusion. Bowel ischemia requires surgical resection. Assessment of bowel viability after ischemia is mandatory to determine the resection boundaries It is vital to evaluate the perfusion in the anastomotic area to prevent further damage. We evaluated and quantitatively assessed tissue perfusion of the bowel and gastric tube using fluorescent imaging in an experimental setting. This is a new tool for intraoperative quality control. The study was performed in collaboration with the Department of General and Visceral Surgery of the University Hospital Hamburg Eppendorf. Experimental research is completed and published or under review.

Name/Names of Researcher: Sabine Wipper

Biomechanical analysis using the finite element method:

This project aims to develop a novel pre-operative risk score that integrates patient-specific biomechanical finite element analysis (FEA) of CT imaging with high-dimensional spatial proteomics and transcriptomics of abdominal aortic aneurysm (AAA) wall tissue, with the goal of preventing infrarenal aortic rupture, particularly in elderly patients, due to their high perioperative risk during elective surgery. Biomechanical stress parameters, such as peak wall stress (PWS) and peak wall rupture risk ratio (PWRR), will be quantified through FEA modelling. In parallel, biomechanical mapping will be used to guide sampling of resected aneurysm wall tissue, which will then undergo advanced spatial profiling using the MACSima™ multiplex imaging platform and Xenium in situ transcriptomic analysis via 10x Genomics sequencing. This combined approach will map extracellular matrix remodelling, inflammatory cell infiltration and degeneration patterns at the single-cell level, providing deep insight into the molecular mechanisms underlying wall weakening and rupture susceptibility. The study is performed in collaboration with the department of solid mechanics of the KTH Royal Technology in Stockholm and the department of Molecular Medicine and Surgery, Karolinska Hospital, Stockholm, Sweden.

Name/Names of Researcher: Kristina Grassl, Juliana Heidler, Florian Enzmann, Josef Klocker, David Wippel, Sabine Wipper

Teaching research and simulator training

• Simulation-based education is an essential part of training in vascular surgery and endovascular interventions. Our projects focus on the development, validation and implementation of simulator-based curricula for medical students, residents and fellows. We explore the role of simulation in accelerating the acquisition of technical skills, optimising learning curves and improving patient safety. Special emphasis is placed on low-cost simulation setups and virtual reality environments to enhance accessibility.
• A 3D printing core facility was established for printing real patients’ anatomies based on CT angiography scans.
• A pulsatile flow model, specifically designed for endovascular training in vascular surgery, has been established. This model enables realistic simulation of endovascular procedures, particularly focusing on peripheral arterial interventions and aortic repair techniques. Training activities are centred on skill development in catheter and wire handling, angioplasty and stent placement under lifelike haemodynamic conditions.
• In addition, the integration of novel technologies, such as the Philips Lumiguide navigation system, into the training environment allows for the simulation of advanced, radiation-free endovascular guidance. Simulation sessions with these technologies are planned to be incorporated into the vascular surgery training program and are evaluated in terms of technical performance improvement and user experience.

Research Topics

• Validation of simulator-based training for endovascular skills.
• Low-cost, portable angiography simulators for early training stages.
• Implementation of simulator-based interventions to improve patient-specific procedural planning.

Ongoing Projects

• Development and pilot testing of an interactive training program for endovascular aortic procedures (in cooperation with engineering faculty partners).
• Evaluation of different pedagogical strategies in simulation-based learning (peer teaching, self-directed learning vs instructor-led training).
• This happened in collaboration with a colleague from the Hospital das Clinicas in Sao Paulo, Dr. Inez Ohashi Torres.

Name/Names of Researcher: David Wippel, Florian Enzmann, Werner Westreicher, Sabine Wipper Collaboration with Alexander Loizides, Elke Gizewski

Carotid disease

• QUICAS Study: The prospective study investigates 200 patients with stenoses of the common or internal carotid artery who are scheduled to undergo balloon or stent angioplasty or surgical endarterectomy. Various MRI sequences are used without contrast agents. Additionally, neurocognitive tests are performed at all scheduled study visits
• The study aims to analyse cerebral changes in carotid stenosis and assess the impact of therapy on these changes through obtaining quantitative MRI Imaging.
• The quantitative MRI data will be compared and statistically analysed with sonographic, neurocognitive and other clinical data.
• Additionally, in patients receiving an operation samples of the Carotid wall and Plaque will be included in the vascular biobank

Name/Names of Researcher: Ingrid Gruber, Laura Schönherr, Juliana Heidler, Sabine Wipper Collaboration with Astrid Grams and Elke Gizewski

Acute and chronic limb ischaemia

In addition to the clinical evaluation of incidences, prognosis and outcome using retrospective databases, new diagnostic tools (hyperspectral imaging as well as fluorescence imaging) for peripheral arterial diseases are evaluated within a prospective cohort study. For this purpose, funding was raised by the Austrian Society of Vascular Surgery.

A randomised controlled trial was established to further investigate the effect of different treatment strategies on mitochondrial outcome parameters. Further extension of this project on chronic limb-threatening ischemia is planned.

A cohort study on outcome and factors associated with major and minor amputations for diabetes and / or arterial disease was initiated (together with local leaders of diabetes care services), with special interest in revascularisation procedures, mobility and prosthetic use as well as in patient-reported outcome measures after amputation

Name/Names of Researcher: Michaela Kluckner, Florian Enzmann, Josef Klocker, Daniela Lobenwein, Juliana Heidler, Sabine Wipper

To investigate incidences, treatment strategies and outcome of patients with acute limb ischemia, a prospective multicentre observational study (PROMOTE-ALI) was initiated by our institution using a European network of vascular researchers.

Name/Names of Researcher: Florian Enzmann, Michaela Kluckner

Vascular trauma

Retrospective data collection about vascular trauma management in injured extremities is performed within our institution. Outcome parameters were compared in upper and lower limb trauma patients.

A new haemostyptic agent, based on polyphosphate was tested in a haemorrhagic shock porcine model. Influence on haemodynamic, organ perfusion and efficacy of the haemostypticum compared to control with Combat Gaze® were evaluated.

Management of blunt thoracic aortic injury (BTAI) has shifted from open surgical repair to endovascular therapy (TEVAR) over the past decades. Our research focuses on the evaluation of outcomes following TEVAR for BTAI in haemodynamically stable and unstable patients, with special interest in perioperative complications, mortality rates, long-term aortic remodelling and device durability. Special emphasis is placed on procedural strategies to minimise the risk of spinal cord ischemia and stroke in these high-risk trauma patients. At our institution, a retrospective cohort of all patients treated for BTAI has been established, collecting detailed data on clinical presentation, imaging findings (CT angiography), treatment modalities (TEVAR vs conservative management), intra- and postoperative complications and long-term follow-up results. Particular attention is paid to the timing of the intervention (immediate vs delayed TEVAR), aortic injury grading (I–IV) and the role of concomitant injuries in influencing treatment decisions.

• Retrospective analysis of BTAI patients treated with TEVAR at our centre over a 15-year period.
• Evaluation of different Trauma scores in terms of applicability on aortic injuries (ISS, NISS)
• Collaboration with the Department of Radiology

Name/Names of Researcher: Sabine Wipper, Florian Enzmann, Josef Klocker, Kristina Grassl, Michaela Kluckner, Daniela Lobenwein, David Wippel

Aortic disease

• Grassl K, Hangler H, Gratl A, Enzmann F, Grimm M, Klocker J, Wipper S. A Free-Floating Aortic Thrombus: An Uncommon Approach to Handle a Rare Clinical Entity. J Endovasc Ther. 2024 May 30:15266028241256817.
• Nana P, Spanos K, Tsilimparis N, Haulon S, Sobocinski J, Gallitto E, Dias N, Eilenberg W, Wanhainen A, Mani K, Böckler D, Bertoglio L, van Rijswijk C, Modarai B, Seternes A, Enzmann FK, Giannoukas A, Gargiulo M, Kölbel T; APT-F/BEVAR Study Contributors. Early Prediction of Abdominal Aortic Aneurysm Rupture Risk Using Numerical Biomechanical Analysis. Grassl K, Gasser TC, Enzmann FK, Gratl A, Klocker J, Wippel D, Walcher DC, Gizewski ER, Wipper SH. Diagnostics (Basel). 2024 Dec 26;15(1):25. Editor’s Choice – Role of Antiplatelet Therapy in Patients Managed for Complex Aortic Aneurysms using Fenestrated or Branched Endovascular Repair.
• Eur J Vasc Endovasc Surg. 2025 Feb;69(2):272-281.
• Enzmann FK, Grandi A, Panuccio G, Torrealba JI, Kluckner M, Nana P, Rohlffs F, Kölbel T. Unintended Exchange of Target Vessels for Celiac Trunk and Superior Mesenteric Artery Branches in Complex Endovascular Aortic Repair. J Endovasc Ther. 2024 May 6:15266028241251985.
• Wipper SH, Kölbel T, Dumfarth J, Schelzig H, Estrera AL, Sandhu HK, Enzmann F, Debus ES. A new hybrid graft for open thoracoabdominal aortic aneurysm repair. Ann Cardiothorac Surg. 2023 Sep 28;12(5):503-505.
• Malik KD, Debus S, Enzmann FK, Schulte-Uentrop L, Kölbel T, Wipper S. Open Conversion After Branched Endovascular Aortic Repair With a Novel Hybrid Graft. J Endovasc Ther. 2025 Feb 7:15266028251315030.
• Wipper SH, Kölbel T, Dorweiler B, Dumfarth J, Gratl A, Gorny O, Estrera AL, Sandhu HK, Debus ES. Hybrid repair of a thoracoabdominal aortic aneurysm in female patient with Loeys-Dietz syndrome. Ann Cardiothorac Surg. 2023 Nov 27;12(6):612-614.
• Pruna-Guillen R, Wipper SH, Lopez-Marco A, Wippel D, Adams B, Debus ES, Oo AY. Hybrid thoraco-abdominal aortic repair via limited thoraco-phreno-laparotomy using Thoracoflo® Graft. Eur J Cardiothorac Surg. 2025 Mar 28;67(4):ezaf115.
• Debus ES, Malik K, Kölbel T, Honig S, Brickwedel J, Behem C, Wipper SH.First in Human Implantation of the Thoracoflo Graft: A New Hybrid Device for Thoraco-Abdominal Aortic Repair. EJVES Vasc Forum. 2023 Mar 7;58:28-31.

Translational research and basic science

• Simon F, Larena-Avellaneda A, Wipper S. Experimental Atherosclerosis Research on Large and Small Animal Models in Vascular Surgery. J Vasc Res. 2022;59(4):221-228.
• Schoenherr L, Heidler J, Kluckner M, Lobenwein D, Pesta D, Frese JP, Wipper SH, Gratl A. A Randomized Control Trial Investigating the Effect of Different Treatment Strategies on Mitochondrial Function in Peripheral Arterial Disease: A Study Protocol. J Surg Res. 2025 Mar;307:78-85.
• Aschacher T, Geisler D, Lenz V, Aschacher O, Winkler B, Schaefer AK, Mitterbauer A, Wolf B, Enzmann FK, Messner B, Laufer G, Ehrlich MP, Grabenwöger M, Bergmann M. Impacts of Telomeric Length, Chronic Hypoxia, Senescence, and Senescence-Associated Secretory Phenotype on the Development of Thoracic Aortic Aneurysm. Int J Mol Sci. 2022 Dec 7;23(24):15498.
• Aschacher T, Aschacher O, Schmidt K, Enzmann FK, Eichmair E, Winkler B, Arnold Z, Nagel F, Podesser BK, Mitterbauer A, Messner B, Grabenwöger M, Laufer G, Ehrlich MP, Bergmann M. The Role of Telocytes and Telocyte-Derived Exosomes in the Development of Thoracic Aortic Aneurysm. Int J Mol Sci. 2022 Apr 25;23(9):4730.
• Aschacher T, Schmidt K, Aschacher O, Eichmair E, Baranyi U, Winkler B, Grabenwoeger M, Spittler A, Enzmann F, Messner B, Riebandt J, Laufer G, Bergmann M, Ehrlich M. Telocytes in the human ascending aorta: Characterization and exosome-related KLF-4/VEGF-A expression. J Cell Mol Med. 2021 Oct;25(20):9697-9709.
• Gratl A, Wipper S, Frese JP, Raude B, Greiner A, Pesta D.The Role of Mitochondrial Function in Peripheral Arterial Disease: Insights from Translational Studies. Int J Mol Sci. 2021 Aug 6;22(16):8478.
• Behem CR, Friedheim T, Holthusen H, Rapp A, Suntrop T, Graessler MF, Pinnschmidt HO, Wipper SH, von Lucadou M, Schwedhelm E, Renné T, Pfister K, Schierling W, Trepte CJC.Goal-directed colloid versus crystalloid therapy and microcirculatory blood flow following ischemia/reperfusion. Microvasc Res. 2024 Mar;152:104630
• Behem CR, Haunschild J, Pinnschmidt HO, Gaeth C, Graessler MF, Trepte CJC, Etz CD, Debus ES, Wipper SH. Effects of fluids vs. vasopressors on spinal cord microperfusion in hemorrhagic shock induced ischemia/reperfusion. Microvasc Res. 2022 Sep;143:104383
• von Kroge P, Russ D, Wagner J, Grotelüschen R, Reeh M, Izbicki JR, Mann O, Wipper SH, Duprée A. Quantification of gastric tube perfusion following esophagectomy using fluorescence imaging with indocyanine green. Langenbecks Arch Surg. 2022 Nov;407(7):2693-2701.
• von Kroge PH, Russ D, Rieß HC, Debus ES, Pinnschmidt HO, Izbicki JR, Mann O, Wipper SH, Duprée A. The impact of nitroglycerine and volume on gastric tube microperfusion assessed by indocyanine green fluorescence imaging. Sci Rep. 2022 Dec 27;12(1):22394.
• Behem CR, Graessler MF, Friedheim T, Kluttig R, Pinnschmidt HO, Duprée A, Debus ES, Reuter DA, Wipper SH, Trepte CJC. The use of pulse pressure variation for predicting impairment of microcirculatory blood flow. Sci Rep. 2021 Apr 28;11(1):9215.
• Duprée A, Rieß H, von Kroge PH, Izbicki JR, Debus ES, Mann O, Pinnschmidt HO, Russ D, Detter C, Wipper SH. Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) in a porcine model of mesenteric ischemia. PLoS One. 2021 Jul 20;16(7):e0254144.
• Wipper S, Sandhu HK, Kölbel T, Estrera AL, Trepte C, Behem C, Miller CC 3rd, Debus ES. In vivo evaluation of a new hybrid graft using retrograde visceral perfusion for thoracoabdominal aortic repair in an animal model. JTCVS Tech. 2022 Aug 8;15:1-8.
• Haunschild J, von Aspern K, Khachatryan Z, Bianchi E, Friedheim T, Wipper S, Trepte CJ, Ossmann S, Borger MA, Etz CD. Detrimental effects of cerebrospinal fluid pressure elevation on spinal cord perfusion: first-time direct detection in a large animal model. Eur J Cardiothorac Surg. 2020 Aug 1;58(2):286-293.
• Lobenwein D, Huber R, Kerbler L, Gratl A, Wipper S, Gollmann-Tepeköylü C, Holfeld J. Neuronal Pre- and Postconditioning via Toll-like Receptor 3 Agonist or Extracorporeal Shock Wave Therapy as New Treatment Strategies for Spinal Cord Ischemia: An In Vitro Study. J Clin Med. 2022 Apr 11;11(8):2115.

Acute and chronic limb ischaemia

• Kluckner M, Nierlich P, Hitzl W, Aschacher T, Gratl A, Wipper S, Aspalter M, Moussalli H, Linni K, Enzmann FK. Long-Term Results of Endovascular Treatment with Nitinol Stents for Femoropopliteal TASC II C and D Lesions. Medicina (Kaunas). 2022 Sep 5;58(9):1225.
• Kluckner M, Gratl A, Wipper SH, Hitzl W, Nierlich P, Aspalter M, Linni K, Enzmann FK. Comparison of Prosthetic and Vein Bypass with Nitinol Stents in Long Femoropopliteal Lesions. Ann Vasc Surg. 2022 Jan;78:272-280.
• Enzmann FK, Nierlich P, Hölzenbein T, Aspalter M, Kluckner M, Hitzl W, Opperer M, Linni K. Vein Bypass Versus Nitinol Stent in Long Femoropopliteal Lesions: 4-Year Results of a Randomized Controlled Trial. Ann Surg. 2023 Jun 1;277(6):e1208-e1214.
• Kluckner M, Gruber L, Wippel D, Lobenwein D, Westreicher W, Pilz M, Enzmann FK. Long-Term Outcome of Bypass Surgery versus Endovascular Revascularization in Long Femoropopliteal Lesions. J Clin Med. 2023 May 17;12(10):3507.
• Farhan S, Enzmann FK, Bjorkman P, Kamran H, Zhang Z, Sartori S, Vogel B, Tarricone A, Linni K, Venermo M, van der Veen D, Moussalli H, Mehran R, Reijnen MMPJ, Bosiers M, Krishnan P. Revascularization Strategies for Patients With Femoropopliteal Peripheral Artery Disease. J Am Coll Cardiol. 2023 Jan 31;81(4):358-370.
• Gratl A, Kluckner M, Gruber L, Klocker J, Wipper S, Enzmann FK. The Mangled Extremity Severity Score (MESS) does not predict amputation in popliteal artery injury. Eur J Trauma Emerg Surg. 2023 Dec;49(6):2363-2371
• Gratl Al, Busch A, Caradu C, Doukas P, Noronen K, Predenciuc A, Tran L, Zielasek C, Zlatanovic P, Enzmann FK. Prospective multicentre observational study evaluating acute lower limb ischaemia (PROMOTE-ALI). Br J Surg. 2024 Aug 30;111(9):znae230.
• Doukas P, Enzmann FK, Noronen K, Tran L, Busch A, Zlatanovic P, Predenciuc A, Raffort J, Gratl A, Caradu C. Insights from the Prospective Multicentre Observational Study Evaluating Acute Lower Limb Ischaemia on the Influence of Patient Characteristics on Treatment Strategy Selection and Outcomes. J Vasc Surg. 2025 Apr 7:S0741-5214(25)00910-3.
• Hitzl W, Kluckner M, Pilz M, Opperer M, Linni K, Nierlich P, Enzmann FK. Role of Multistate Models to Predict Patency, Limb Salvage, and Survival: New Concepts to Analyse Data in Peripheral Arterial Disease. Eur J Vasc Endovasc Surg. 2024 Dec;68(6):804-813.
• Kluckner M, Enzmann FK, Hitzl W, Wippel D, Hold A, Hölzenbein T, Nierlich P. Alternative vein bypass in octogenarians with chronic limb-threatening ischaemia. BJS Open. 2024 May 8;8(3):zrae041.
• Zywicka EM, Moore AJ, Twine C, Behrendt CA, Bosiers M, Brodmann M, Choke E, deBorst GJ, Diamantopoulos A, Enzmann F, Farber A, Ansel G, Gattuso D, Goh GS, Yann G, Jansen S, Landini M, Lejay A, Lichtenberg M, Menard M, Mezes P, Mills J, Nixon J, Nordanstig J, O’Connell K, Ozdemir B, Patrone L, Puppala S, Saratzis A, Secemsky EA, Sigrid N, Stavroulakis K, Steiner S, Teraa M, Van Herzeele I, Venermo M, Zeller T, Mouton R, Hinchliffe RJ. Endovascular treatment of peripheral arterial disease: Endo-STAR framework for the design, conduct, and reporting of trials. Br J Surg. 2025 Mar 28;112(4):znaf020.

Simulator-based Training

• Wippel D, Ouaret M, Gizewski ER, Kluckner M, Enzmann FK, Wipper S. Simulation Based Training for Iliac Endovascular Interventions: 3D Printed Versus Digital Models, European Journal of Vascular and Endovascular Surgery, 2025, https://doi.org/10.1016/j.ejvs.2025.03.026.
• Wippel D, Westreicher W, Gummerer M, Kluckner M, Ouaret M, Lamprecht F, Grams A, Gratl A, Wipper S. Comparing the Efficacy of Endovascular Simulation Training in Different Training Formats: A Randomized Controlled Trial. Ann Vasc Surg. 2024 Dec;109:266-272.

Vascular Trauma

• Gratl A, Kluckner M, Gruber L, Klocker J, Wipper S, Enzmann FK. The Mangled Extremity Severity Score (MESS) does not predict amputation in popliteal artery injury. Eur J Trauma Emerg Surg. 2023 Dec;49(6):2363-2371.
• Lutz M, Wippel D, Loizides A, Galijasevic M, Schönherr L, Gizewski ER, Wipper S, Freund M, Enzmann FK. Blunt Traumatic Aortic Injury Treated with Endovascular Aortic Repair: Does Age Influence the Outcome? J Clin Med. 2025 Jan 24;14(3):776.
• Wippel D, Lutz M, Kluckner M, Gruber L, Loizides A, Fischer J, Gizewski ER, Enzmann FK, Wipper S. Beyond the Slopes and Highways: Endovascular Repair of Blunt Traumatic Aortic Injuries after Skiing versus Motor Vehicle Accidents. J Clin Med. 2024 Jun 4;13(11):3315.

• Department of Vascular Medicine, University Heart & Vascular Centre Hamburg Eppendorf, German Aortic Center, Hamburg, Germany
• Department of Vascular Surgery, RWTH Aachen/Maastricht, Germany/Netherlands
• Department of Vascular Surgery, UMC Amsterdam, Netherlands
• Department of Vascular and Endovascular Surgery, UKM Muenster, Germany
• Clinic of Vascular Surgery, Charité University Hospital of Berlin, Germany
• Zena and Michael A. Wiender Cardiovascular Institute Icahn School of Medicine at Mount Sinai Hospital, New York, USA
• Department of Cardiothoracic and Vascular Surgery, McGovern Medical School, Houston, USA
• Department of Vascular Surgery, Hospital das Clinicas, Medical Faculty, Sao Paolo, Brazil
• Department of Cardiothoracic Surgery, Rikkshospitalet, University Hospital Oslo, Oslo, Norway
• Department of Surgery (Division of Cardiac Surgery), Medical University Vienna, Austria
• European Vascular Research Collaborative
• Department of Solid Mechanics, KTH Royal Technology Stockholm, Sweden
• Department of Molecular Medicine and Surgery, Karolinska Hospital, Stockholm, Sweden