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| 2. |
- De Basso, Rachel, et al.
(författare)
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Low wall stress in popliteal artery – other mechanisms responsible for the predilection of aneurysmal dilatation?
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The popliteal artery (PA) is, after aorta, the most common site for aneurysm formation. Why the PA is more susceptible than other peripheral muscular arteries is unknown. We hypothesised that the wall composition, which in turn affects wall properties, as well as the circumferential wall stress imposed on the arterial wall, might differ compared to other muscular arteries. The aim was to study the circumferential wall stress of the PA in healthy subjects with the adjacent muscular common femoral artery (CFA) as a comparison.Material and Methods: Ninety-four healthy subjects were included in this study (45 males, range 10-78 years and 49 females, range 10-83 years). The lumen diameter (LD) and intima-media thickness (IMT) in the PA and CFA were investigated with a Philips P700 ultrasound device. Together with blood pressure the circumferential wall stress was defined according to the law of Laplace adjusted for IMT.Results: The diameter increased with age in both PA and CFA (P<.001), with males having larger diameter than females (P<.001). IMT increased with age in both PA and CFA (P<.001), with higher IMT values in males only in PA (P<0.001). The calculated wall stress was unchanged with age in both arteries, but lower in PA than in CFA in both male and female subjects (P<0.001).Conclusion: This study shows that the popliteal and common femoral artery wall stress is maintained during ageing, probably due to compensatory remodeling response with an increase in arterial wall thickness. However, the stress imposed on the popliteal artery wall is quite low, indicating that other mechanisms than wall stress contribute to the process of pathological arterial dilatation in the popliteal artery.
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| 3. |
- Debasso, Rachel, 1978-, et al.
(författare)
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The popliteal artery, an unusual muscular artery with wall properties similar to the aorta : Implications for susceptibility to aneurysm formation?
- 2004
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Ingår i: Journal of Vascular Surgery. - : Elsevier BV. - 0741-5214 .- 1097-6809. ; 39:4, s. 836-842
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The popliteal artery is, after the aorta, the most common site for aneurysm formation. Why the popliteal artery is more susceptible than other peripheral muscular arteries is unknown. An important factor may be differences in arterial wall composition as compared with other peripheral muscular arteries, which in turn affect wall properties. These are however unknown. We studied the mechanical wall properties of the popliteal artery in healthy subjects. Material and Methods: An ultrasound echo-tracking system was used to measure pulsatile changes in popliteal diameter in 108 healthy subjects (56 female, 52 male, age range, 9-82 years). In combination with blood pressure, stiffness (β), strain, cross-sectional artery wall compliance coefficient (CC), and distensibility coefficient (DC) were calculated. Intima-media thickness (IMT) was registered with a Philips P700 ultrasound scanner. Results: The popliteal diameter increased with age, and was larger in male subjects than in female subjects (P < .001). Fractional diameter change (strain) decreased with age (P < .001), and strain values were lower in male subjects than in female subjects (P < .01). Accordingly, stiffness increased with age (P < .001), with higher stiffness values in male subjects (P < .01). DC decreased with age (P < .001), with lower DC values in male subjects (P < .01). CC decreased with age, with no difference between genders (P < .001). IMT increased with age (P < .001), with higher IMT values in male subjects (P < .001). The increase in IMT did not affect distensibility. Conclusion: The wall properties of the popliteal artery are affected by age and gender, not only with an increase in diameter, but also with an age-related decrease in distensibility, with male subjects having lower distensibility than in female subjects. This seems not to be the behavior of a true muscular artery, but of a central elastic artery, such as the aorta, and might have implications for susceptibility to arterial dilatation, as well as the association of aneurysm formation between the aorta and the popliteal artery.
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| 5. |
- Gavali, Hamid, et al.
(författare)
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Outcome of Radical Surgical Treatment of Abdominal Aortic Graft and Endograft Infections Comparing Extra-anatomic Bypass with In Situ Reconstruction : A Nationwide Multicentre Study
- 2021
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Saunders Elsevier. - 1078-5884 .- 1532-2165. ; 62:6, s. 918-926
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Abdominal aortic graft and endograft infection (AGI) is primarily treated by resection of the infected graft and restoration of distal perfusion through extra-anatomic bypass (EAB) or in situ reconstruction/repair (ISR). The aim of this study was to compare these surgical strategies in a nationwide multicentre retrospective cohort study.Methods: The Swedish Vascular Registry (Swedvasc) was used to identify surgically treated abdominal AGIs in Sweden between January 1995 and May 2017. The primary aim was to compare short and long term survival, as well as complications for EAB and ISR.Results: Some 126 radically surgically treated AGI patients were identified – 102 graft infections and 24 endograft infections – treated by EAB: 71 and ISR: 55 (23 neo-aorto-iliac systems, NAISs). No differences in early 30 day (EAB 81.7% vs. ISR 76.4%, p =.46), or long term five year survival (48.2% vs. 49.9%, p =.87) were identified. There was no survival difference comparing NAIS to other ISR strategies. The frequency of recurrent graft infection during follow up was similar: EAB 20.3% vs. ISR 17.0% (p =.56). Survival and re-infection rates of the new conduit did not differ between NAIS and other ISR strategies. Age ≥ 75 years (odds ratio [OR] 4.0, confidence interval [CI] 1.1 – 14.8), coronary artery disease (OR 4.2, CI 1.2 – 15.1) and post-operative circulatory complications (OR 5.2, CI 1.2 – 22.5) were associated with early death. Prolonged antimicrobial therapy (> 3 months) was associated with reduced long term mortality (HR 0.3, CI 0.1 – 0.9).Conclusion: In this nationwide multicentre study comparing outcomes of radically treated AGI, no differences in survival or re-infection rate could be identified comparing EAB and ISR.
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| 6. |
- Gavali, Hamid, et al.
(författare)
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Semi-Conservative Treatment Versus Radical Surgery in Abdominal Aortic Graft and Endograft Infections
- 2023
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier. - 1078-5884 .- 1532-2165. ; 66:3, s. 397-406
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Abdominal aortic graft and endograft infections (AGIs) are rare complications following aortic surgery. Radical surgery (RS) with resection of the infected graft and reconstruction with extra-anatomical bypass or in situ reconstruction is the preferred therapy. For patients unfit for RS, a semi-conservative (SC), graft preserving strategy is possible. This paper aimed to compare survival and infection outcomes between RS and SC treatment for AGI in a nationwide cohort.Methods: Patients with abdominal AGI related surgery in Sweden between January 1995 and May 2017 were identified. The Management of Aortic Graft Infection Collaboration (MAGIC) criteria were used for the definition of AGI. Multivariable regression was performed to identify factors associated with mortality.Results: One hundred and sixty-nine patients with surgically treated abdominal AGI were identified, comprising 43 SC (14 endografts; 53% with a graft enteric fistula [GEF] in total) and 126 RS (26 endografts; 50% with a GEF in total). The SC cohort was older and had a higher frequency of cardiac comorbidities. There was a non-significant trend towards lower Kaplan -Meier estimated five year survival for SC vs. RS (30.2% vs. 48.4%; p = .066). A non-significant trend was identified towards worse Kaplan -Meier estimated five year survival for SC patients with a GEF vs. without a GEF (21.7% vs. 40.1%; p = .097). There were significantly more recurrent graft infections comparing SC with RS (45.4% vs. 19.3%; p < .001). In a Cox regression model adjusting for confounders, there was no difference in five year survival comparing SC vs. RS (HR 1.0, 95% CI 0.6 -1.5).Conclusion: In this national AGI cohort, there was no mortality difference comparing SC and RS for AGI when adjusting for comorbidities. Presence of GEF probably negatively impacts survival outcomes of SC patients. Rates of recurrent infection remain high for SC treated patients.
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| 7. |
- Lilja, Mirjam, et al.
(författare)
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Effect of deposition parameters on the photocatalytic activity and bioactivity of TiO(2) thin films deposited by vacuum arc on Ti-6Al-4V substrates
- 2012
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Ingår i: Journal of Biomedical Materials Research. Part B - Applied biomaterials. - : Wiley. - 1552-4973 .- 1552-4981. ; 100B:4, s. 1078-1085
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Tidskriftsartikel (refereegranskat)abstract
- This article evaluates the influence of the main parameters in a cathodic arc deposition process on the microstructure of titanium dioxide thin coatings and correlates these to the photocatalytic activity (PCA) and in vitro bioactivity of the coatings. Bioactivity of all as deposited coatings was confirmed by the growth of uniform layers of hydroxyapatite (HA) after 7 days in phosphate buffered saline at 37°C. Comparison of the HA growth after 24 h indicated enhanced HA formation on coatings with small titanium dioxide grains of rutile and anatase phase. The results from the PCA studies showed that coatings containing a mixed microstructure of both anatase and rutile phases, with small grain sizes in the range of 26-30 nm and with a coating thickness of about 250 nm, exhibited enhanced activity as compared with other microstructures and higher coating thickness. The results of this study should be valuable for the development of new bioactive implant coatings with photocatalytically induced on-demand antibacterial properties.
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| 8. |
- Lilja, Mirjam, 1981-, et al.
(författare)
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Influence of microstructure and chemical composition of sputter deposited TiO2 thin films on in vitro bioactivity
- 2011
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Ingår i: Journal of materials science. Materials in medicine. - : Springer. - 0957-4530 .- 1573-4838. ; 22:12, s. 2727-2734
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Tidskriftsartikel (refereegranskat)abstract
- Functionalisation of biomedical implants viasurface modifications for tailored tissue response is agrowing field of research. Crystalline TiO2 has been provento be a bone bioactive, non-resorbable material. In contactwith body fluids a hydroxyapaptite (HA) layer forms on itssurface facilitating the bone contact. Thus, the path ofimproving biomedical implants via deposition of crystallineTiO2 on the surface is interesting to follow. In thisstudy we have evaluated the influence of microstructureand chemical composition of sputter deposited titaniumoxide thin films on the in vitro bioactivity. We find thatboth substrate bias, topography and the flow ratio of thegases used during sputtering affect the HA layer formed onthe films after immersion in simulated body fluid at 37C.A random distribution of anatase and rutile crystals, formedat negative substrate bias and low Ar to O2 gas flow ratios,are shown to favor the growth of flat HA crystal structureswhereas higher flow ratios and positive substrate biasinduced growth of more spherical HA structures. Thesefindings should provide valuable information when optimizingthe bioactivity of titanium oxide coatings as well asfor tailoring process parameters for sputtered-based productionof bioactive titanium oxide implant surfaces.
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| 9. |
- Lilja, Mirjam, 1981-, et al.
(författare)
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Photocatalytic and antimicrobial properties of surgical implant coatings of titanium dioxide deposited though cathodic arc evaporation
- 2012
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Ingår i: Biotechnology letters. - : Springer Science and Business Media LLC. - 0141-5492 .- 1573-6776. ; 41:6, s. 740-746
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Tidskriftsartikel (refereegranskat)abstract
- Nanostructured crystalline titaniumdioxide coatings deposited by cathodic arc evaporated on titanium grade five medical implant substrates were demonstrated to exhibit UV-induced photocatalytic activity that can be utilized to provide bactericidal effects against Staphylococcus epidermidis. The photocatalytic activity of the coatings was confirmedvia degradation of Rhodamine B under UV illumination.A 90 %reduction of viable bacteria was achieved in a clinically suitable time of only 2 min with a UVdose of 2.4 J delivered at 365 nm. These results areencouraging for the development of antimicrobialsurfaces in orthopedics and dentistry in order to prevent or treat post-surgical infections.
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