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- Asciutto, Giuseppe, et al.
(author)
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Long-term progression of contralateral carotid artery disease after endarterectomy: is there a need for Duplex surveillance?
- 2012
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In: International Angiology. - 1827-1839. ; 31:4, s. 361-367
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Journal article (peer-reviewed)abstract
- AIM: The aim of this paper was to define the incidence of disease progression of the contralateral internal carotid artery (CICA) in patients undergoing carotid endarterectomy (CEA) and to identify factors influencing disease progression. METHODS: Patients from our primary catchment area that had undergone CEA between 2002 and 2005 were included. The study cohort was divided in four groups based on the preoperative stenosis grade (normal ICA <40%, N.=56; mild 40-60%, N.=41; moderate 61-80%, N.=12; severe 81-99%, N.=7). Patients initially planned or already submitted to contralateral CEA or with contralateral occlusion were excluded. RESULTS: One hundred and seventeen patients were analysed. Disease progression occurred in 13 (11%) patients after a mean of 47.6 months (SD 1.6 months). A moderate preoperative CICA stenosis was associated with disease progression (P=0.017). Late neurologic events referable to the CICA independently of progression occurred in 13 (11%) patients. There were 4 (30.7%) events in the 13 carotids with progression and only 9 (7%) in the 117 without progression (P=0.060). .Moderate and severe preoperative CICA stenosis and renal insufficiency were associated with postoperative ipsilateral neurological symptoms (P=0.001 and 0.009, respectively). CONCLUSION: Disease progression of the CICA after CEA is not uncommon. The preoperative degree of CICA stenosis is related to subsequent disease progression and to the occurrence of symptoms. More studies are needed to identify risk factors influencing the progression of ICA disease.
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- Bro, Tomas, et al.
(author)
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Medicinhistoria i Lund : En kort översikt
- 2012
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In: Socialmedicinsk tidskrift. - 0037-833X. ; 89:1, s. 14-17
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Journal article (peer-reviewed)abstract
- Lunds historia innehåller många medicinhistoriska händelser. Medicinhistoria som akademisk disciplin är dock inte endast deskriptiv utan även analyserande. Flera institutioner vid Lunds universitet bedriver medicinhistorisk forskning från olika utgångspunkter. Medicinhistoria är ett viktigt ämne för förståelsen av dagens medicin och denna översikt vill visa varför och hur ämnet behandlas vid Lunds universitet.
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- Dias, Nuno, et al.
(author)
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Hemodynamics and jugular venous oxygen saturation during carotid endarterectomy: a comparison between general and locoregional anesthesia.
- 2010
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In: International Angiology. - 1827-1839. ; 29:3, s. 232-238
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Journal article (peer-reviewed)abstract
- AIM: To study hemodynamic and blood oxygenation changes in patients undergoing carotid endarterectomy (CEA) under general (GA) or locoregional (LRA) anesthesia. METHODS: Prospective non-randomized study including 50 patients undergoing CEA (31 men, mean age 72 (range 50-84) years-old under GA (N.=23) or LRA (N.=27). Systemic blood pressure, ECG, venous oxygen saturation in the ipsilateral jugular bulb and pulse-oximetry were monitored. Blood-gas analysis was done from blood obtained from the radial artery and ipsilateral jugular vein. RESULTS: Pulse rate and systemic systolic blood pressure were higher in LRA compared to the GA before, during and after cross clamping (P<0.05). Seven GA patients required dopamine-infusion to maintain systolic blood pressure >120 mmHg. Jugular venous saturation was initially identical in both groups, but decreased significantly upon cross clamping in LRA compared to GA (P<0.05). This difference remained at least 3 minutes after cross clamp release (P<0.05). CONCLUSION: Patients under LRA seem to have increased sympathetic activity compared to patients under GA, as expressed by higher pulse rates and systolic blood pressures. Jugular venous saturation was lower during clamping of LRA patients. The differences were small and concur with the near-equality findings in studies analysing the clinical outcome.
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