| 1. |
- Basu, Samar, et al.
(författare)
-
Biomarkers of free radical injury during spinal cord ischemia
- 2001
-
Ingår i: FEBS Letters. - 0014-5793 .- 1873-3468. ; 508:1, s. 36-38
-
Tidskriftsartikel (refereegranskat)abstract
- Plasma and urinary levels of 8-iso-PGF(2alpha) and 15-keto-dihydro-PGF(2alpha) were analysed at baseline and during the ischemia-reperfusion period in experimental spinal cord ischemia. A significant and immediate increase of 8-iso-PGF(2alpha) in plasma at the start and up to 60 min, and in the urine at 90-150 min following ischemia indicate an association of oxidative injury. The inflammatory response indicator 15-keto-dihydro-PGF(2alpha) in plasma increased significantly at the start and up to 60 min after ischemia. No such increase was seen in animals with no spinal cord ischemia. Thus, free radical mediated and cyclooxygenase catalysed products of arachidonic acid are increased during spinal cord ischemia as a consequence of oxidative injury and inflammation.
|
|
| 2. |
|
|
| 3. |
- Bergqvist, David, et al.
(författare)
-
Akupunktur kan ge kärlskador
- 1998
-
Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 95:3, s. 180-181
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Bergqvist, David, et al.
(författare)
-
Is balloon angioplasty below the knee joint wise?
- 1998
-
Ingår i: Indications in Vascular and Endovascular Surgery. - London : WB Saunders. - 0702024457 - 9780702024450 ; , s. 353-365
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
- Bergqvist, David, et al.
(författare)
-
Klinisk värdering av kritisk ischemi skall alltid göras före amputation
- 1999
-
Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 96:7, s. 727-729
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Patients with critical limb ischemia (rest pain and/or ulcer/gangrene, together with low ankle pressure) are at risk of amputation, and should therefore undergo arterial reconstruction if that is at all technically possible. Thorough clinical investigation will usually distinguish patients in need of further evaluation by a vascular surgeon. No amputation should be undertaken without such evaluation. Diabetic patients belong to a special category, in that neuropathy makes it difficult to evaluate pain, and ankle pressure is often falsely high due to medial arterios sclerosis.
|
|
| 11. |
|
|
| 12. |
- Bergqvist, David, et al.
(författare)
-
Paediatric arterial trauma
- 1998
-
Ingår i: European Journal of Surgery. - : Oxford University Press (OUP). - 1102-4151 .- 1741-9271. ; 164:10, s. 723-731
-
Tidskriftsartikel (refereegranskat)
|
|
| 13. |
|
|
| 14. |
- Bergqvist, David, et al.
(författare)
-
Secondary aortoenteric fistula : changes from 1973 to 1993
- 1996
-
Ingår i: European Journal of Vascular and Endovascular Surgery. - 1078-5884 .- 1532-2165. ; 11:4, s. 425-428
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate a series of patients with secondary aortoenteric fistulas and compare it with a previous series (1985-93 vs. 1973-84). DESIGN: Retrospective study of medical records. SETTING: Sixteen vascular surgical centers in Sweden. PATIENTS: Twenty-seven patients were identified making an overall incidence of 0.5% of all aortoiliac operations. Among aneurysm patients the incidence was significantly lower than in the previous series. One patient record could not be identified. Fourteen primary operations were for aortic aneurysm, 12 for occlusive disease and one was an aortorenal vein bypass. RESULTS: Symptoms of the fistula occurred after a median interval of 90 months which is significantly later than the previous series (32 months; p<0.05). The commonest presentation was bleeding followed by septis. The median diagnostic delay was 10.5 days, which was significantly shorter than in the previous series. Most fistulas involved the duodenum (88%). One patient died before surgery. The postoperative mortality was 28%, significantly lower than in the previous series (58%) (p<0.05). At the end of follow up (median 43 months) significantly more patients were alive than in the previous series (42% vs 18%) (p<0.05). CONCLUSION: Over a 21 year period there seems to have been a decrease in the frequency of secondary aortoenteric fistulas after aneurysm surgery, a longer interval before they occur, a shorter diagnostic delay, and a better survival.
|
|
| 15. |
- Boström, Annika, et al.
(författare)
-
Duplex scanning as the sole preoperative imaging method for infrainguinal arterial surgery
- 2002
-
Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 23:2, s. 140-145
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: to evaluate preoperative duplex as the sole investigation prior to lower limb reconstruction. Design retrospective analysis. MATERIALS AND METHODS: between January 1995 and December 1999, 157 of 329 surgical interventions for chronic infrainguinal arterial or aneurysmal disease were performed without preoperative angiography. RESULTS: in patients undergoing femoral artery endarterectomy, the extent of the stenosis and the status of the distal deep femoral artery were correctly diagnosed with duplex scanning in all but one patient. Duplex scan findings in patients undergoing infrainguinal bypass procedures were in agreement with the findings obtained from on-table angiography in regard to the selection of optimal outflow anastomotic sites in 123 (98%). Duplex scanning correctly evaluated the status of runoff in 113 (90%). There were no significant differences in 30-day occlusion rate and patency at 12 months between reconstructions performed with and without preoperative angiography. CONCLUSION: in patients with conclusive duplex scan findings there is no need to perform angiography prior to lower limb reconstruction.
|
|
| 16. |
- Boström, Annika, et al.
(författare)
-
Repeat surgery without preoperative angiography in limbs with patent infrainguinal bypass grafts
- 2002
-
Ingår i: European Journal of Vascular and Endovascular Surgery. - : SAGE Publications. - 1078-5884 .- 1532-2165. ; 36:5, s. 343-350
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to assess the feasibility and results of repeat surgery without preoperative angiography in limbs with patent infrainguinal bypass grafts. Between January 1995 and December 1999, 73 surgical interventions were performed for correction of inflow, graft, or runoff-related lesions in limbs with patent infrainguinal bypass grafts. Fifty-six of the 73 cases were operated on based on the findings obtained from duplex scanning alone. There were 53 vein and 3 prosthetic grafts in the series. The indications for intervention without angiography were stenotic or occlusive lesions in 35, graft aneurysm in 7, and arteriovenous fistulae in 14. There were no deviations from the preoperatively planned surgical strategy in patients undergoing surgery without preoperative angiography. Cumulative life table primary, (stenosis free) and primary-assisted patency rates, at 12 months following graft revisions (excluding arteriovenous fistulae ligatures) without preoperative angiography, were 64% and 85%, respectively. The corresponding figures for revisions performed with preoperative angiography were 58% and 84%, respectively. There were no significant differences between patients undergoing surgery with or without preoperative diagnostic angiography with regard to patency rates. Surgical interventions for correction of infrainguinal graft-related stenotic or aneurysmal lesions can be safely performed based on findings obtained from duplex scanning.
|
|
| 17. |
- Boström Ardin, Annika, et al.
(författare)
-
Selection of patients with infrainguinal arterial occlusive disease for percutaneous transluminal angioplasty with duplex scanning
- 2002
-
Ingår i: Acta Radiologica. - 0284-1851 .- 1600-0455. ; 43:4, s. 391-395
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate the role of duplex scanning in the selection of patients with infrainguinal arterial occlusive disease for percutaneous transluminal angioplasty (PTA). MATERIAL AND METHODS: From January 1995 through May 2000, 702 patients (952 limbs), with chronic lower extremity ischemia due to infrainguinal atherosclerotic disease diagnosed by duplex scanning, were retrospectively studied. Diagnostic angiography (130 limbs) or infrainguinal PTA (108 limbs) was performed in 238 limbs. Two investigators retrospectively analyzed the duplex examinations and angiographies in a blinded manner and used similar criteria for the interpretation of lesions suitable or not suitable for PTA. RESULTS: The superficial femoral, popliteal and crural artery lesions were correctly selected for PTA in 85%, 66% and 32%, respectively. The accuracy, sensitivity, specificity, negative predictive value and positive predictive value of duplex scanning to appropriately categorize femoropopliteal lesions as suitable or unsuitable for PTA were 89%, 83%, 92%, 94% and 78%, respectively. The accuracy of duplex scanning for predicting the performance of infrainguinal PTA was 83%. CONCLUSION: Duplex scanning has an important impact on the selection of treatment modalities in limbs with infrainguinal arterial occlusive disease. Femoropopliteal lesions can be reliably selected to PTA according to duplex scan findings.
|
|
| 18. |
- Boström Ardin, Annika, et al.
(författare)
-
Surgical reconstruction without preoperative angiography in patients with aortoiliac occlusive disease
- 2002
-
Ingår i: Annals of Vascular Surgery. - : Elsevier BV. - 0890-5096 .- 1615-5947. ; 16:3, s. 273-278
-
Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to evaluate the feasibility of performing surgical reconstructions in patients with aortoiliac occlusive disease with findings obtained solely from duplex scanning. Between January 1995 through December 1999, among 112 patients who underwent surgical intervention due to aortoiliac occlusive disease, 44 were operated on with findings obtained solely from preoperative duplex scanning. Deviations from preoperatively planned surgical interventions according to duplex scan findings and the outcome were analyzed. Our results showed that surgical reconstructions for treatment of aortoiliac occlusive disease can be safely performed by using duplex scanning as the sole preoperative diagnostic modality in patients with conclusive duplex scan findings.
|
|
| 19. |
- Christiansson, Lennart, et al.
(författare)
-
A new method of intrathecal PO2, PCO2, and pH measurements for continuous monitoring of spinal cord ischemia during thoracic aortic clamping in pigs
- 2000
-
Ingår i: Surgery. - : Elsevier BV. - 0039-6060 .- 1532-7361. ; 127:5, s. 571-576
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Impaired spinal cord circulation during thoracic aortic clamping may result in paraplegia. Reliable and fast responding methods for intraoperative monitoring are needed to facilitate the evaluation of protective measures and efficiency of revascularization.METHODS: In 11 pigs, a multiparameter PO2, PCO2, and pH sensor (Paratrend 7, Biomedical Sensors Ltd, United Kingdom) was introduced into the intrathecal space for continuous monitoring of cerebrospinal fluid (CSF) oxygenation during thoracic aortic cross-clamping (AXC) distal to the left subclavian artery. A laser-Doppler probe was inserted into the epidural space for simultaneous measurements of spinal cord flux. Registrations were made before and 30 minutes after clamping and 30 and 60 minutes after declamping. The same measuring points were used for systemic hemodynamic and metabolic data acquisition.RESULTS: The mean CSF PO2 readings of 41 mm Hg (5.5 kPa) at baseline decreased within 3 minutes to 5 mm Hg (0.7 kPa) during AXC (P < .01). Spinal cord flux measurement responded immediately in the same way to AXC. Both methods indicated normalization of circulation during declamping. Significant (P < .01) changes were also observed in the CSF metabolic parameters PCO2 and pH.CONCLUSIONS: In this experimental model of spinal ischemia by AXC, online monitoring of intrathecal PO2, PCO2, and pH showed significant changes and correlated well with epidural laser-Doppler flowmetry (P < .01).
|
|
| 20. |
- Christiansson, Lennart, et al.
(författare)
-
Aspects of the spinal cord circulation as assessed by intrathecal oxygen tension monitoring during various arterial interruptions in the pig
- 2001
-
Ingår i: Journal of Thoracic and Cardiovascular Surgery. - : Elsevier BV. - 0022-5223 .- 1097-685X. ; 121:4, s. 762-772
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: We sought to study the effect of various modes of interruption of the spinal cord blood supply on intrathecal oxygenation.METHODS: In 24 pigs intrathecal PO (2), PCO (2), and pH were continuously monitored with a multiparameter catheter (Paratrend 7, Biomedical Sensors; Diametrics Medical, Inc, St Paul, Minn) during and after aortic crossclamping or selective interruption of segmental arteries and proximal collateral circulation.RESULTS: Proximal aortic clamping (n = 6) produced complete ischemia, whereas a second clamp close to the celiac trunk (n = 4) partly protected against spinal cord ischemia. This is explained by prevention of the steal phenomenon in the excluded part of the aorta. Adding clamps to the subclavian arteries (n = 6) created complete spinal ischemia as the collateral circulation was interrupted. In another group (n = 4) all segmental arteries below T5 were occluded with no reaction in the intrathecal variables. Additional selective clamping of supreme intercostal arteries (n = 4) showed the relative importance of the subclavian and vertebral collateral pathways.CONCLUSIONS: Continuous intrathecal PO (2) was monitored during various modes of interruption of the spinal cord blood supply. This provided insight into the ischemia mechanisms and relative importance of the segmental contribution and proximal collateral pathways of the spinal cord circulation in pigs. A short literature review is given, and aspects of comparative anatomy are discussed.
|
|
| 21. |
|
|
| 22. |
- Christiansson, Lennart, et al.
(författare)
-
Increased FiO2 improves intrathecal oxygenation during thoracic aortic cross-clamping in pigs
- 2001
-
Ingår i: Scandinavian Cardiovascular Journal. - 1401-7431 .- 1651-2006. ; 35:2, s. 147-150
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate the effect of 100% oxygen ventilation on cerebrospinal fluid (CSF) oxygenation in 11 pigs during thoracic aortic cross-clamping.DESIGN: An aorto-aortic shunt was used for control of central hemodynamics and study of hypoperfusion by exsanguination. CSF PO2, PCO2 and pH were continuously monitored before and during clamping. The changes in hemodynamic parameters and intrathecal gas tensions in response to variations in proximal mean aortic pressure and fraction of inspired oxygen (FiO2) were recorded.RESULTS: Baseline CSF PO2 decreased from 4.8 +/- 1.9 to 2.6 +/- 2.2 kPa following aortic occlusion. Increasing FiO2 to 1.0 resulted in a significant increase in CSF PO2 to 4.1 +/- 3.0 with a return to 2.7 +/- 2.1 kPa after reducing FiO2 to 0.4 again. The same variations in FiO2 did not induce any significant changes in CSF PO2 during hypotension.CONCLUSION: Increased FiO2 during experimental thoracic aortic cross-clamping with stable proximal arterial pressure helps to maintain CSF PO2, whereas severe hypotension could not be compensated for by hyperoxemia.
|
|
| 23. |
- Christiansson, Lennart, et al.
(författare)
-
Relationship between intrathecal oxygen tension and ultrastructural changes in the spinal cord during experimental aortic clamping
- 2000
-
Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 19:4, s. 413-420
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate spinal cord ultrastructure related to cerebrospinal fluid (CSF) oxygenation.DESIGN: experimental aortic occlusion model with intrathecal oxygen tension monitoring.MATERIALS AND METHODS: Two groups of pigs underwent proximal (P) or double (D) aortic occlusion for 30 min followed by 1 h of reperfusion. In a third group (I) segmental arteries distal to T3 were clamped for 90 min. A thin pO(2), pCO(2) and pH sensor was placed intrathecally for continuous monitoring of CSF. Spinal cord segments were studied by electron microscopy (EM).RESULTS: In group P, CSF-pO(2)rapidly decreased during clamping and major changes in pH and pCO(2)were seen. EM demonstrated neuronal degeneration with loss of cellular integrity and severe affection of organelles. In the group D, CSF oxygenation decreased to about half, but with only moderate changes in the metabolic parameters. Group I showed no significant changes in CSF measurements. The latter groups were similar at EM, showing only mild mitochondrial changes.CONCLUSIONS: The level of CSF oxygenation during aortic cross-clamping or segmental artery interruption seems to correlate with ultrastructural changes in the spinal cord. This online intrathecal monitoring technique may provide valuable information on spinal cord circulation during thoracoabdominal aortic surgery.
|
|
| 24. |
- Demirer, S., et al.
(författare)
-
Haemostasis in patients with Behcet's disease
- 2000
-
Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 19:6, s. 570-574
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: to determine whether Behçet's disease affects haemostatic function. SETTING: University Hospital, Turkey. PATIENTS: one hundred and twenty-seven consecutive patients with Behçet's disease, 34 of whom with a history of vascular involvement. METHODS: prothrombin fragment 1+2 tissue plasminogen activator, protein S and C, antithrombin, fibrinogen, von Willebrand factor, thrombomodulin and prothrombin time (PT) were measured in patient plasma. RESULTS: soluble thrombomodulin was significantly lower and von Willebrand factor (vWF) and tissue plasminogen activator (tPA) significantly higher in Behçet's patients. Patients with vascular involvement showed the highest levels of vWF and tPA. There was no activation of coagulation, not even in patients with an active disease at the time of sampling. CONCLUSION: there were indirect signs of endothelial activity or damage, particularly in patients with vascular involvement. Coagulation was not activated.
|
|
| 25. |
- Eklöf, Hampus, et al.
(författare)
-
2D inflow MR angiography in severe chronic leg ischemia
- 1998
-
Ingår i: Acta Radiologica. - 0284-1851 .- 1600-0455. ; 39:6, s. 663-668
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to compare 2D inflow MR angiography (MRA) with selective X-ray angiography (XRA) in patients with severe chronic leg ischemia. MATERIAL AND METHODS: In a blinded prospective study, 2D inflow MRA and XRA were compared with regard to evaluation of the arteries distal to the knee in 24 patients (median age 72 years) with severe ischemia; 23 of them had either rest pain or tissue loss. Statistics were calculated with XRA as the reference method. RESULTS: The interpretations of 2D inflow MRA and XRA showed moderate agreement in the calf arteries but poor agreement in the foot arteries. Of the discrepancies, two-thirds were observer-related and only one-third method-related. Of all the comparable arteries, 9% showed method-related differences between the two methods. An assessment of MRA using only maximum intensity projections (MIP) resulted in 19% of findings being judged inconclusive whereas all the arteries could be classified when the cross-sectional images were studied on the viewing console. CONCLUSION: The agreement between MRA and XRA was good in the calf but questionable in the foot.
|
|
