In vitro experiments were performed in order to investigate the appearance of different types of ... more In vitro experiments were performed in order to investigate the appearance of different types of central venous catheters at intravascular ultrasonography. The experiments were repeated with artificially produced thrombi which were made adherent to the catheter wall. All thrombi larger than 1 mm could be identified. In a clinical study including 12 patients who had a central venous catheter, transfemoral intravascular ultrasonography was performed. The catheters had been in place for an average period of 54 days (range 1-360 days). In 3 patients a catheter thrombus, mural thrombus, or occlusive vein thrombosis was found. In 2 of these patients the catheter was occluded, in the 3rd patient it was malpositioned into the contralateral brachiocephalic vein. There were no complications following the ultrasonographic procedures. Mean catheterization time was 7.5 min (range 3-20 min). The advantages of this new method compared with conventional phlebographic studies and its impact on further clinical investigations are discussed.
This retrospective, multiple-center study includes 172 PTFE (Gore-Tex) and 35 umbilical vein graf... more This retrospective, multiple-center study includes 172 PTFE (Gore-Tex) and 35 umbilical vein grafts (Bio-graft) used for femoro-popliteal bypass grafting. The one-year patency rate was approximately 63% in both groups. Until further experience is accumulated, autogenous saphenous vein should probably be the first choice for femoro-popliteal bypass grafting. Prosthetic grafts should preferably be used when the saphenous vein is absent or insufficient.
Scandinavian journal of thoracic and cardiovascular surgery, 1974
Twenty-five patients, who developed oedema of the operated leg after successful arterial reconstr... more Twenty-five patients, who developed oedema of the operated leg after successful arterial reconstruction, were examined by phlebography in order to determine the incidence of postoperative deep venous thrombosis. Only two patients (8%) had phlebographic evidence of venous thrombosis, and then only in the calf veins of the operated leg. Four factors are considered as being contributory to the low incidence of venous thrombosis after the arterial reconstructions in the present study. (1) Post reconstructive hyperaemia with resulting increase of venous blood flow in the extremity. (2) Anticoagulation therapy with moderate doses of heparin, primarily directed at the prevention of arterial thrombosis during the operation. (3) Dextran administration, primarily administered to improve the peripheral arterial blood flow. (4) Destruction of lymph channels at the sites of dissection with compensatory increase of venous back-flow in the operated extremity.Arterial reconstructions of the lower extremity are frequently...
In vitro experiments were performed in order to investigate the appearance of different types of ... more In vitro experiments were performed in order to investigate the appearance of different types of central venous catheters at intravascular ultrasonography. The experiments were repeated with artificially produced thrombi which were made adherent to the catheter wall. All thrombi larger than 1 mm could be identified. In a clinical study including 12 patients who had a central venous catheter, transfemoral intravascular ultrasonography was performed. The catheters had been in place for an average period of 54 days (range 1-360 days). In 3 patients a catheter thrombus, mural thrombus, or occlusive vein thrombosis was found. In 2 of these patients the catheter was occluded, in the 3rd patient it was malpositioned into the contralateral brachiocephalic vein. There were no complications following the ultrasonographic procedures. Mean catheterization time was 7.5 min (range 3-20 min). The advantages of this new method compared with conventional phlebographic studies and its impact on further clinical investigations are discussed.
Health related quality of life in long term-survivors following thoracoabdominal aortic aneurysm ... more Health related quality of life in long term-survivors following thoracoabdominal aortic aneurysm repair
Aim: Aim of the study was to assess if endovascular treatment is a feasible alternative in patien... more Aim: Aim of the study was to assess if endovascular treatment is a feasible alternative in patients with descending thoracic aortic disease. Methods: Seventy-three patients were admitted for stent-grafting of descending thoracic aortic disease during the period 1997-2008. The majority of the patients had aneurysm (35) or type B dissection (21), but also traumas, penetrating ulcers and other conditions were treated. Sixteen (22%) were unfit for open surgery. Thirty-four (47%) of the patients were symptomatic and 18 had rupture. The primary technical success rate was 96%. Results: Early mortality (<30 days) for the whole group was 3%. Early endoleak (<30 days) was identified in 11 patients (15%) of whom 4 (5%) had a secondary procedure. In addition, two trauma patients required insertion of a new stent-graft due to stent-graft collapse. Two patients had stroke, one had paraplegia and two paraparesis. Mean follow-up was 3.1 years (range 0-12 years). Late endoleak (>30 days) was identified in 5 patients (7%) treated by 6 secondary procedures. One patient (1.7%) had an explant. Two patients have had extensions of endografts due to increasing diameter of the aorta at the distal end of the stent-graft. Conclusion: Endovascular treatment seems to be a viable alternative in patients with descending thoracic aortic disease.
Health related quality of life in long term-survivors following thoracoabdominal aortic aneurysm ... more Health related quality of life in long term-survivors following thoracoabdominal aortic aneurysm repair
The purpose was to assess health-related quality of life (HRQOL) in long-term survivors of thorac... more The purpose was to assess health-related quality of life (HRQOL) in long-term survivors of thoracoabdominal aneurysm repair. Between 1983 and 2001, 43 patients underwent thoracoabdominal aneurysm repair. Long-term survivors (13) were investigated. Two were lost to follow-up. The mean follow-up period was 6.2 years. HRQOL was measured by Short Form (SF)-36, constructed of 36 items grouped into eight scales measuring physical functioning, role limitations caused by physical problems, bodily pain, general health perceptions, vitality, social functioning, role limitations caused by emotional problems, and mental health. Additional questions specific for vascular disease were ascribed. The patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; relatives received corresponding questions, responding on behalf of the patients. Patient data scores were compared with a selection of individuals from the general population. The patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; SF-36 scores were generally poorer than that of the healthy population in both physical and mental dimensions. Patients who had a complicated postoperative course generally scored lowest in physical dimensions. Comparing patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; scores with relatives scoring on behalf of the patients showed no statistical differences. According to disease-specific questions, impotence and pain were reported as major long-term postoperative problems. Patients with uncomplicated postoperative courses all reported improved health status (six) compared with the preoperative status, whereas five patients with complicated postoperative courses reported poorer health status. Nine of 11 patients experienced the same or improved HRQOL, and two patients reported reduced HRQOL after surgery. Ten of 11 patients evaluated the operation as successful. Although the sample size in this study is small, those who had postoperative complications or reported a decreased physical function in the years after surgery generally had low scores in almost all dimensions of the SF-36. When disease-specific questions were related to thoracoabdominal aneurysm surgery, most patients reported an acceptable HRQOL.
In vitro experiments were performed in order to investigate the appearance of different types of ... more In vitro experiments were performed in order to investigate the appearance of different types of central venous catheters at intravascular ultrasonography. The experiments were repeated with artificially produced thrombi which were made adherent to the catheter wall. All thrombi larger than 1 mm could be identified. In a clinical study including 12 patients who had a central venous catheter, transfemoral intravascular ultrasonography was performed. The catheters had been in place for an average period of 54 days (range 1-360 days). In 3 patients a catheter thrombus, mural thrombus, or occlusive vein thrombosis was found. In 2 of these patients the catheter was occluded, in the 3rd patient it was malpositioned into the contralateral brachiocephalic vein. There were no complications following the ultrasonographic procedures. Mean catheterization time was 7.5 min (range 3-20 min). The advantages of this new method compared with conventional phlebographic studies and its impact on further clinical investigations are discussed.
This retrospective, multiple-center study includes 172 PTFE (Gore-Tex) and 35 umbilical vein graf... more This retrospective, multiple-center study includes 172 PTFE (Gore-Tex) and 35 umbilical vein grafts (Bio-graft) used for femoro-popliteal bypass grafting. The one-year patency rate was approximately 63% in both groups. Until further experience is accumulated, autogenous saphenous vein should probably be the first choice for femoro-popliteal bypass grafting. Prosthetic grafts should preferably be used when the saphenous vein is absent or insufficient.
Scandinavian journal of thoracic and cardiovascular surgery, 1974
Twenty-five patients, who developed oedema of the operated leg after successful arterial reconstr... more Twenty-five patients, who developed oedema of the operated leg after successful arterial reconstruction, were examined by phlebography in order to determine the incidence of postoperative deep venous thrombosis. Only two patients (8%) had phlebographic evidence of venous thrombosis, and then only in the calf veins of the operated leg. Four factors are considered as being contributory to the low incidence of venous thrombosis after the arterial reconstructions in the present study. (1) Post reconstructive hyperaemia with resulting increase of venous blood flow in the extremity. (2) Anticoagulation therapy with moderate doses of heparin, primarily directed at the prevention of arterial thrombosis during the operation. (3) Dextran administration, primarily administered to improve the peripheral arterial blood flow. (4) Destruction of lymph channels at the sites of dissection with compensatory increase of venous back-flow in the operated extremity.Arterial reconstructions of the lower extremity are frequently...
In vitro experiments were performed in order to investigate the appearance of different types of ... more In vitro experiments were performed in order to investigate the appearance of different types of central venous catheters at intravascular ultrasonography. The experiments were repeated with artificially produced thrombi which were made adherent to the catheter wall. All thrombi larger than 1 mm could be identified. In a clinical study including 12 patients who had a central venous catheter, transfemoral intravascular ultrasonography was performed. The catheters had been in place for an average period of 54 days (range 1-360 days). In 3 patients a catheter thrombus, mural thrombus, or occlusive vein thrombosis was found. In 2 of these patients the catheter was occluded, in the 3rd patient it was malpositioned into the contralateral brachiocephalic vein. There were no complications following the ultrasonographic procedures. Mean catheterization time was 7.5 min (range 3-20 min). The advantages of this new method compared with conventional phlebographic studies and its impact on further clinical investigations are discussed.
Health related quality of life in long term-survivors following thoracoabdominal aortic aneurysm ... more Health related quality of life in long term-survivors following thoracoabdominal aortic aneurysm repair
Aim: Aim of the study was to assess if endovascular treatment is a feasible alternative in patien... more Aim: Aim of the study was to assess if endovascular treatment is a feasible alternative in patients with descending thoracic aortic disease. Methods: Seventy-three patients were admitted for stent-grafting of descending thoracic aortic disease during the period 1997-2008. The majority of the patients had aneurysm (35) or type B dissection (21), but also traumas, penetrating ulcers and other conditions were treated. Sixteen (22%) were unfit for open surgery. Thirty-four (47%) of the patients were symptomatic and 18 had rupture. The primary technical success rate was 96%. Results: Early mortality (<30 days) for the whole group was 3%. Early endoleak (<30 days) was identified in 11 patients (15%) of whom 4 (5%) had a secondary procedure. In addition, two trauma patients required insertion of a new stent-graft due to stent-graft collapse. Two patients had stroke, one had paraplegia and two paraparesis. Mean follow-up was 3.1 years (range 0-12 years). Late endoleak (>30 days) was identified in 5 patients (7%) treated by 6 secondary procedures. One patient (1.7%) had an explant. Two patients have had extensions of endografts due to increasing diameter of the aorta at the distal end of the stent-graft. Conclusion: Endovascular treatment seems to be a viable alternative in patients with descending thoracic aortic disease.
Health related quality of life in long term-survivors following thoracoabdominal aortic aneurysm ... more Health related quality of life in long term-survivors following thoracoabdominal aortic aneurysm repair
The purpose was to assess health-related quality of life (HRQOL) in long-term survivors of thorac... more The purpose was to assess health-related quality of life (HRQOL) in long-term survivors of thoracoabdominal aneurysm repair. Between 1983 and 2001, 43 patients underwent thoracoabdominal aneurysm repair. Long-term survivors (13) were investigated. Two were lost to follow-up. The mean follow-up period was 6.2 years. HRQOL was measured by Short Form (SF)-36, constructed of 36 items grouped into eight scales measuring physical functioning, role limitations caused by physical problems, bodily pain, general health perceptions, vitality, social functioning, role limitations caused by emotional problems, and mental health. Additional questions specific for vascular disease were ascribed. The patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; relatives received corresponding questions, responding on behalf of the patients. Patient data scores were compared with a selection of individuals from the general population. The patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; SF-36 scores were generally poorer than that of the healthy population in both physical and mental dimensions. Patients who had a complicated postoperative course generally scored lowest in physical dimensions. Comparing patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; scores with relatives scoring on behalf of the patients showed no statistical differences. According to disease-specific questions, impotence and pain were reported as major long-term postoperative problems. Patients with uncomplicated postoperative courses all reported improved health status (six) compared with the preoperative status, whereas five patients with complicated postoperative courses reported poorer health status. Nine of 11 patients experienced the same or improved HRQOL, and two patients reported reduced HRQOL after surgery. Ten of 11 patients evaluated the operation as successful. Although the sample size in this study is small, those who had postoperative complications or reported a decreased physical function in the years after surgery generally had low scores in almost all dimensions of the SF-36. When disease-specific questions were related to thoracoabdominal aneurysm surgery, most patients reported an acceptable HRQOL.
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