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  • 1. Abbott, A. L.
    et al.
    Adelman, M. A.
    Alexandrov, A. V.
    Barnett, H. J. M.
    Beard, J.
    Bell, P.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Blacker, D.
    Buckley, C. J.
    Cambria, R. P.
    Comerota, A. J.
    Connolly, E. S., Jr.
    Davies, A. H.
    Eckstein, H. H.
    Faruqi, R.
    Fraedrich, G.
    Gloviczki, P.
    Hankey, G. J.
    Harbaugh, R. E.
    Heldenberg, E.
    Kittner, S. J.
    Kleinig, T. J.
    Mikhailidis, D. P.
    Moore, W. S.
    Naylor, R.
    Nicolaides, A.
    Paraskevas, K. I.
    Pelz, D. M.
    Prichard, J. W.
    Purdie, G.
    Ricco, J. B.
    Riles, T.
    Rothwell, P.
    Sandercock, P.
    Sillesen, H.
    Spence, J. D.
    Spinelli, F.
    Tan, A.
    Thapar, A.
    Veith, F. J.
    Zhou, W.
    Why the United States Center for Medicare and Medicaid Services (CMS) Should not Extend Reimbursement Indications for Carotid Artery Angioplasty/Stenting2012In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 43, no 3, p. 247-251Article in journal (Refereed)
  • 2. Aboyans, Victor
    et al.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Brodmann, Marianne
    Collet, Jean-Philippe
    Czerny, Martin
    De Carlo, Marco
    Naylor, A Ross
    Roffi, Marco
    Tendera, Michal
    Vlachopoulos, Charalambos
    Ricco, Jean-Baptiste
    Document Reviewers,
    Widimsky, Petr
    Kolh, Philippe
    Dick, Florian
    de Ceniga, Melina Vega
    Piepoli, Massimo Francesco
    Sievert, Horst
    Sulzenko, Jakub
    Esc Committee For Practice Guidelines Cpg,
    Windecker, Stephan
    Aboyans, Victor
    Agewall, Stefan
    Barbato, Emanuele
    Bueno, Héctor
    Coca, Antonio
    Collet, Jean-Philippe
    Coman, Ioan Mircea
    Dean, Veronica
    Delgado, Victoria
    Fitzsimons, Donna
    Gaemperli, Oliver
    Hindricks, Gerhard
    Iung, Bernard
    Jüni, Peter
    Katus, Hugo A
    Knuuti, Juhani
    Lancellotti, Patrizio
    Leclercq, Christophe
    McDonagh, Theresa
    Piepoli, Massimo Francesco
    Ponikowski, Piotr
    Richter, Dimitrios J
    Roffi, Marco
    Shlyakhto, Evgeny
    Simpson, Iain A
    Zamorano, Jose Luis
    Questions and Answers on Diagnosis and Management of Patients with Peripheral Arterial Diseases: A Companion Document of the 2017 ESC Guidelines for the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS).2018In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 55, no 4, p. 457-464, article id S1078-5884(17)30516-6Article in journal (Refereed)
  • 3. Aboyans, Victor
    et al.
    Ricco, Jean-Baptiste
    Bartelink, Marie-Louise E L
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Brodmann, Marianne
    Cohnert, Tina
    Collet, Jean-Philippe
    Czerny, Martin
    De Carlo, Marco
    Debus, Sebastian
    Espinola-Klein, Christine
    Kahan, Thomas
    Kownator, Serge
    Mazzolai, Lucia
    Naylor, A Ross
    Roffi, Marco
    Röther, Joachim
    Sprynger, Muriel
    Tendera, Michal
    Tepe, Gunnar
    Venermo, Maarit
    Vlachopoulos, Charalambos
    Desormais, Ileana
    Widimsky, Petr
    Kolh, Philippe
    Agewall, Stefan
    Bueno, Héctor
    Coca, Antonio
    De Borst, Gert J
    Delgado, Victoria
    Dick, Florian
    Erol, Cetin
    Ferrini, Marc
    Kakkos, Stavros
    Katus, Hugo A
    Knuuti, Juhani
    Lindholt, Jes
    Mattle, Heinrich
    Pieniazek, Piotr
    Piepoli, Massimo Francesco
    Scheinert, Dierk
    Sievert, Horst
    Simpson, Iain
    Sulzenko, Jakub
    Tamargo, Juan
    Tokgozoglu, Lale
    Torbicki, Adam
    Tsakountakis, Nikolaos
    Tuñón, José
    de Ceniga, Melina Vega
    Windecker, Stephan
    Zamorano, Jose Luis
    2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)2018In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 55, no 3, p. 305-368Article in journal (Refereed)
  • 4.
    Acosta, S.
    et al.
    Lund Univ, Vasc Ctr, Dept Clin Sci, Malmo, Sweden..
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Temporary Abdominal Closure After Abdominal Aortic Aneurysm Repair: A Systematic Review of Contemporary Observational Studies2016In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 51, no 3, p. 371-378Article, review/survey (Refereed)
    Abstract [en]

    Objectives: The aim of this paper was to review the literature on temporary abdominal closure (TAC) after abdominal aortic aneurysm (AAA) repair. Methods: This was a systematic review of observational studies. A PubMed, EM BASE and Cochrane search from 2007 to July 2015 was performed combining the Medical Subject Headings "aortic aneurysm" and "temporary abdominal closure", "delayed abdominal closure", "open abdomen", "abdominal compartment syndrome", "negative pressure wound therapy", or "vacuum assisted wound closure". Results: Seven original studies were found. The methods used for TAC were the vacuum pack system with (n = 1) or without (n = 2) mesh bridge, vacuum assisted wound closure (VAWC; n = 1) and the VAWC with mesh mediated fascial traction (VACM; n = 3). The number of patients included varied from four to 30. Three studies were exclusively after open repair, one after endovascular aneurysm repair, and three were mixed series. The frequency of ruptured AAA varied from 60% to 100%. The primary fascia] closure rate varied from 79% to 100%. The median time to closure of the open abdomen was 10.5 and 17 days in two prospective studies with a fascia] closure rate of 100% and 96%, respectively; the inclusion criterion was an anticipated open abdomen therapy time >= 5 days using the VACM method. The graft infection rate was 0% in three studies. No patient with longterm open abdomen therapy with the VACM in the three studies was left with a planned ventral hernia. The in hospital survival rate varied from 46% to 80%. Conclusions: A high fascial closure rate without planned ventral hernia is possible to achieve with VACM, even after long-term open abdomen therapy. There are, however, few publications reporting specific results of open abdomen treatment after AAA repair, and there is a need for randomized controlled trials to determine the most efficient and safe TAC method during open abdomen treatment after AAA repair.

  • 5. Acosta, Stefan
    et al.
    Seternes, Arne
    Venermo, Maarit
    Vikatmaa, Leena
    Sörelius, Karl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Svensson, Mats
    Djavani, Khatereh
    Department of Surgery, Gävle Hospital, Gävle, Sweden.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Open Abdomen Therapy with Vacuum and Mesh Mediated Fascial Traction After Aortic Repair: an International Multicentre Study2017In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 54, no 6, p. 697-705Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    Open abdomen therapy may be necessary to prevent or treat abdominal compartment syndrome (ACS). The aim of the study was to analyse the primary delayed fascial closure (PDFC) rate and complications after open abdomen therapy with vacuum and mesh mediated fascial traction (VACM) after aortic repair and to compare outcomes between those treated with open abdomen after primary versus secondary operation.

    METHODS:

    This was a retrospective cohort, multicentre study in Sweden, Finland, and Norway, including consecutive patients treated with open abdomen and VACM after aortic repair at six vascular centres in 2006-2015. The primary endpoint was PDFC rate.

    RESULTS:

    Among 191 patients, 155 were men. The median age was 71 years (IQR 66-76). Ruptured abdominal aortic aneurysm (RAAA) occurred in 69.1%. Endovascular/hybrid and open repairs were performed in 49 and 142 patients, respectively. The indications for open abdomen were inability to close the abdomen (62%) at primary operation and ACS (80%) at secondary operation. Duration of open abdomen was 11 days (IQR 7-16) in 157 patients alive at open abdomen termination. The PDFC rate was 91.8%. Open abdomen initiated at primary (N=103), compared with secondary operation (N=88), was associated with less severe initial open abdomen status (p=.006), less intestinal ischaemia (p=.002), shorter duration of open abdomen (p=.007), and less renal replacement therapy (RRT, p<.001). In hospital mortality was 39.3%, and after entero-atmospheric fistula (N=9) was 88.9%. Seven developed graft infection within 6 months, 1 year mortality was 28.6%. Intestinal ischaemia (OR 3.71, 95% CI 1.55-8.91), RRT (OR 3.62, 95% CI 1.72-7.65), and age (OR 1.12, 95% CI 1.06-1.12), were independent factors associated with in hospital mortality, but not open abdomen initiated at primary versus secondary operation.

    CONCLUSIONS:

    VACM was associated with a high PDFC rate after prolonged open abdomen therapy following aortic repair. Patient outcomes seemed better when open abdomen was initiated at primary, compared with secondary operation but a selection effect is possible.

  • 6. Ajari, A
    et al.
    Bergqvist, D
    Elfström, Johan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery.
    Örtenvall, P
    Troeng, T
    Hedberg, B
    Ljungström, KG
    Norgren, L
    Diabetes mellitus as a risk factor for early outcome after carotid endarterectomy - a population study.1999In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 18, p. 122-126Article in journal (Refereed)
  • 7.
    Balaz, P.
    et al.
    Inst Clin & Expt Med, Vasc & Transplant Surg Dept, Prague, Czech Republic.;Charles Univ Prague, Fac Med 3, Fac Hosp Kralovske Vinohrady, Vasc Surg Unit,Dept Surg, Prague, Czech Republic..
    Wohlfahrt, P.
    St Annes Univ Hosp, Int Clin Res Ctr, Brno, Czech Republic.;Inst Clin & Expt Med, Dept Prevent Cardiol, Prague, Czech Republic.;Charles Univ Prague, Fac Med 1, Ctr Cardiovasc Prevent, Prague, Czech Republic.;Thomayer Hosp, Prague, Czech Republic..
    Rokosny, S.
    Inst Clin & Expt Med, Vasc & Transplant Surg Dept, Prague, Czech Republic..
    Maly, S.
    Inst Clin & Expt Med, Vasc & Transplant Surg Dept, Prague, Czech Republic..
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Is It Worthwhile Treating Occluded Cold Stored Venous Allografts by Thrombolysis?2016In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 52, no 3, p. 370-376Article in journal (Refereed)
    Abstract [en]

    Objectives: Thrombolysis has been reported to be suboptimal in occluded vein grafts and cryopreserved allografts, and there are no data on the efficacy of thrombolysis in occluded cold stored venous allografts. The aim was to evaluate early outcomes, secondary patency and limb salvage rates of thrombolysed cold stored venous allograft bypasses and to compare the outcomes with thrombolysis of autologous bypasses. Methods: This was a single center study of consecutive patients with acute and non-acute limb ischemia between September 1, 2000, and January 1, 2014, with occlusion of cold stored venous allografts, and between January 1, 2012, and January 1, 2014, with occlusion of autologous bypass who received intra-arterial thrombolytic therapy. Results: Sixty-one patients with occlusion of an infrainguinal bypass using a cold stored venous allograft (n = 35) or an autologous bypass (n = 26) underwent percutaneous intra-arterial thrombolytic therapy. The median duration of thrombolysis was 20 h (IQR 18-24) with no difference between the groups (p = .14). The median follow up was 18.5 months (IQR 11.0-52.0). Secondary patency rates of thrombolysed bypass at 6 and 12 months were 44 +/- 9% and 32 +/- 9% in patients with a venous allograft bypass and 46 +/- 10% and 22 +/- 8% with an autologous bypass, with no difference between groups (p = .40). Limb salvage rates at 1, 6, and 12 months after thrombolysis in the venous allograft group were 83 +/- 7%, 72 8% and 63 +/- 9%, and in the autologous group 91 +/- 6%, 76 +/- 9%, and 65 +/- 13%, with no difference between groups (p = .69). Conclusions: Long-term results of thrombolysis of venous allograft bypasses are similar to those of autologous bypasses. Occluded cold stored venous allograft can be successfully re-opened in most cases with a favorable effect on limb salvage.

  • 8.
    Baubeta Fridh, Erik
    et al.
    Ryhov Cty Hosp, Sweden; Gothenburg Univ, Sweden.
    Andersson, Manne
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Ryhov Cty Hosp, Sweden.
    Thuresson, Marcus
    Statisticon AB, Sweden.
    Sigvant, Birgitta
    Karlstad Cent Hosp, Sweden; Uppsala Univ, Sweden.
    Kragsterman, Bjorn
    Uppsala Univ, Sweden.
    Johansson, Saga
    AstraZeneca Nord Balt, Sweden.
    Hasvold, Pal
    AstraZeneca Gothenburg, Sweden.
    Nordanstig, Joakim
    Gothenburg Univ, Sweden.
    Falkenberg, Marten
    Gothenburg Univ, Sweden.
    Editors Choice - Impact of Comorbidity, Medication, and Gender on Amputation Rate Following Revascularisation for Chronic Limb Threatening Ischaemia2018In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 56, no 5, p. 681-688Article in journal (Refereed)
    Abstract [en]

    Objective/background: Chronic limb threatening ischaemia (CLTI) has a high risk of amputation and mortality. Increased knowledge on how sex, comorbidities, and medication influence these outcomes after revascularisation may help optimise results and patient selection. Methods: This population based observational cohort study included all individuals revascularised for CLTI in Sweden during a five year period (10,617 patients in total). Data were retrieved and merged from mandatory national healthcare registries, and specifics on amputations were validated with individual medical records. Results: Mean age at revascularisation was 76.8 years. Median follow up was 2.7 years (range 0-6.6 years). Male sex (hazard ratio [HR] 1.20, 95% confidence interval [CI] 1.09-1.33), renal insufficiency (HR 1.57, 95% CI 1.32-1.87), diabetes (HR 1.45, 95% CI 1.32-1.60), and heart failure (HR 1.17, 95% CI 1.05-1.31) were independently associated with an increased amputation rate, whereas the use of statins (HR 0.71, 95% CI 0.64-0.78) and low dose acetylsalicylic acid (HR 0.77, 95% CI 0.70-0.86) were associated with a reduced amputation rate. For the combined end point of amputation or death, an association with increased rates was found for male sex (HR 1.25, 95% CI 1.18-1.32), renal insufficiency (HR 1.94, 95% CI 1.75-2.14), heart failure (HR 1.50, 95% CI 1.40-1.60), and diabetes (HR 1.31, 95% CI 1.23-1.38). The use of statins (HR 0.74, 95% CI 0.67-0.82) and low dose acetylsalicylic acid (HR 0.82, 95% CI 0.77-0.881) were related to a reduced risk of amputation or death. Conclusions: Renal insufficiency is the strongest independent risk factor for both amputation and amputation/ death in revascularised CLTI patients, followed by diabetes and heart failure. Men with CLTI have worse outcomes than women. These results may help govern patient selection for revascularisation procedures. Statin and low dose acetylsalicylic acid are associated with an improved limb outcome. This underlines the importance of preventive medication to reduce general cardiovascular risk and increase limb salvage. (C) 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.

  • 9.
    Baubeta Fridh, Erik
    et al.
    Ryhov County Hospital, Sweden; University of Gothenburg, Sweden.
    Andersson, Manne
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Ryhov County Hospital, Sweden.
    Thuresson, Marcus
    Statisticon AB, Sweden.
    Sigvant, Birgitta
    Karlstad Central Hospital, Sweden; Karolinska Institute, Sweden.
    Kragsterman, Björn
    Uppsala University, Sweden.
    Johansson, Saga R.
    AstraZeneca Gothenburg, Sweden.
    Hasvold, Pål
    AstraZeneca Nordic Balt, Sweden.
    Falkenberg, Mårten
    University of Gothenburg, Sweden.
    Nordanstig, Joakim
    Gothenburg University, Sweden; Gothenburg University, Sweden.
    Amputation Rates, Mortality, and Pre-operative Comorbidities in Patients Revascularised for Intermittent Claudication or Critical Limb Ischaemia: A Population Based Study2017In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 54, no 4, p. 480-486Article in journal (Refereed)
    Abstract [en]

    Objectives

    The aims of this population based study were to describe mid- to long-term amputation risk, cumulative incidence of death or amputation, and differences in pre-operative comorbidities in patients revascularised for lower limb peripheral artery disease (PAD).

    Methods

    This was an observational cohort study. Data from the Swedish National Quality Registry for Vascular Surgery (Swedvasc) were combined with mandatory national health care registries and patient medical records. All patients who underwent revascularisation in Sweden between May 2008 and May 2013 for intermittent claudication (IC) or critical limb ischaemia(CLI), aged 50 years and older, were identified through the Swedvasc database. The mandatory national health care registries and medical records provided data on comorbidities, mortality, and major amputations.

    Results

    A total of 16,889 patients with PAD (IC, n = 6272; CLI, n = 10,617) were studied. The incidence of amputations in IC patients was 0.4% (range 0.3%–0.5%) per year. Among CLI patients, the amputation rate during the first 6 months following revascularisation was 12.0% (95% CI 11.3–12.6). Thereafter, the incidence declined to approximately 2% per year. The cumulative combined incidence of death or amputation 3 years after revascularisation was 12.9% (95% CI 12.0–13.9) in IC patients and 48.8% (95% CI 47.7–49.8) in CLI patients. Among CLI patients, compared with IC patients, the prevalence of diabetes, ischaemic stroke, heart failure, and atrial fibrillation was approximately doubled and renal failure was nearly tripled, even after age standardisation.

    Conclusion

    The risk of amputation is particularly high during the first 6 months following revascularisation for CLI. IC patients have a benign course in terms of limb loss. Mortality in both IC and CLI patients is substantial. Revascularised CLI patients have different comorbidities from IC patients.

  • 10. Beebe, Hugh G.
    et al.
    Bergan, John J.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Eklöf, Bo
    Eriksson, Ingvar
    Goldman, Mitchel P.
    Greenfield, Lazar J.
    Hobson, Robert W.
    Juhan, Claude
    Kistner, Robert L.
    Labropoulos, Nicos
    Malouf, G. Mark
    Menzoian, James O.
    Moneta, Gregory L.
    Myers, Kenneth A.
    Neglen, Peter
    Nicolaides, Andrew N.
    O'Donell, Thomas F.
    Partsch, Hugo
    Perrin, Michel
    Porter, John M.
    Raju, Seshadri
    Rich, Norman M.
    Richardson, Graeme
    Schanzer, Harry
    Coleridge Smith, Philip
    Strandness, D. Eugene
    Summer, David S.
    Classification and grading of chronic venous disease in the lower limbs: A consensus statement1996In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 12, no 4, p. 487-92Article in journal (Refereed)
  • 11.
    Behrendt, Christian-Alexander
    et al.
    Univ Med Ctr Hamburg Eppendorf, Univ Heart Ctr Hamburg, Dept Vasc Med, Hamburg, Germany.
    Bertges, Daniel
    Univ Vermont, Med Ctr, Div Vasc Surg, Burlington, VT USA.
    Eldrup, Nikolaj
    Aarhus Univ Hosp, Dept Cardiothorac & Vasc Surg, Aarhus, Denmark.
    Beck, Adam W.
    Univ Alabama Birmingham, Div Vasc Surg & Endovasc Therapy, Birmingham, AL USA.
    Mani, Kevin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Venermo, Maarit
    Helsinki Univ Hosp, Dept Vasc Surg, Helsinki, Finland;Univ Helsinki, Helsinki, Finland.
    Szeberin, Zoltan
    Semmelweis Univ, Dept Vasc Surg, Budapest, Hungary.
    Menyhei, Gabor
    Pecs Univ, Med Ctr, Dept Vasc Surg, Pecs, Hungary.
    Thomson, Ian
    Dunedin Publ Hosp, Dunedin Sch Med, Dept Vasc Surg, Dunedin, New Zealand.
    Heller, Georg
    Kantonsspital St Gallen, Dept Vasc Surg, St Gallen, Switzerland.
    Wigger, Pius
    Kantonspital, Dept Surg, Winterthur, Switzerland.
    Danielsson, Gudmundur
    Reykjav Venous Ctr, Domus Med, Reykjavik, Iceland.
    Galzerano, Giuseppe
    Usl Toscana Sud Est, Misericordia Hosp Grosseto, Vasc Surg, Grosseto, Italy.
    Lopez, Cristina
    Univ Hosp Granada, Dept Vasc Surg, Granada, Spain.
    Altreuther, Martin
    St Olays Hosp, Dept Vasc Surg, Trondheim, Norway.
    Sigvant, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Riess, Henrik C.
    Univ Med Ctr Hamburg Eppendorf, Univ Heart Ctr Hamburg, Dept Vasc Med, Hamburg, Germany.
    Sedrakyan, Art
    Weill Cornell Med Coll, Healthcare Policy & Res, New York, NY USA.
    Beiles, Barry
    Australian & New Zealand Soc Vasc Surg, Melbourne, Vic, Australia.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Boyle, Jonathan R.
    Cambridge Univ Hosp NHS Trust, Dept Vasc Surg, Cambridge, England.
    Debus, E. Sebastian
    Univ Med Ctr Hamburg Eppendorf, Univ Heart Ctr Hamburg, Dept Vasc Med, Hamburg, Germany.
    Cronenwett, Jack
    Dartmouth Hitchcock Med Ctr, Dept Surg, Lebanon, NH 03766 USA.
    International Consortium of Vascular Registries Consensus Recommendations for Peripheral Revascularisation Registry Data Collection2018In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 56, no 2, p. 217-237Article in journal (Refereed)
    Abstract [en]

    Objective/Background: To achieve consensus on the minimum core data set for evaluation of peripheral arterial revascularisation outcomes and enable collaboration among international registries.

    Methods: A modified Delphi approach was used to achieve consensus among international vascular surgeons and registry members of the International Consortium of Vascular Registries (ICVR). Variables, including definitions, from registries covering open and endovascular surgery, representing 14 countries in ICVR, were collected and analysed to define a minimum core data set and to develop an optimum data set for registries. Up to three different levels of variable specification were suggested to allow inclusion of registries with simpler versus more complex data capture, while still allowing for data aggregation based on harmonised core definitions.

    Results: Among 31 invited experts, 25 completed five Delphi rounds via internet exchange and face to face discussions. In total, 187 different items from the various registry data forms were identified for potential inclusion in the recommended data set. Ultimately, 79 items were recommended for inclusion in minimum core data sets, including 65 items in the level 1 data set, and an additional 14 items in the more specific level 2 and 3 recommended data sets. Data elements were broadly divided into (i) patient characteristics; (ii) comorbidities; (iii) current medications; (iv) lesion treated; (v) procedure; (vi) bypass; (vii) endarterectomy (viii) catheter based intervention; (ix) complications; and (x) follow up.

    Conclusion: A modified Delphi study allowed 25 international vascular registry experts to achieve a consensus recommendation for a minimum core data set and an optimum data set for peripheral arterial revascularisation registries. Continued global harmonisation of registry infrastructure and definition of items will overcome limitations related to single country investigations and enhance the development of real world evidence.

  • 12.
    Behrendt, Christian-Alexander
    et al.
    Univ Med Ctr Hamburg Eppendorf, Univ Heart Ctr Hamburg, Dept Vasc Med, Hamburg, Germany.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Schwaneberg, Thea
    Univ Med Ctr Hamburg Eppendorf, Univ Heart Ctr Hamburg, Dept Vasc Med, Hamburg, Germany.
    Debus, Eike S.
    Univ Med Ctr Hamburg Eppendorf, Univ Heart Ctr Hamburg, Dept Vasc Med, Hamburg, Germany.
    Cronenwett, Jack
    Dartmouth Hitchcock Med Ctr, Dept Surg, Lebanon, NH 03766 USA.
    Sigvant, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Aboyans, Victor
    Acosta, Stefan
    Ambler, Graeme
    Altreuther, Martin
    Goncalves, Frederico Bastos
    Beck, Adam Wayne
    Beiles, Barry
    Bertges, Daniel
    van den Berg, Jos C.
    de Borst, Gert J.
    Boyle, Jonathan R.
    Cochennec, Frederic
    Dick, Florian
    Diener, Holger
    Earnshaw, Jonothan
    Espinola-Klein, Christine
    Eldrup, Nikolaj
    Gottsaeter, Anders
    Hinchliffe, Rob
    Hoffmann, Ulrich
    Jongkind, Vincent
    Koelemay, Mark
    Kolh, Philippe
    Lopez-Espada, Cristina
    Mani, Kevin
    Menyhei, Gabor
    Ricco, Jean-Baptiste
    Schellong, Sebastian M.
    Svetlikov, Alexei
    Szeberin, Zoltan
    Thomson, Ian
    Tulamo, Riikka
    Tshomba, Yamume
    Twine, Christopher P.
    Venermo, Maarit
    Zeller, Thomas
    Editor's Choice - Recommendations for Registry Data Collection for Revascularisations of Acute Limb Ischaemia: A Delphi Consensus from the International Consortium of Vascular Registries2019In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 57, no 6, p. 816-821Article in journal (Refereed)
    Abstract [en]

    Objective: To develop a minimum core data set for evaluation of acute limb ischaemia (ALI) revascularisation treatment and outcomes that would enable collaboration among international registries. Methods: A modified Delphi approach was used to achieve consensus among international multidisciplinary vascular specialists and registry members of the International Consortium of Vascular Registries (ICVR). Variables identified in the literature or suggested by the expert panel, and variables, including definitions, currently used in 15 countries in the ICVR, were assessed to define both a minimum core and an optimum data set to register ALI treatment. Clinical relevance and practicability were both assessed, and consensus was defined as >= 80% agreement among participants. Results: Of 40 invited experts, 37 completed a preliminary survey and 31 completed the two subsequent Delphi rounds via internet exchange and face to face discussions. In total, 117 different items were generated from the various registry data forms, an extensive review of the literature, and additional suggestions from the experts, for potential inclusion in the data set. Ultimately, 35 items were recommended for inclusion in the minimum core data set, including 23 core items important for all registries, and an additional 12 more specific items for registries capable of capturing more detail. These 35 items supplement previous data elements recommended for registering chronic peripheral arterial occlusive disease treatment. Conclusion: A modified Delphi study allowed 37 international vascular registry experts to achieve a consensus recommendation for a minimum core and an optimum data set for registries covering patients who undergo ALI revascularisation. Continued global harmonisation of registry infrastructure and definition of items allows international comparisons and global quality improvement. Furthermore, it can help to define and monitor standards of care and enable international research collaboration.

  • 13.
    Behrendt, Christian-Alexander
    et al.
    Univ Med Ctr Hamburg Eppendorf, Univ Heart Ctr Hamburg, Dept Vasc Med, Hamburg, Germany.
    Debus, Eike S.
    Univ Med Ctr Hamburg Eppendorf, Univ Heart Ctr Hamburg, Dept Vasc Med, Hamburg, Germany.
    Mani, Kevin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Sedrakyan, Art
    Weill Cornell Med Coll, Healthcare Policy & Res, New York, NY USA.
    The Strengths and Limitations of Claims Based Research in Countries With Fee for Service Reimbursement2018In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 56, no 5, p. 615-616Article in journal (Other academic)
  • 14.
    Behrendt, Christian-Alexander
    et al.
    Univ Med Ctr Hamburg Eppendorf, Univ Heart Ctr Hamburg, Dept Vasc Med, Hamburg, Germany.
    Sigvant, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Szeberin, Zoltan
    Semmelweis Univ, Dept Vasc Surg, Budapest, Hungary.
    Beiles, Barry
    Australian & New Zealand Soc Vasc Surg, Melbourne, Vic, Australia.
    Eldrup, Nikolaj
    Aarhus Univ Hosp, Dept Cardiothorac & Vasc Surg, Aarhus, Denmark.
    Thomson, Ian A.
    Dunedin Publ Hosp, Dunedin Sch Med, Dept Vasc Surg, Dunedin, New Zealand.
    Venermo, Maarit
    Univ Helsinki, Dept Vasc Surg, Cent Hosp, Helsinki, Finland.
    Altreuther, Martin
    St Olays Hosp, Dept Vasc Surg, Trondheim, Norway.
    Menyhei, Gabor
    Pecs Univ, Dept Vasc Surg, Med Ctr, Pecs, Hungary.
    Nordanstig, Joakim
    Gothenburg Univ, Sahlgrenska Acad, Dept Vasc Surg, Gothenburg, Sweden;Gothenburg Univ, Sahlgrenska Acad, Inst Med, Gothenburg, Sweden.
    Clarke, Mike
    Newcastle Upon Tyne Hosp NHS Fdn Trust, Northern Vasc Ctr, Newcastle Upon Tyne, Tyne & Wear, England.
    Riess, Henrik Christian
    Univ Med Ctr Hamburg Eppendorf, Univ Heart Ctr Hamburg, Dept Vasc Med, Hamburg, Germany.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Debus, Eike Sebastian
    Univ Med Ctr Hamburg Eppendorf, Univ Heart Ctr Hamburg, Dept Vasc Med, Hamburg, Germany.
    International Variations in Amputation Practice: A VASCUNET Report2018In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 56, no 3, p. 391-399Article in journal (Refereed)
    Abstract [en]

    Objectives: To study international differences in incidence and practice patterns as well as time trends in lower limb amputations related to peripheral arterial disease and/or diabetes mellitus. Methods: Data on lower limb amputations during 2010-2014 were collected from population based administrative data from countries in Europe and Australasia participating in the VASCUNET collaboration. Amputation rates, time trends, in hospital or 30 day mortality and reimbursement systems were analysed. Results: Data from 12 countries covering 259 million inhabitants in 2014 were included. Individuals aged >= 65 years ranged from 12.9% (Slovakia) to 20.7% (Germany) and diabetes prevalence among amputees from 25.7% (Finland) to 74.3% (Slovakia). The mean incidence of major amputation varied between 7.2/100,000 (New Zealand) and 41.4/100,000 (Hungary), with an overall declining time trend with the exception of Slovakia, while minor amputations increased over time. The older age group (>= 65 years) was up to 4.9 times more likely to be amputated compared with those younger than 65 years. Reported mortality rates were lowest in Finland (6.3%) and highest in Hungary (20.3%). Countries with a fee for service reimbursement system had a lower incidence of major amputation compared with countries with a population based reimbursement system (14.3/100,000 versus 18.4/100,000, respectively, p < .001). Conclusions: This international audit showed large geographical differences in major amputation rates, by a factor of almost six, and an overall declining time trend during the 4 year observation of this study. Diabetes prevalence, age distribution, and mortality rates were also found to vary between countries. Despite limitations attributable to registry data, these findings are important, and warrant further research on how to improve limb salvage in different demographic settings.

  • 15.
    Berglund, Jan
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery.
    Björck, M
    Elfström, Johan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery.
    Long-term results of above knee femoro-popliteal bypass depend on indication for surgery and graft-material2005In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 29, no 4, p. 412-418Article in journal (Refereed)
    Abstract [en]

    Objective. To determine the long-term results of above-knee femoro-popliteal bypass with autologous saphenous vein (SV) or expanded polytetrafluoroethylene (ePTFE) in routine surgical practice. Methods. Data from the Swedish vascular registry, Swedvasc was reviewed retrospectively. Patients with bypass surgery in 1996 and 1997 were assessed 5-7 years later. Data were gathered from the case-records and from clinical follow-up. The composite endpoint of graft failure included death within 30 days, occlusion, major amputation, extension of the graft to below-knee position and removal of an infected graft. Kaplan-Meier curves and Cox' proportional hazard ratios were calculated. Results. Four hundred and ninety-nine patients undergoing bypass for critical limb ischemia (CLI) (56%) or claudication (44%), SV (28%) or ePTFE (72%), were included. There were no significant differences in patient characteristics between patients with SV or ePTFE. CLI and ePTFE were risk factors for graft failure. For patients with both claudication and CLI SV grafts yielded better long-term results than ePTFE grafts (p<0.03) and (p<0.003), respectively. Symptom aggravation after graft occlusion was almost exclusively restricted to ePTFE grafts. Conclusions. Femoro-popliteal bypass above-knee with SV gives good long-term results, especially for claudication. ePTFE grafts cannot be recommended in claudicants, since occlusion occurs often and frequently leads to CLI. © 2005 Elsevier Ltd. All rights reserved.

  • 16.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Pharmacological interventions to attenuate the expansion of abdominal aortic aneurysm (AAA): a systematic review2011In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 41, no 5, p. 663-667Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION:

    Is it possible by pharmacological methods to attenuate the expansion rate of abdominal aortic aneurysms?

    METHOD:

    An Internet-based systematic literature search was performed to identify published reports on pharmacological methods to influence aneurysmal expansion rate.

    RESULTS:

    Of an original 450 articles, 21 remained to review: they included 15 cohort studies with 12,321 patients and seven randomised clinical trials (RCTs) with 1069 patients. Most studies are performed without a pre-study sample size calculation. There is no consistent pattern of pharmacological influence on expansion rate, but statins, non-steroidal anti-inflammatory drugs (NSAIDs) and macrolides should be further evaluated.

    CONCLUSION:

    Properly designed RCTs are needed before conclusions can be drawn on the possibility to pharmacologically attenuate aneurysmal expansion and prevent rupture.

  • 17.
    Bergqvist, David
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    The annual meeting of the European Society for Vascular Surgery: the scientific contents over the years2008In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 36, no 1, p. 114-7Article in journal (Refereed)
    Abstract [en]

    AIM AND METHOD: to analyze the presentations given at the annual meeting of European Society for Vascular Surgery: topic, geographical distribution, later publication. Three six-year periods from 1989 have been evaluated. RESULTS: case series dominates but randomized trials have increased somewhat. Papers on animal experiments and basic science have decreased. The most frequently reported diseases have been aortic aneurysm, carotid artery problems, lower extremity ischaemia and with an increasing number of papers on venous disease. Around two thirds of the presentations have been later published as full papers in European Journal of Vascular and Endovascular Surgery, but as many as one quarter has not been published. Geographical origin has varied over time with a decrease in the UK dominance. CONCLUSION: The presentations at the Annual meeting of European Society for Vascular Surgery contribute substantially to the contents of the Society Journal but a large proportion of the presentations never appear in print. Northern Europe dominates when papers per population unit is counted.

  • 18.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Update on in hospital venous thromboembolism prophylaxis2007In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 33, no 3, p. 343-350Article in journal (Refereed)
    Abstract [en]

    The surgical and hereditary risk factors for post-operative venous thromboembolism (VTE) are discussed and the heightened risk associated with particular risk factors quantified. Mechanical and pharmacological methods of prophylaxis are described, together with the different recommendations for use with general and regional anaesthesia. Prophylaxis may be started post-operatively and the duration of prophylaxis is discussed. The use of prophylaxis in vascular surgery is illustrated with case examples.

  • 19.
    Bergqvist, David
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Vascular injuries caused by acupuncture2008In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 36, no 2, p. 160-3Article in journal (Refereed)
    Abstract [en]

    AIM: To systematically review the literature on vascular injuries caused by acupuncture. METHOD: Systematic literature search in Medline and PubMed. RESULTS: Twentyone cases were identified and the majority developed symptoms in direct connection with the acupuncture treatment. Three patients died, two from pericardial tamponade and one from an aortoduodenal fistula. There were five more tamponades, seven pseudoaneurysms, two with ischaemia, two with venous thrombosis, one with compartment syndrome and one with bleeding. The two patients with ischaemia had remaining sequeleae. Information on follow-up was suboptimal with no information in nine patients. CONCLUSION: Vascular injuries are rare, bleeding and pseudoaneurysm dominating. Follow-up is insufficient in the hitherto published papers.

  • 20.
    Bergqvist, David
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Secondary arterioenteric fistulation: a systematic literature analysis2009In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 37, no 1, p. 31-42Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVE: To analyze the problem of secondary arterioenteric fistulation, a rare but serious complication. METHODS: A systematic literature review was performed searching for case reports as well as patients included in articles analyzing especially infectious complications. RESULTS: 332 individual cases and 1135 patients from papers on complications were identified. All types of surgery involving aorta and its branches could precede the complication, endovascular procedures included. The development of a fistula can occur at any time after primary surgery, the longest delay being 26 years. Bleeding was the dominating symptom with herald bleeding in more than half of the patients, infectious problems present in around one quarter. Diagnostic delay was typical, although decreasing over time. The mortality was high, lowest after axillobifemoral revascularization and aortic graft removal. The information in the articles is often heterogeneous and incomplete, and follow-up time is often too short. Mortality after fistulation seems to have decreased over time. CONCLUSION: Secondary arterioenteric fistula continues to be an extremely serious complication after surgery on aorta and its branches. Every effort must be made to arrive at a rapid diagnosis. The best therapeutic option seems to be axillobifemoral revascularization and subsequent graft removal, which however, requires haemodynamically stable patients. Endovascular repair may serve as a bridge to open surgery.

  • 21.
    Bergqvist, David
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Säwe, Juliette
    Troëng, Thomas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Randomized trials or population-based registries2007In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 34, no 3, p. 253-256Article in journal (Refereed)
  • 22.
    Bergqvist, David
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Abdominal aortic aneurysm--to screen or not to screen2008In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 35, no 1, p. 13-18Article in journal (Refereed)
    Abstract [en]

    With the ten WHO criteria for a screening program to be started, screening for abdominal aortic aneurysm is analyzed. Most of the criteria are fulfilled concerning the 65-year old male population, whereas concerning females we need more knowledge. Still the aneurysmal diameter is the most important factor to select patients for treatment meaning that many aneurysms are treated where rupture should never have occurred. Research projects giving more information on pathophysiological processes behind expansion and rupture should have priority.

  • 23.
    Bergqvist, David
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Björkman, H.
    Bolin, T.
    Dalman, P.
    Elfström, J.
    Forsberg, O.
    Johansen, L.
    Karacagil, Sadettin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Karlqvist, P-Å.
    Länne, T.
    Plate, G.
    Ribbe, E.
    Spangen, L.
    Stenbaek, J.
    Thomsen, M.
    Wiklund, B.
    Ängquist, K-A.
    Secondary aortoenteric fistula: changes from 1973 to 19931996In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 11, no 4, p. 425-428Article in journal (Refereed)
    Abstract [en]

    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.

  • 24.
    Bergqvist, David
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Boström, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Karacagil, Sadettin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Ljungman, C.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Nyman, Rickard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
    Pärsson, H.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    A new collateral pathway in a patient with renal artery occlusion2001In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 21, no 2, p. 187-188Article in journal (Refereed)
  • 25.
    Bergqvist, David
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Clement, D.
    Adjudication of end points in studies on substances influencing haemostasis: an example from vascular surgery2008In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 36, no 6, p. 703-4Article in journal (Refereed)
  • 26.
    Bernhoff, Karin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Larsson, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Jangland, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Patient Experiences of Life Years After Severe Civilian Lower Extremity Trauma With Vascular Injury2016In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 52, no 5, p. 690-695Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Severe lower limb trauma with arterial injury is often devastating for the individual. Many studies describe how to manage these injuries when they occur. Short-term functional outcome is quite well described, but the patients are often young, and their suffering is physical, mental, and social from a lifelong perspective. The aim of this study was to report patient experiences of their lives several years after their accidents, and to explore mechanisms of how to improve management.

    METHOD: The Swedvasc registry was searched for participants from 1987 to 2011, living in the region of Uppsala, Sweden. Some amputated participants were added from the Walking Rehabilitation Center. There were five reconstructed patients with an intact limb, and three with amputations. In depth interviews were conducted and systematically analyzed, using A Giorgi's descriptive phenomenological method.

    RESULTS: Eight patients participated, five with reconstructed and three with amputated limbs. Life affecting functional impairments were described by all patients. The patients undergoing amputation had received more structured follow up and support through the Walking Rehabilitation Center. The satisfaction with the cosmetic result was poorer than expected. All patients had developed strategies of how to cope with their impairments and stated they now lived "normal lives."

    CONCLUSIONS: Despite substantial physical, psychological, and cosmetic impairments years after severe lower limb trauma, the participants described life as "normal" and mainly satisfactory. Transition to the new situation could have been facilitated by more frequent and continuous follow up after discharge from hospital, in particular among the non-amputated patients who tend to be lost to follow up. Findings also indicate that family members have to be acknowledged, strengthened, and supported.

  • 27.
    Björck, M
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Invited Commentary re: "are adverse events after carotid endarterectomy reported comparably in different registries?" by Taha AG, Vikatmaa P, Albäck A, Aho PS, Railo M and Lepäntalo M.2008In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 35, no 3, p. 286-287Article in journal (Refereed)
  • 28. Björck, M.
    et al.
    Bergqvist, D.
    Eliasson, K.
    Jansson, I.
    Karlström, L.
    Kragsterman, B.
    Lundell, A.
    Malmstedt, J.
    Nordanstig, J.
    Norgren, Lars
    Örebro University, School of Health and Medical Sciences.
    Troëng, T.
    Twenty years with the Swedvasc Registry2008In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 35, no 2, p. 129-130Article in journal (Refereed)
  • 29.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Can we learn anything from the dinosaurs?2019In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 57, no 3, p. 399-399Article in journal (Other academic)
  • 30.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Commentary on 'A Decision Aid Regarding Treatment Options for Patients with an Asymptomatic Abdominal Aortic Aneurysm: A Randomised Clinical Trial'2014In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 48, no 3, p. 284-284Article in journal (Other academic)
  • 31.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Commentary on 'Is Hypovitaminosis D Associated with Abdominal Aortic Aneurysm, and is there a Dose Response Relationship?'2013In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 45, no 6, p. 665-665Article in journal (Other academic)
  • 32.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Comments Regarding "Results from Craniocaudal Carotid Body Tumor Resection; Should It be the Standard Surgical Approach?"2013In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 46, no 6, p. 630-630Article in journal (Other academic)
  • 33.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Endotension After Bypass for Popliteal Aneurysm2015In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 49, no 4, p. 411-411Article in journal (Other academic)
  • 34.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    More Light on Isolated Mesenteric Artery Dissection from the Countries of the Rising Sun2019In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 58, no 3, p. 400-400Article in journal (Other academic)
  • 35.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Part One: For the Motion. An Endovascular First Strategy is the Optimal Approach for Treating Acute Mesenteric Ischemia.2015In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 50, no 3, p. 273-280Article in journal (Refereed)
  • 36.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Studying Colonic Ischaemia after Aortic Surgery Using Claims Data - An Intelligent Study Design and Low Hanging Fruit2018In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 56, no 4, p. 514-514Article in journal (Other academic)
  • 37.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    The Fall of a Giant Professor: Nicolai Leontyevich Volodos May 15, 1934-April 3, 2016 OBITUARY2016In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 52, no 1, p. 3-4Article in journal (Refereed)
  • 38.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    The RESCAN Study Creates More Questions than Answers2013In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 46, no 2, p. 173-Article in journal (Refereed)
  • 39.
    Björck, Martin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Beiles, B
    Menyhei, G
    Thomson, I
    Wigger, P
    Venermo, M
    Laxdal, E
    Danielsson, G
    Lees, T
    Troëng, Thomas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Editor's Choice: Contemporary Treatment of Popliteal Artery Aneurysm in Eight Countries: A Report from the Vascunet Collaboration of Registries2014In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 47, no 2, p. 164-171Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    To study contemporary popliteal artery aneurysm (PA) repair.

    METHODS:

    Vascunet is a collaboration of population-based registries in 10 countries: eight had data on PA repair (Australia, Finland, Hungary, Iceland, New Zealand, Norway, Sweden, and Switzerland).

    RESULTS:

    From January 2009 until June 2012, 1,471 PA repairs were registered. There were 9.59 operations per million person years, varying from 3.4 in Hungary to 17.6 in Sweden. Median age was 70 years, ranging from 66 years in Switzerland and Iceland to 74 years in Australia and New Zealand; 95.6% were men and 44% were active smokers.

    Elective surgery dominated, comprising 72% of all cases, but only 26.2% in Hungary and 39.7% in Finland, (p < .0001). The proportion of endovascular PA repair was 22.2%, varying from 34.7% in Australia, to zero in Switzerland, Finland, and Iceland (p < .0001). Endovascular repair was performed in 12.2% of patients with acute thrombosis and 24.1% of elective cases (p < .0001). A vein graft was used in 87.2% of open repairs, a synthetic or composite graft in 12.7%.

    Follow-up was until discharge or 30 days. Amputation rate was 2.0% overall: 6.5% after acute thrombosis, 1.0% after endovascular, 1.8% after open repair, and 26.3% after hybrid repair (p < .0001). Mortality was 0.7% overall: 0.1% after elective repair, 1.6% after acute thrombosis, and 11.1% after rupture.

    CONCLUSIONS:

    Great variability between countries in incidence of operations, indications for surgery, and choice of surgical technique was found, possibly a result of surgical tradition rather than differences in case mix. Comparative studies with longer follow-up data are warranted.

  • 40.
    Björck, Martin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Bown, M J
    Choke, E
    Earnshaw, J
    Flørenes, T
    Glover, M
    Kay, M
    Laukontaus, S
    Lees, T
    Lindholt, J
    Powell, J T
    van Rij, A
    Svensjö, Sverker
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    International update on screening for abdominal aortic aneurysms: issues and opportunities.2015In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 49, no 2Article in journal (Refereed)
  • 41.
    Björck, Martin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Boyle, Jonathan R.
    Cambridge Univ Hosp NHS Trust, Dept Vasc Surg, Cambridge, England.
    Colonic Ischaemia - A Devastating Complication of Abdominal Aortic Aneurysm Repair2018In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 56, no 1, p. 3-4Article in journal (Other academic)
  • 42.
    Björck, Martin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Djavani-Gidlund, Khatereh
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Response to comment on "Intraabdominal hypertension and abdominal compartment syndrome after endovascular repair of ruptured abdominal aortic aneurysm"2012In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 43, no 1, p. 132-132Article in journal (Refereed)
  • 43.
    Björck, Martin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Gibbons, C. P.
    Jensen, L. P.
    Laustsen, J.
    Lees, T.
    Moreno-Carriles, R.
    Troeng, Thomas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Wigger, P.
    Vascular registries join to create a common international dataset on AAA surgery2007In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 34, no 3, p. 257-259Article in journal (Refereed)
  • 44.
    Björck, Martin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Kolh, P
    Cardiovascular Surgery Department, University Hospital (CHU, ULg) of Liège, Belgium.
    Into the Lead: How EJVES Became the Leading Journal in Vascular Surgery2017In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 54, no 3, p. 273-274, article id S1078-5884(17)30463-XArticle in journal (Other academic)
  • 45.
    Björck, Martin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Lepkowska Eriksson, M.
    Bylock, A.
    Steuer, Johnny
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Carlsson, B. C. L.
    Bock, D.
    Kragsterman, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Plasminogen Activator Inhibitor-1 Levels and Activity Decrease After Intervention in Patients with Critical Limb Ischaemia2013In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 46, no 2, p. 214-222Article in journal (Refereed)
    Abstract [en]

    Patients with peripheral arterial occlusive disease (PAOD), in particular critical limb ischaemia (CLI), carry a high risk of thrombotic events. We hypothesised that patients undergoing conservative, endovascular, or open surgical treatment for CLI have increased levels of plasminogen activator inhibitor-1 (PAI-1), leading to a prothrombotic state. The objective was to determine levels of PAI-1 in patients with acute or chronic PAOD/CLI. Thirty-two patients with a median age of 74 (49–90) years were included. Three underwent thrombolysis for acute limb-threatening ischaemia. Twenty-six patients with chronic ischaemia received endovascular (n = 20) or open (n = 6) surgical treatment. Three were treated conservatively. Biomarkers and ankle brachial index (ABI) were measured before and up to 1 month after intervention. Patency was studied with repeated duplex ultrasound. Ankle pressure and ABI improved after intervention (p < .001). C-reactive protein (CRP) increased from a median of 7.90 mg/L at baseline to 31.5 on day 1 (p < .001), 28.0 on day 6 (p < .001), and returned to baseline levels on day 30. PAI-1 antigen and activity decreased from day 6 and onwards post-intervention compared with baseline (p < .05). A great individual variability in PAI-1 antigen and activity was observed. Although most actively treated patients had normal PAI-1 activity, 11/29 (38%) were above that level of normality at baseline, 10/24 (42%) on day 1, 3/23 (13%) on day 6, and 5/27 (19%) on day 30 after intervention. Endovascular and open surgical treatment resulted in improved ankle pressure and ABI. The intervention was followed by a transient increase in CRP and a sustained reduction in PAI-1 levels and activity.

  • 46.
    Björck, Martin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Mani, Kevin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Publication of Vascular Surgical Registry Data: Strengths and Limitations2017In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 54, no 6, p. 788-788Article in journal (Other academic)
  • 47.
    Björck, Martin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Management of Abdominal Compartment Syndrome and the Open Abdomen2014In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 47, no 3, p. 279-287Article, review/survey (Refereed)
    Abstract [en]

    Objectives: The management of the abdominal compartment syndrome (ACS) and the open abdomen (OA) are important to improve survival after major vascular surgery, in particular ruptured abdominal aortic aneurysm (RAAA). The aim is to summarize contemporary knowledge in this field. Methods: The consensus definitions of the World Society of the Abdominal Compartment Syndrome (WSACS) that were published in 2006 and the clinical practice guidelines published in 2007 were updated in 2013. Structured clinical questions were formulated (modified Delphi method), and the evidence base to answer those questions was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guidelines. Results: Most of the previous definitions were kept untouched, or were slightly modified. Four new definitions were added, including a definition of OA and of lateralization of the abdominal wall, an important clinical problem to approach during prolonged OA treatment. A classification system of the OA was added. Seven recommendations were formulated, in summary: Trans-bladder intra-abdominal pressure (IAP) should be monitored in patients at risk. Protocolized monitoring and management are recommended, and decompression laparotomy if ACS. When OA, protocolized efforts to obtain an early abdominal fascial closure, and strategies utilizing negative pressure wound therapy should be used, versus not. In most cases the evidence was graded as weak or very weak. In six of the structured clinical questions, no recommendation could be made. Conclusion: This review summarizes changes in definitions and management guidelines of relevance to vascular surgery, and data on the incidence of ACS after open and endovascular aortic surgery. (C) 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  • 48. Block, T
    et al.
    Isaksson, H S
    Acosta, S
    Björck, M
    Brodin, D
    Nilsson, Torbjörn K
    Department of Laboratory Medicine, Örebro University Hospital.
    Altered mRNA expression due to acute mesenteric ischaemia in a porcine model2011In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 41, no 2, p. 281-287Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Messenger RNA (mRNA) changes in the small intestine in response to acute mesenteric ischaemia (AMI) could offer novel diagnostic possibilities, but have not been described. The aim was to characterize the mRNA response to experimental AMI.

    MATERIALS AND METHODS: Twelve pigs underwent catheterisation of the superior mesenteric artery with injection of polivinylalcohol embolisation particles or sodium chloride. Laparotomy and intestinal tissue sampling were performed. Microarray analysis was performed using the GeneChip(®) whole porcine genome array.

    RESULTS: Seven down-regulated cellular pathways were associated with protein, lipid and carbohydrate metabolism. Seventeen up-regulated pathways were associated with inflammatory and immunological activity, regulation of extracellular matrix and decreased cellular proliferation. Thrombospondin (THS), monocyte chemoattractant protein 1(MCP-1) and gap junction alpha 1(GJA-1) were consistently up-regulated in all embolised pigs. Genes encoding earlier proposed biomarkers for AMI were up-regulated, such as lactate dehydrogenase and creatine kinase, or down-regulated, such as intestinal fatty acid binding protein and glutathione S-transferase.

    CONCLUSION: This study describes the intestinal tissue response on a gene expression level to AMI. THS, MCP-1 and GJA-1 were consistently up-regulated by ischaemia, whereas earlier proposed biomarkers for AMI were not. Gene expression may not be directly linked to the use of the corresponding proteins as potential clinical biomarkers.

  • 49.
    Block, Tomas
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Isaksson, H.
    Sektionen för klinisk kemi, Örebro Universitetssjukhus.
    Acosta, S.
    Kärlcentrum, Malmö Universitetssjukhus.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Brodin, D.
    Sektionen för Biovetenskaper, Karolinska Institutet.
    Nilsson, T.
    Sektionen för klinisk kemi, Örebro Universitetssjukhus.
    Altered mRNA-expression due to acute mesenteric ischaemia in a porcine model2011In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 41, no 2, p. 281-287Article in journal (Refereed)
    Abstract [en]

    Introduction: mRNA changes in the small intestine in response to acute mesenteric ischaemia (AMI) could offer novel diagnostic possibilities, but have not been described. The aim was to characterize the mRNA response to experimental AMI.

    Materials and methods: Twelve pigs underwent catheterization of the superior mesenteric artery with injection of polivinylalcohol embolization particles or sodium chloride. Laparotomy and intestinal tissue sampling was performed. Microarray analysis was performed using the GeneChip® whole porcine genome array.

    Results: Seven down-regulated cellular pathways were associated with protein, lipid and carbohydrate metabolism. Seventeen up-regulated pathways were associated with inflammatory and immunological activity, regulation of extracellular matrix and decreased cellular proliferation. Thrombospondin(THS), Monocyte Chemoattractant Protein 1(MCP-1) and Gap Junction Alpha 1(GJA-1) were consistently up-regulated in all embolized pigs. Genes encoding earlier proposed biomarkers for AMI were up-regulated, such as lactate dehydrogenase and creatine kinase, or down-regulated, such as intestinal fatty acid binding protein and glutathione S-transferase.

    Conclusion: This study describes the intestinal tissue response on a gene expression level to AMI. THS, MCP-1 and GJA-1 were consistently up-regulated by ischemia, whereas earlier proposed biomarkers for AMI were not. Gene expression may not be directly linked to the use of the corresponding proteins as potential clinical biomarkers.

  • 50. Block, Tomas
    et al.
    Isaksson, Helena S.
    Örebro University, School of Health and Medical Sciences.
    Acosta, Stefan
    Björck, Martin
    Brodin, David
    Nilsson, Torbjörn K.
    Örebro University, School of Health and Medical Sciences.
    Altered mRNA Expression due to Acute Mesenteric Ischaemia in a Porcine Model2011In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 41, no 2, p. 281-287Article in journal (Refereed)
    Abstract [en]

    Introduction: Messenger RNA (mRNA) changes in the small intestine in response to acute mesenteric ischaemia (AMI) could offer novel diagnostic possibilities, but have not been described. The aim was to characterize the mRNA response to experimental AMI. Materials and methods: Twelve pigs underwent catheterisation of the superior mesenteric artery with injection of polivinylalcohol embolisation particles or sodium chloride. Laparotomy and intestinal tissue sampling were performed. Microarray analysis was performed using the GeneChip (R) whole porcine genome array. Results: Seven down-regulated cellular pathways were associated with protein, lipid and carbohydrate metabolism. Seventeen up-regulated pathways were associated with inflammatory and immunological activity, regulation of extracellular matrix and decreased cellular proliferation. Thrombospondin (THS), monocyte chemoattractant protein 1(MCP-1) and gap junction alpha 1(GJA-1) were consistently up-regulated in all embolised pigs. Genes encoding earlier proposed biomarkers for AMI were up-regulated, such as lactate dehydrogenase and creatine kinase, or down-regulated, such as intestinal fatty acid binding protein and glutathione S-transferase. Conclusion: This study describes the intestinal tissue response on a gene expression level to AMI. THS, MCP-1 and GJA-1 were consistently up-regulated by ischaemia, whereas earlier proposed biomarkers for AMI were not. Gene expression may not be directly linked to the use of the corresponding proteins as potential clinical biomarkers. (C) 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

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