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  • 1.
    Aboyans, Victor
    et al.
    Dupuytren University Hospital.
    Criqui, Michael
    University of California, USA.
    Abraham, Pierre
    University Hospital of Angers, France.
    Allison, Matthew
    University of California, USA.
    Creager, Mark
    Brigham and Women’s Hospital, USA.
    Diehm, Curt
    Karlsbad Clinic/University of Heidelberg, Germany.
    Fowkes, Gerry
    University of Edinburgh, UK.
    Hiatt, William
    University of Colorado, USA.
    Jönsson, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Thoraxkirurgi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Lacroix, Philippe
    Limoges University, France.
    Marin, Benoit
    Limoges Teaching Hospital, France.
    McDermott, Mary
    Northwestern University,USA.
    Norgren, Lars
    University Hospital, Örebro, Sweden.
    Pande, Reena
    Brigham and Women’s Hospital, USA.
    Preux, Pierre-Marie
    University of Limoges, France.
    Stoffers, H.E.
    Maastricht University, Netherlands.
    Treat-Jacobsson, Diane
    University of Minnesota, USA.
    Measurement and interpretation of the ankle-brachial index: a scientific statement from the Ammerican Heart Association2012Ingår i: Circulation, ISSN 0009-7322, E-ISSN 1524-4539Artikel i tidskrift (Refereegranskat)
  • 2.
    Borch, Kurt
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Kirurgi. Östergötlands Läns Landsting, MKC-2, GE: Gastrokir.
    Jönsson, Björn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Tarpila, Erkki
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Hand och plastikkirurgi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Hand- och plastikkirurgiska kliniken US.
    Franzén, Thomas
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Kirurgi. Östergötlands Läns Landsting, MKC-2, GE: Gastrokir.
    Berglund, J
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Kullman, Eric
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Kirurgi. Östergötlands Läns Landsting, MKC-2, GE: Gastrokir.
    Franzén, L
    Changing pattern of histological type, location, stage and outcome of surgical treatment of gastric carcinoma2000Ingår i: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 87, nr 5, s. 618-626Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There are indications that some features of gastric carcinoma are changing, with a possible impact on prognosis. The aim of this study was to examine any changes in type, location, stage, resection rate, postoperative mortality rate or prognosis for patients with gastric carcinoma in a well defined population. Methods: During 1974-1991, 1161 new cases of gastric adenocarcinoma were diagnosed in Ostergotland County, Sweden. Tumour location, Lauren histological type, tumour node metastasis (TNM) stage, radicality of tumour resection and postoperative complications were recorded after histological re-evaluation of tissue specimens and examination of all patient records. Dates of death were obtained from the Swedish Central Bureau of Statistics. Time trends were studied by comparing the intervals 1974-1982 (period 1) and 1983-1991 (period 2). Results: The proportion of diffuse type of adenocarcinoma increased (from 27 to 35 per cent), while that of mixed type decreased (from 16 to 9 per cent) and that of intestinal type was unchanged. The proportion of tumours located in the proximal two-thirds of the stomach increased (from 32 to 42 per cent) and the proportion of patients with tumours in TNM stage IV decreased (from 32 to 25 per cent). Overall tumour resection rates were unchanged, although the proportion of radical total gastrectomies increased (from 36 to 50 per cent). Excluding tumours of the cardia or gastric remnant after previous ulcer surgery, the 5-year relative survival rate after radical resection increased from 25 to 36 per cent and the postoperative mortality rate decreased for both radical (from 11 to 4 per cent) and palliative (from 18 to 6 per cent) resection. Conclusion: The patterns of tumour histology, location and stage of gastric carcinoma have changed in the authors' region. These changes were paralleled by a significant improvement in survival and postoperative mortality rates.

  • 3.
    Jönsson, Björn
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Linköpings universitet, Hälsouniversitetet.
    On leg ischaemia: aspects of epidemiology and diagnostics2005Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The first part of this thesis consists of a population-based epidemiological study on symptomatic leg arterial disease in a Swedish community, based on a postal questionnaire and systolic ankle pressure measurements, with calculation of the ankle-brachial pressure index (ABPI; usually ≥ 1.0 in healthy subjects). The second part investigates alternative methods for ankle systolic pressure measurements, with the potential of automation.

    (Papers I-III) A postal questionnaire on leg symptoms and concomitant diseases was distributed to all the inhabitants of Vadstena 50-89 years old (n=7,524). The response rate was 92% and of those reporting any leg pain, 80% (353/441) attended an examination with ABPI determination. Symptomatic leg ischaemia (SLI) was defined as leg pain on walking + ABPI ≤ 0.8. The prevalence was 4.1 %, increasing with age, with no major difference between men and women. Other manifestations of arteriosclerotic disease (previous angina pectoris, myocardial infarction or cerebrovascular incident), hypertension and diabetes mellitus were more prevalent among SLI cases than in healthy subjects. At a four-year follow-up, the age and sex adjusted mortality ratio was almost doubled in SLI subjects. Their relative risk of a myocardial infarction, cardiac death and death due to any cardiovascular event was 2.7, 2.0 and 1.9, respectively, compared to an age and sex matched control group. In SLI subjects without a previous history of ischaemic heart disease, the relative risk of a myocardial infarction was 3.1. Cardiovascular disease alone was mainly responsible for the increased risk of death. At a ten-year follow-up, a baseline ABPI up to 0.8 was inversely correlated with mortality. In a Cox regression model, a low ABPI was significantly and independently associated with an increased risk of death. An ABPI of 0.81-0.99 was not associated with an increased mortality risk. Over ten years, 1/7 of the SLI cases had a leg vascular reconstructive procedure, the majority within the first two years, and 1/14 underwent a major amputation. In conclusion, in spite of the good prognosis of the local disease, SLI can be looked upon as a marker for generalised arteriosclerotic disease and as a risk predictor for severe arteriosclerotic events and premature death.

    (Papers IV-VI) Oscillometric technique, commonly used for automatic arm blood pressure measurements, was validated against the CW Doppler in systolic ankle pressure determination in healthy subjects and in patients with leg arterial disease. While performing adequately in healthy subjects, it was found to be invalid in leg arterial disease. The oscillometric technique was deemed as not suitable for use as an automatic ankle pressure recorder in the diagnosis ofleg arteriosclerotic disease.

    A new technique, based on a two-channel photoplethysmographic (PPG) probe (880nm) placed underneath the pneumatic cuff, together with electronics, was developed and compared with both CW Doppler and intra-arterial recordings in subjects without vascular disease, and with the CW Doppler in leg arterial disease. On visual analysis of the PPG curves, the agreement was good. An automatic algorithm for analysis of PPG-data gave comparable results. The PPG method is a promising technique for future automation of systolic ankle pressure measurements, and for inclusion in a complete ABPI recorder.

  • 4.
    Jönsson, Björn
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Ebrelius, P
    Measure ankle pressure in suspected arterial disease of the lower extremity!2007Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 104, s. 3776-3779Artikel i tidskrift (Övrigt vetenskapligt)
  • 5.
    Jönsson, Björn
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Ebrelius, Peter
    Läkarstuderande termin 11 Hälsouniversitet.
    Mät ankeltrycket vid misstänkt benartärsjukdom. Ankeltrycksmätning underutnyttjad metod i primärvården, visar enkätstudie2007Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 104, nr 49-50, s. 3776-3779Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

    Symtomgivande

    benartärsjukdom (BAS) innebär, förutom ofta handikappande symtom och i vissa fall risk för förlorad extremitet, en till följd av den generella aterosklerossjukdomen signifikant ökad risk för allvarliga ateroskleroshändelser som hjärtinfarkt och slaganfall samt förtida död.

    Symtomgivande

    benartärsjukdom är vanlig i primärvården. Då sekundärpreventiva insatser är betydelsefulla för denna patientgrupp, är det angeläget att tillståndet identifieras.

    Ett sänkt ankel–brakialindex

    (ABI) har hög sensitivitet och specificitet för benartärsjukdom, och ankeltrycksmätning och beräkning av ABI bör utföras i alla fall där symtom som kan ge misstanke om BAS föreligger.

    Ankeltrycksmätning är

    en underutnyttjad undersökningsmetod i primärvården. Ett av de viktigare, och åtgärdbara, skälen till detta är brist på utbildning och träning.

  • 6.
    Jönsson, Björn
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Laurent, Claes
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik.
    Eneling, Martin
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik.
    Skau, Tommy
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi.
    Lindberg, Lars-Göran
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik.
    Automatic ankle pressure measurements using PPG in ankle-brachial pressure index determination2005Ingår i: Scandinavian Cardiovascular Journal,2005, Sweden: Taylor & Francis , 2005, s. 13-Konferensbidrag (Refereegranskat)
  • 7.
    Jönsson, Björn
    et al.
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Linköpings universitet, Hälsouniversitetet.
    Laurent, Claes
    Linköpings universitet, Institutionen för medicinsk teknik. Linköpings universitet, Tekniska högskolan.
    Eneling, Martin
    Linköpings universitet, Institutionen för medicinsk teknik. Linköpings universitet, Tekniska högskolan.
    Skau, Tommy
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Linköpings universitet, Hälsouniversitetet.
    Lindberg, Lars-Göran
    Linköpings universitet, Institutionen för medicinsk teknik. Linköpings universitet, Tekniska högskolan.
    Automatic ankle pressure measurements using PPG in ankle-brachial pressure index determination2005Ingår i: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 30, nr 4, s. 395-401Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    To evaluate a new technique using a photoplethysmographic (PPG) probe for automatic ankle pressure measurements.

    Design

    Comparative study on two techniques for ankle pressure measurement.

    Setting

    University hospital.

    Material

    Thirty-five patients with leg arterial disease and eight healthy volunteers. Ankle-brachial indices (ABPI) were measured using conventional CW Doppler technique and PPG-based prototype equipment for the ankle pressure recordings.

    Chief outcome measures

    ABPIs calculated from CW Doppler and PPG ankle pressure measurements. The PPG signals were analysed both by visual judgement and by a software based, automatic algorithm.

    Main results

    The mean difference between ABPIs calculated from CW Doppler recordings and PPG (visual analysis) was −0.01 (limits of agreement (±two standard deviations) +0.16 to −0.19). The correlation coefficient was 0.93. When the algorithm was used, the mean difference (CW Doppler−PPG) was 0.05 (limits of agreement 0.28 to −0.18, r=0.89).

    Conclusions

    The PPG method is a promising technique with an inherent potential for automatisation of the ankle pressure measurements, thereby reducing the observer-dependency in ABPI recordings.

  • 8.
    Jönsson, Björn
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Laurent, Claes
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik.
    Eneling, Martin
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik.
    Skau, Tommy
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi.
    Lindberg, Lars-Göran
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik.
    Automatisk ankeltryckmätning med PPG för bestämning av ankel-armindex (ABP)2005Ingår i: Svensk Kirurgi,2005, 2005, s. 23-Konferensbidrag (Refereegranskat)
  • 9.
    Jönsson, Björn
    et al.
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Linköpings universitet, Hälsouniversitetet.
    Laurent, Claes
    Linköpings universitet, Institutionen för medicinsk teknik. Linköpings universitet, Tekniska högskolan.
    Skau, Tommy
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Linköpings universitet, Hälsouniversitetet.
    Lindberg, Lars-Göran
    Linköpings universitet, Institutionen för medicinsk teknik. Linköpings universitet, Tekniska högskolan.
    A new probe for ankle systolic pressure measurement using Photoplethysmography (PPG)2005Ingår i: Annals of Biomedical Engineering, ISSN 0090-6964, E-ISSN 1573-9686, Vol. 33, nr 2, s. 232-239Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    An automated method for ankle systolic pressure measurement, less operator dependent than the standard continuous wave (CW) Doppler technique, would imply an advantage both in patient measurements and in epidemiological studies. We present a new photoplethysmographic (PPG) probe that uses near-infrared light (880 nm) to detect pulsatory blood flow underneath the distal end of a standard pneumatic cuff. The probe is adapted to the anatomical conditions at the ankle, permitting recording of pressures in both ankle arteries separately. The validity of the equipment was tested with CW Doppler-derived systolic pressures and invasive blood pressure measurements for reference. In 20 healthy subjects, visual analysis of the PPG curves revealed a mean difference between CW Doppler and PPG measurements of –0.5 mmHg (SD 6.9). Corresponding results for the anterior and posterior tibial arteries separately were –1.8 mmHg (SD 6.2) and 0.9 mmHg (SD 7.3), respectively. A correct probe position was essential for the results. In direct recordings from the dorsalis pedis artery in 10 intensive care patients, PPG underestimated systolic pressure in the anterior tibial artery by 4.5 mmHg (SD 12.1). With further development, the PPG probe, integrated in the pneumatic cuff, may simplify measurements of ankle systolic pressures.

  • 10.
    Jönsson, Björn
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Laurent, Claes
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik.
    Skau, Tommy
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård.
    Lindberg, Lars-Göran
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik.
    A new probe for ankle systolic pressure measurements using photopethysmography2004Ingår i: International Angiology,2004, 2004, s. 186-186Konferensbidrag (Övrigt vetenskapligt)
  • 11.
    Jönsson, Björn
    et al.
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Linköpings universitet, Hälsouniversitetet.
    Lindberg, Lars-Göran
    Linköpings universitet, Institutionen för medicinsk teknik. Linköpings universitet, Hälsouniversitetet.
    Skau, Tommy
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Linköpings universitet, Hälsouniversitetet.
    Thulesius, Olav
    Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Is oscillometric ankle pressure reliable in leg vascular disease?2001Ingår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 21, nr 2, s. 155-163Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The objective of the study was to evaluate the validity of oscillometric systolic ankle pressure in symptomatic leg arterial occlusive disease. Ankle pressure measurements using oscillometric curves obtained using a standard 12-cm cuff with a specially designed device for signal processing were validated against the continuous wave (CW) Doppler technique. Thirty-four subjects without signs or symptoms of peripheral vascular disease (68 legs) and 47 patients with leg ischaemia (85 legs) varying from moderate claudication to critical ischaemia were examined. The oscillometric curves were analysed using several algorithms reported in the literature, based on the assumption that maximum oscillations are recorded near mean arterial pressure. In normals, reasonable agreement between CW Doppler and oscillometric methods was seen. When an algorithm that determined the lowest cuff pressure at which maximum oscillations occurred, and a characteristic ratio for systolic pressure of 0·52 was used, the mean difference between CW Doppler and oscillometry was 1·7 mmHg [range −19 to +27, limits of agreement (2 SD) 21·1 mmHg]. In ischaemic legs, oscillometry overestimated systolic ankle pressure by a mean of 28·8 mmHg [range –126 to +65, limits of agreement 82·8 mmHg]. The difference was more pronounced among patients with critical ischaemia compared with claudicants, and also more evident among diabetics. The error of oscillometric pressure determination in subjects with leg arterial disease inversely increased with CW Doppler ankle pressure. In 39% of the recordings in legs with a CW Doppler systolic pressure below 100 mmHg, the oscillometric mean arterial pressure was higher than the recorded CW Doppler systolic pressure. In conclusion, the oscillometric method to determine systolic ankle pressure, based on the concept of maximum cuff oscillations occurring near mean arterial pressure, is not reliable in leg arterial disease, usually overestimating ankle pressure.

  • 12.
    Jönsson, Björn
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Skau, T
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Lundgren, F
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Aortoenteric fistula with aortic graft nfection - reconstruction of the abdominal aorta without a graft: a possible approach inb selected cases.1999Ingår i: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 165, s. 1201-1202Artikel i tidskrift (Refereegranskat)
  • 13.
    Jönsson, Björn
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Skau, Tommy
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    ABPI och mortalitet vid symtomgivande venischemi - en populationsbaserad studie med 10 års uppföljning. (Svensk kirurgi)2002Ingår i: Rapportklass C eller D samt Impactvärde 0,000 sätts om ISSN inte kan uppges.,2002, 2002Konferensbidrag (Refereegranskat)
  • 14.
    Jönsson, Björn
    et al.
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Linköpings universitet, Hälsouniversitetet.
    Skau, Tommy
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Linköpings universitet, Hälsouniversitetet.
    Ankle-brachial index and mortality in a cohort of questionnaire recorded leg pain on walking2002Ingår i: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 24, nr 5, s. 405-410Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: to study the association between the ankle–brachial pressure index (ABPI), premature death and the need for surgical treatment for lower limb ischaemia.

    Design: population based cohort study.

    Subjects: three hundred and fifty-three men and women, 50–89 years old, underwent a leg pain questionnaire and measurement of ABPI and was then followed for 10 years.

    Outcome Measures: all cause mortality, vascular procedures and major amputations.

    Results: a low ABPI was independently associated with premature all cause mortality in the multiple regression analysis, carrying a relative risk of 3.4 (95% confidence interval 2.0–5.9) and 2.1 (1.3–3.3) for ABPIs ≤0.50 and 0.51–0.80, respectively, compared to those with ABPI ≥1.0. Individuals with an ABPI in the interval 0.81–0.99 suffered only a slight, not statistically significant risk increase compared to normals. A low ABPI at baseline implied a continuous constant increased risk of death throughout the study period. The same risk was observed among elderly (70–89, median 77 years), and in the middle aged (50–69, median 63 years) individuals. The vast majority of those subjected to vascular intervention or major amputation during follow-up had an ABPI≤0.8 at baseline (83 and 89%, respectively). However, within that group, the individual ABPI was not predictive for surgical intervention.

    Conclusion: the association found between an ABPI ≤0.8 and premature mortality in this cohort of symptomatic subjects implies that the ABPI is a powerful, independent predictor for premature death. The prognostic information carried by an ABPI in the interval 0.81–0.99 remains uncertain. Septuagenarians and octogenarians carry the same risk increase associated with a low ABPI as those in the middle ages.

  • 15.
    Jönsson, Björn
    et al.
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Linköpings universitet, Hälsouniversitetet.
    Skau, Tommy
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Linköpings universitet, Hälsouniversitetet.
    Outcome of symptomatic leg ischaemia: four year morbidity and mortality in vadstena, Sweden1996Ingår i: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 11, nr 3, s. 315-232Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective:

    To quantify cardiovascular morbidity and mortality including the incidence of vascular surgery and amputations, among individuals with symptomatic leg ischaemia.

    Design:

    Prospective cohort study.

    Material:

    Inhabitants 50–89 years of age (n = 2784) of Vadstena community, Östergötland, Sweden, with 4 years of follow-up. 107 subjects with symptomatic leg ischaemia (SLI), selected by a postal questionnaire and ankle pressure measurements, and an age and sex matched control group of 214 individuals.

    Chief outcome measures:

    Cardiovascular morbidity and mortality, all cause mortality, surgical procedures for leg ischaemia, major amputations, ankle brachial pressure index.

    Main results:

    Age and sex adjusted all-cause mortality risk in the SLI-group was increased by 1.9. This was most prominent among men in their sixties and women in their seventies. Cardiovascular mortality was increased by 1.9 (95% confidence interval 1.1–3.3). Relative risks for acute myocardial infarction and cerebrovascular events were 2.4 (1.1–5.1) and 1.7 (0.9–3.2), respectively. The increase in age and sex adjusted incidence of primary reconstructive surgery during the first year after initial examination was 67-fold compared to the total population of Vadstena 50–89 years old, and 18-fold for the whole observation period, while the increase in risk for major amputation during the observation period was 12-fold. Median ankle brachial index improved significantly during follow-up among the individuals alive and not subjected to vascular surgery.

    Conclusions:

    Among the SLI-subjects identified in a general population, the overall risk for cardiovascular morbidity and mortality over 4 years was significantly increased compared to normals.

  • 16.
    Laurent, Claes
    et al.
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik.
    Jönsson, Björn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Vegfors, Magnus
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Östergötlands Läns Landsting, Anestesi- och operationscentrum, Anestesi- och intensivvårdskliniken VIN.
    Eneling, M
    Lindberg, Lars-Göran
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik.
    Nonivasive monitoring of systolic blood pressuire on the arm utilizing photoplethysmpgraphy (PPG)2004Ingår i: Proceedings of SPIE jfr 1998-2000 SPIE proceedings ISSN 1017-2653, ISSN 1605-7422, s. 99-107Artikel i tidskrift (Refereegranskat)
  • 17.
    Laurent, Claes
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik. Linköpings universitet, Tekniska högskolan.
    Jönsson, Björn
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken. Linköpings universitet, Hälsouniversitetet.
    Vegfors, Magnus
    Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Linköpings universitet, Hälsouniversitetet.
    Eneling, Martin
    Linköpings universitet, Institutionen för medicinsk teknik. Linköpings universitet, Tekniska högskolan.
    Lindberg, Lars-Göran
    Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik. Linköpings universitet, Tekniska högskolan.
    Noninvasive monitoring of systolic blood pressure on the arm utilizing photoplethysmography (PPG): clinical report2004Ingår i: Proc. SPIE 5318, Advanced Biomedical and Clinical Diagnostic Systems II / [ed] Gerald E. Cohn; Warren S. Grundfest; David A. Benaron; Tuan Vo-Dinh, Bellingham WA, USA: SPIE , 2004, s. 99-Konferensbidrag (Refereegranskat)
    Abstract [en]

    A soft (silicone) probe, containing six light emitting diodes (880 nm) and three photo detectors, utilizes photoplethysmography (PPG) to monitor pulsations from the brachialis artery under an occluding cuff during deflation. When the arterial pulse returns, measured by PPG, the corresponding pressure in the cuff is determined. This pressure is assumed to equal the systolic pressure. An assessment trial was performed on 21 patients (9 women and 12 men, aged 27-69) at the Neuro-Intensive care unit. Since the patients were already provided with arterial needles, invasive blood pressure could be used as the reference. By choosing a threshold, for detecting pulses, as a fraction (4%) of the maximum amplitude, the systolic blood pressure was underestimated (-0.57 mmHg, SD 12.1). The range of systolic pressure for the patients was 95.5 - 199.0 mmHg, n=14. The method is promising, but improvements still have to be made in order to improve the technique.

  • 18.
    Laurent, Claes
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik. Linköpings universitet, Tekniska högskolan.
    Jönsson, Björn
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken. Linköpings universitet, Hälsouniversitetet.
    Vegfors, Magnus
    Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Östergötlands Läns Landsting, Anestesi- och operationscentrum, Anestesi- och intensivvårdskliniken VIN. Linköpings universitet, Hälsouniversitetet.
    Lindberg, Lars-Göran
    Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik. Linköpings universitet, Tekniska högskolan.
    Non-invasive measurement of systolic blood pressure on the arm utilising photoplethysmography: development of the methodology2005Ingår i: Medical and Biological Engineering and Computing, ISSN 0140-0118, E-ISSN 1741-0444, Vol. 43, nr 1, s. 131-135Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Photoplethysmography (PPG) can be used to measure systolic blood pressure at the brachial artery. With a specially designed probe, positioned in the most distal position beneath a pressure cuff on the upper arm, this is possible. The distance between the light source (880 nm) and the photodetector was 20 mm. A test was performed on neuro-intensive care patients by determining blood pressure from the PPG curves, and, when it was compared with systolic blood pressure obtained from inserted indwelling arterial catheters, a correlation factor of r=0.95 was achieved. The difference between blood pressure obtained using PPG and invasive blood pressure measurement was 3.9±9.1 mmHg (mean±SD), n=19. The depth to the brachial artery was 13.9±4.1 mm (mean±SD), n=18. A digital PPG system utilising pulsating light was also developed.

  • 19.
    Laurent, Claes
    et al.
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik.
    Jönsson, Björn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Vegfors, Magnus
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Östergötlands Läns Landsting, Anestesi- och operationscentrum, Anestesi- och intensivvårdskliniken VIN.
    Lindberg, Lars-Göran
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik.
    Non-invasive monitoring of systolic blood preassure on arm utilizing photoplethysmography (PPG)2000Ingår i: World Congress of Medical Physics and Biomedical Engineering,2000, Springer-Verlag , 2000, s. 131-135Konferensbidrag (Refereegranskat)
    Abstract [en]

    Photoplethysmography (PPG) can be used to measure systolic blood pressure at the brachial artery. With a specially designed probe, positioned in the most distal position beneath a pressure cuff on the upper arm, this is possible. The distance between the light source (880 nm) and the photodetector was 20 mm. A test was performed on neuro-intensive care patients by determining blood pressure from the PPG curves, and, when it was compared with systolic blood pressure obtained from inserted indwelling arterial catheters, a correlation factor of r=0.95 was achieved. The difference between blood pressure obtained using PPG and invasive blood pressure measurement was 3.9±9.1 mmHg (mean±SD), n=19. The depth to the brachial artery was 13.9±4.1 mm (mean±SD), n=18. A digital PPG system utilising pulsating light was also developed.

  • 20. Lindgren, P
    et al.
    Stenestrand, Ulf
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Hambraeus, K
    Wallentin, L
    Jönsson, Björn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    PCI reduces utility loss after myocardial infarction in Sweden.2006Ingår i: World Congress of Cardiology - ESC,2006, 2006Konferensbidrag (Refereegranskat)
    Abstract [en]

     Abstract 4615. European Heart J 2006.

  • 21.
    Lundgren, Fredrik
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Almstrom, Christian
    Boden.
    Almgren, Bo
    Boden.
    Drott, Christer
    Borås.
    Jansson, Ingvar
    Eskilstuna.
    Hallstensson, Stig
    Falun.
    Jivegard, Lennart
    Göteborg-Sahlgrenska.
    Ortenwall, Pelle
    Göteborg-Östra.
    Tuvesson, Torbjorn
    Gävle.
    Plate, Gunnar
    Helsingborg.
    Potemkowski, Antony
    Kalmar.
    Lundqvist, Becke
    Karlstad.
    Emtersjo, Goran
    Kristian.
    Jönsson, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Jonung, Torbjorn
    Lund.
    Lindblad, Bengt
    Malmö.
    Almstrom, Christian
    Motala.
    Wingren, Urban
    Mölndal.
    Svensson, Monica
    Norrköping.
    Fornander, Bjorn
    Nyköping.
    Bjorck, Martin
    Skellefteå.
    Brunes, Lars
    Skövde.
    Johansson, Gunnar
    Stockholm-StGöran.
    Karlstrom, Lars
    Stockholm.
    Tornell, Per-Erland
    Trollhättan.
    Ljungman, Christer
    Uppsala.
    Aldman, Ake
    Västervik.
    Forsberg, Ola
    Västerås.
    Bjorkman, Hilding
    Växjö.
    Arfvidsson, Berndt
    Örebro.
    Bohlin, Thomas
    Östersund.
    Sloth Nielsen, Jorgen
    Aalborg.
    Schroeder, Torben
    Copenhagen.
    Stahl Madsen, Morten
    Kolding.
    PTFE Bypass to Below-knee Arteries: Distal Vein Collar or Not? A Prospective Randomised Multicentre Study2010Ingår i: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 39, nr 6, s. 747-754Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Patency and limb salvage after synthetic bypass to the arteries below-knee are inferior to that which can be achieved with autologous vein. Use of a vein collar at the distal anastomosis has been suggested to improve patency and limb salvage, a problem that is analysed in this randomised clinical study. Methods: Patients with critical limb ischaennia undergoing polytetrafluoroethylene (PTFE) bypass to below-knee arteries were randomly either assigned a vein collar or not in two groups bypass to the popliteal artery below-knee (femoro-popliteal below-knee (FemPopBK)) and more distal bypass (femoro-distal bypass (FemDist)). Follow-up was scheduled until amputation, death or at most 5 years, whichever event occurred first. Results: In the FemPopBK and in the FemDist groups, 115/202 and 72/150 were randomised to have a vein collar, respectively. Information was available for 345 of 352 randomised patients (98%). At 3 years, primary patency was 26% (95% confidence interval (CI) 18-38) with a vein collar and 43 (33-58) without a vein collar for femoro-popliteal bypass and 20 (11-38), and 17 (9-33) for femoro-distal bypass, respectively. The corresponding figures for limb salvage were 64 (54-75) and 61(50-74) for femoro-popliteal bypass, and 59 (46-76) and 44 (32-61) for femoro-distal bypass with and without a vein collar, respectively. Log-rank-test for the whole Kaplan-Meier life table curve showed no statistically significant differences with or without vein collar primary patency: p = 0.0853, p = 0.228; secondary patency: p = 0.317, p = 0.280; limb salvage: p = 0.757, p = 0.187 for FemPopBK and FemDist, respectively. The use of a vein collar did not influence patency or limb salvage. Conclusion: This study failed to show any benefit for vein collar with PTFE bypass to a below-knee artery.

  • 22.
    Skau, Tommy
    et al.
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Linköpings universitet, Hälsouniversitetet.
    Jönsson, Björn
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Linköpings universitet, Hälsouniversitetet.
    Prevalence of symptomatic leg ischaemia in a swedish community: an epidemiological study1993Ingår i: European Journal of Vascular Surgery (United Kingdom), ISSN 0950-821X, Vol. 7, nr 4, s. 432-437Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The prevalence of symptomatic leg ischaemia (SLI) was studied using a standardised postal questionnaire and by measuring ankle systolic blood pressure among those with leg pain. All individuals, aged 50–89 years, of both sexes (n = 2748) in a community of 7524 inhabitants were included. The overall questionnaire response rate was 92%, of whom 441 (17%) reported any form of leg pain. Ankle systolic blood pressure (ASBP) was measured in 353 (80%) of those. Ankle/brachial index (ABI) ⩽0.8 was chosen as the criterion for verified SLI. One hundred and seven (30%) had a verified SLI (ABI ⩽0.8).Hospital records could be reviewed in 83% of the non-responders, and revealed corresponding distributions of risk factors among the non-responders and the questionnaire-responders. Risk factor frequencies among ASBP-examined and not examined individuals were also comparable. The overall prevalence of SLI in the age 50–89 years was 4.1%, ranging from 1.5% in the age decade of 50–59 years, to maximum 7.1% in the decade 70–79 years. A slight but not significant male predominance was recorded, except for the age decade 70–79 years. The prevalence of SLI in the whole community population was approximately 2000/100 000 of which 5% were possible candidates for vascular intervention.

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