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2 results on '"Toorop, R.J."'

1. Saccular Abdominal Aortic Aneurysms Patient Characteristics, Clinical Presentation, Treatment, and Outcomes in the Netherlands

Author

Karthaus, E.G., Tong, T.M.L., Vahl, A., Hamming, J.F., Akker, L.H. van den, Akker, P.J. van den, Akkersdijk, G.J., Akkersdijk, G.P., Akkersdijk, W.L., Kempenaer, M.G.V. de, Arts, C.H., Avontuur, J.A., Baal, J.G., Bakker, O.J., Balm, R., Barendregt, W.B., Bender, M.H., Bendermacher, B.L., Berg, M. van den, Berger, P., Beuk, R.J., Blankensteijn, J.D., Bleker, R.J., Bockel, J.H., Bodegom, M.E., Bogt, K.E., Boll, A.P., Booster, M.H., Burg, B.L.B. van der, Borst, G.J. de, Bos-van Rossum, W.T., Bosma, J., Botman, J.M., Bouwman, L.H., Breek, J.C., Brehm, V., Brinckman, M.J., Broek, T.H. van den, Brom, H.L., Bruijn, M.T. de, Bruin, J.L. de, Brummel, P., Brussel, J.P. van, Buijk, S.E., Buimer, M.G., Burger, D.H., Buscher, H.C., Butter, G. den, Cancrinus, E., Castenmiller, P.H., Cazander, G., Coveliers, H.M., Cuypers, P.H., Daemen, J.H., Dawson, I., Derom, A.F., Dijkema, A.R., Diks, J., Dinkelman, M.K., Dirven, M., Dolmans, D.E., Doorn R, C. van, Dortmont, L.M. van, Eb, M.M. van der, Eefting, D., Eijck, G.J. van, Elshof, J.W., Elsman, B.H., Elst, A. van der, Engeland, M.I. van, Eps, R.G. van, Faber, M.J., Fijter, W.M. de, Fioole, B., Fritschy, W.M., Geelkerken, R.H., Gent, W.B. van, Glade, G.J., Govaert, B., Groenendijk, R.P., Groot, H.G. de, Haak, R.F. van den, Haan, E.F. de, Hajer, G.F., Hattum, E.S. van, Hazenberg, C.E., Joosten, P.P.H.M., Helleman, J.N., Hem, L.G. van der, Hendriks, J.M., Herwaarden, J.A. van, Heyligers, J.M., Hinnen, J.W., Hissink, R.J., Ho, G.H., Hoed, P.T. den, Hoedt, M.T., Hoek, F. van, Hoencamp, R., Hoffmann, W.H., Hoksbergen, A.W., Hollander, E.J., Huisman, L.C., Hulsebos, R.G., Hunt-Jens, K.M., Idu, M.M., Jacobs, M.J., Jagt, M.F. van der, Jansbeken, J.R., Janssen, R.J., Jiang, H.H., Jong, S.C. de, Jongkind, V., Kapma, M.R., Keller, B.P., Jahrome, A.K., Kievit, J.K., Klemm, P.L., Klinkert, P., Knippenberg, B., Koedam, N.A., Koelemaij, M.J., Kolkert, J.L., Koning, G.G., Koning, O.H., Krasznai, A.G., Krol, R.M., Kropman, R.H., Kruse, R.R., Laan, L. van der, Laan, M.J. van der, Laanen, J.H. van, Lardenoye, J.H., Lawson, J.A., Legemate, D.A., Leijdekkers, V.J., Lemson, M.S., Lensvelt, M.M., Lijkwan, M.A., Lind, R.C., Linden, F.T. van der, Lung, P.F.L., Loos, M.J., Loubert, M.C., Mahmoud, D.E., Manshanden, C.G., Mattens, E.C., Meerwaldt, R., Mees, B.M., Metz, R., Minnee, R.C., Mol van Otterloo , J.C. de, Moll, F.L., Swijndregt, Y.C.M. van, Morak, M.J., Mortel, R.H. van de, Mulder, W., Nagesser, S.K., Naves, C.C., Nederhoed, J.H., Nevenzel-Putters, A.M., Nie, A.J. de, Nieuwenhuis, D.H., Nieuwen-Huizen, J., Nieuwenhuizen, R.C. van, Nio, D., Oomen, A.P., Oranen, B.I., Oskam, J., Palamba, H.W., Peppelenbosch, A.G., Petersen, A.S. van, Peterson, T.F., Petri, B.J., Pierie, M.E., Ploeg, A.J., Pol, R.A., Ponfoort, E.D., Poyck, P.P., Prent, A., Raa, S. ten, Raymakers, J.T., Reichart, M., Reichmann, B.L., Reijnen, M.M., Rijbroek, A., Rijn, M.J. van, Roo, R.A. de, Rouwet, E.V., Rupert, C.G., Saleem, B.R., Sambeek, M.R. van, Samyn, M.G., Sant, H.P. van 't, Schaik, J. van, Schaik, P.M. van, Scharn, D.M., Scheltinga, M.R., Schepers, A., Schlejen, P.M., Schlosser, F.J., Schol, F.P., Schouten, O., Schreinemacher, M.H., Schreve, M.A., Schurink, G.W., Sikkink, C.J., Siroen, M.P., Slaa, A. te, Smeets, H.J., Smeets, L., Smet, A.A. de, Smit, P. de, Smit, P.C., Smits, T.M., Snoeijs, M.G., Sondakh, A.O., Steenhoven, T.J. van der, Sterkenburg, S.M. van, Stigter, D.A., Stigter, H., Strating, R.P., Stultiens, G.N., Sybrandy, J.E., Teijink, J.A., Telgenkamp, B.J., Testroote, M.J., The, R.M., Thijsse, W.J., Tielliu, I.F., Tongeren, R.B. van, Toorop, R.J., Tordoir, J.H., Tournoij, E., Truijers, M., Turkean, K., Nolthenius, R.P.T., Unlu, C., Vafi, A.A., Vahl, A.C., Veen, E.J., Veger, H.T., Veldman, M.G., Verhagen, H.J., Verhoeven, B.A., Vermeulen, C.F., Vermeulen, E.G., Vierhout, B.P., Visser, M.J., Vliet, J.A. van der, Vlijmen-van Kuelen, C.J., Voesten, H.G., Voorhoeve, R., and Vos

Subjects
Male, medicine.medical_specialty, Aortic Rupture, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Treatment outcome, Patient characteristics, Hospital mortality, 030204 cardiovascular system & hematology, Dutch Surgical Aneurysm Audit (DSAA), Risk Assessment, Blood Vessel Prosthesis Implantation, 03 medical and health sciences, Aortic aneurysm, 0302 clinical medicine, Intervention (counseling), medicine, Humans, Hospital Mortality, Registries, 030212 general & internal medicine, cardiovascular diseases, threshold for elective surgery, Aged, Netherlands, Retrospective Studies, business.industry, General surgery, Follow up studies, Retrospective cohort study, Middle Aged, Saccular abdominal aortic aneurysm, medicine.disease, Survival Analysis, Surgery, Treatment Outcome, Elective Surgical Procedures, 030220 oncology & carcinogenesis, cardiovascular system, Female, 030211 gastroenterology & hepatology, Emergencies, Presentation (obstetrics), Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine, business, Aortic Aneurysm, Abdominal, Follow-Up Studies, Abdominal surgery
Abstract

Objective: The aim of this was to analyze differences between saccularshaped abdominal aortic aneurysms (SaAAAs) and fusiform abdominal aortic aneurysms (FuAAAs) regarding patient characteristics, treatment, and outcome, to advise a threshold for intervention for SaAAAs.Background: Based on the assumption that SaAAAs are more prone to rupture, guidelines suggest early elective treatment. However, little is known about the natural history of SaAAAs and the threshold for intervention is not substantiated.Methods: Observational study including primary repairs of degenerative AAAs in the Netherlands between 2016 and 2018 in which the shape was registered, registered in the Dutch Surgical Aneurysm Audit (DSAA). Patients were stratified by urgency of surgery; elective versus acute (symptomatic/ruptured). Patient characteristics, treatment, and outcome were compared between SaAAAs and FuAAAs.Results: A total of 7659 primary AAA-patients were included, 6.1% (n = 471) SaAAAs and 93.9% (n = 7188) FuAAAs. There were 5945 elective patients (6.5% SaAAA) and 1714 acute (4.8% SaAAA). Acute SaAAApatients were more often female (28.9% vs 17.2%, P = 0.007) compared with acute FuAAA-patients. SaAAAs had smaller diameters than FuAAAs, in elective (53.0mm vs 61 mm, P = 0.000) and acute (68mm vs 75 mm, P = 0.002) patients, even after adjusting for sex. In addition, 25.2% of acute SaAAA-patients presented with diameters

Published
2019

2. Surgical interventions and studies of the carotid sinus

Author

Toorop, R.J., Moll, Frans L, Bleys, Ronald L.A.W., Scheltinga, M.R.M., and University Utrecht

Subjects
otorhinolaryngologic diseases, cardiovascular system
Abstract

Background: The carotid baroreflex buffers acute changes in blood pressure and is triggered by baroreceptors in the carotid sinus. Baroreceptor firing results in an increased parasympathetic tone and a decreased sympathetic tone leading to reduced heart rate and blood pressure. Under normal conditions, sympathetic and parasympathetic action at the level of the carotid sinus is balanced. In contrast, patients suffering from a carotid sinus syndrome (CSS) may demonstrate an exaggerated carotid baroreflex response. Symptoms of dizziness and syncope may occur because of episodes of a brief asystole or a profound drop in blood pressure. In a mostly elderly patient group these syncopes may be associated with frequent falls leading to serious sequelae.Pacemaker implantation is nowadays considered ‘gold standard’ for treating CSS patients with repetitive syncope, but may not always be effective. The sympathetic nervous system also plays a crucial role in the pathofysiology of hypertension. An association was found between systemic hypertension and the presence of an abnormal baroreflex. Large clinical trials indicate that up to 30% of hypertensive patients do not reach normotension despite life style changes in combination with the use of pharmacological agents these measures. This therapy resistant hypertension is a major risk factor for the development of cardiovascular events. Aims Aims of this thesis are: first to study the effects of carotid sinus denervation by means of adventitial stripping in patients suffering from carotid sinus syndrome (CSS) and second, to explore the concept of mechanical carotid sinus stimulation in the treatment of hypertension. Methods A literature study was performed on technique, efficacy and safety of a surgical technique termed adventitial stripping of the carotid sinus as a treatment of CSS. Second, the anatomy of nerve structures surrounding the carotid bifurcation with special emphasis on the carotid sinus nerve (CSN) and its branches was studied, followed by a microscopic study of baroreceptor distribution in the carotid bifurcation. Next, short and long term efficacy and safety of adventitial carotid stripping was studied in a cohort of 27 CSS patients. Finally, a first-in-man study of mechanical carotid sinus stimulation was performed. Conclusions -Substantial or complete relief of CSS associated symptoms was achieved by adventitial carotid stripping in 85% of the patients reported in the literature. -Carotid sinus nerve (CSN) anatomy is characterized by a great variability. Therefore, CSN transection as a single treatment for patients with CSS may be insufficient. -Baroreceptor density is highest in the first cm portion of the medial internal carotid artery (ICA). Therefore, adventitial stripping of the proximal ICA is sufficient for CSS. -Adventitial stripping of the proximal 3 cm of the ICA appears effective in 93% of our CSS patient cohort (n=27),whereas CSS recurrence was absent on the long term. -Carotid denervation by adventitial stripping is safe. -Mechanical carotid stimulation lowers blood pressure in an acute human model.

Published
2012

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