49 results on '"Malmstedt, J"'
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2. Massive Blood Transfusion in Patients with Ruptured Abdominal Aortic Aneurysm
- Author
-
Montan, C., Hammar, U., Wikman, A., Berlin, E., Malmstedt, J., Holst, J., and Wahlgren, C.M.
- Published
- 2016
- Full Text
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3. The Receptor for Advanced Glycation End Products (Rage) and Its Ligands in Plasma and Infrainguinal Bypass Vein
- Author
-
Malmstedt, J., Frebelius, S., Lengquist, M., Jörneskog, G., Wang, J., and Swedenborg, J.
- Published
- 2016
- Full Text
- View/download PDF
4. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy
- Author
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Halliday, A., Bulbulia, R., Bonati, L. H., Chester, J., Cradduck-Bamford, A., Peto, R., Pan, H., Potter, J., Henning Eckstein, H., Farrell, B., Flather, M., Mansfield, A., Mihaylova, B., Rahimi, K., Simpson, D., Thomas, D., Sandercock, P., Gray, R., Molyneux, A., Shearman, C. P., Rothwell, P., Belli, A., Herrington, W., Judge, P., Leopold, P., Mafham, M., Gough, M., Cao, P., Macdonald, S., Bari, V., Berry, C., Bradshaw, S., Brudlo, W., Clarke, A., Cox, R., Fathers, S., Gaba, K., Gray, M., Hayter, E., Holliday, C., Kurien, R., Lay, M., le Conte, S., Mcmanus, J., Madgwick, Z., Morris, D., Munday, A., Pickworth, S., Ostasz, W., Poorthuis, M., Richards, S., Teixeira, L., Tochlin, S., Tully, L., Wallis, C., Willet, M., Young, A., Casana, R., Malloggi, C., Odero, A., Silani, V., Parati, G., Malchiodi, G., Malferrari, G., Strozzi, F., Tusini, N., Vecchiati, E., Coppi, G., Lauricella, A., Moratto, R., Silingardi, R., Veronesi, J., Zini, A., Ferrero, E., Ferri, M., Gaggiano, A., Labate, C., Nessi, F., Psacharopulo, D., Viazzo, A., Malacrida, G., Mazzaccaro, D., Meola, G., Modafferi, A., Nano, G., Occhiuto, M. T., Righini, P., Stegher, S., Chiarandini, S., Griselli, F., Lepidi, S., Pozzi Mucelli, F., Naccarato, M., D'Oria, M., Ziani, B., Stella, A., Dieng, M., Faggioli, G., Gargiulo, M., Palermo, S., Pini, R., Puddu, G. M., Vacirca, A., Angiletta, D., Desantis, C., Marinazzo, D., Mastrangelo, G., Regina, G., Pulli, R., Bianchi, P., Cireni, L., Coppi, E., Pizzirusso, R., Scalise, F., Sorropago, G., Tolva, V., Caso, V., Cieri, E., Derango, P., Farchioni, L., Isernia, G., Lenti, M., Parlani, G. B., Pupo, G., Pula, G., Simonte, G., Verzini, F., Carimati, F., Delodovici, M. L., Fontana, F., Piffaretti, G., Tozzi, M., Civilini, E., Poletto, G., Reimers, B., Praquin, B., Ronchey, S., Capoccia, L., Mansour, W., Sbarigia, E., Speziale, F., Sirignano, P., Toni, D., Galeotti, R., Gasbarro, V., Mascoli, F., Rocca, T., Tsolaki, E., Bernardini, G., Demarco, E., Giaquinta, A., Patti, F., Veroux, M., Veroux, P., Virgilio, C., Mangialardi, N., Orrico, M., Di Lazzaro, V., Montelione, N., Spinelli, F., Stilo, F., Cernetti, C., Irsara, S., Maccarrone, G., Tonello, D., Visona, A., Zalunardo, B., Chisci, E., Michelagnoli, S., Troisi, N., Masato, M., Dei Negri, M., Pacchioni, A., Sacca, S., Amatucci, G., Cannizzaro, A., Accrocca, F., Ambrogi, C., Barbazza, R., Marcucci, G., Siani, A., Bajardi, G., Savettieri, G., Argentieri, A., Corbetta, R., Quaretti, P., Thyrion, F. Z., Cappelli, A., Benevento, D., De Donato, G., Mele, M. A., Palasciano, G., Pieragalli, D., Rossi, A., Setacci, C., Setacci, F., Palombo, D., Perfumo, M. C., Martelli, E., Paolucci, A., Trimarchi, S., Grassi, V., Grimaldi, L., La Rosa, G., Mirabella, D., Scialabba, M., Sichel, L., D'Angelo, C. L., Fadda, G. F., Kasemi, H., Marino, M., Burzotta, Francesco, Codispoti, F. A., Ferrante, A., Tinelli, Giovanni, Tshomba, Yamume, Vincenzoni, Claudio, Amis, D., Anderson, D., Catterson, M., Clarke, M., Davis, M., Dixit, A., Dyker, A., Ford, G., Jackson, R., Kappadath, S., Lambert, D., Lees, T., Louw, S., Mccaslin, J., Parr, N., Robson, R., Stansby, G., Wales, L., Wealleans, V., Wilson, L., Wyatt, M., Baht, H., Balogun, I., Burger, I., Cosier, T., Cowie, L., Gunathilagan, G., Hargroves, D., Insall, R., Jones, S., Rudenko, H., Schumacher, N., Senaratne, J., Thomas, G., Thomson, A., Webb, T., Brown, E., Esisi, B., Mehrzad, A., Macsweeney, S., Mcconachie, N., Southam, A., Sunman, W., Abdul-Hamiq, A., Bryce, J., Chetter, I., Ettles, D., Lakshminarayan, R., Mitchelson, K., Rhymes, C., Robinson, G., Scott, P., Vickers, A., Ashleigh, R., Butterfield, S., Gamble, E., Ghosh, J., Mccollum, C. N., Welch, M., Welsh, S., Wolowczyk, L., Donnelly, M., D'Souza, S., Egun, A. A., Gregary, B., Joseph, T., Kelly, C., Punekar, S., Rahi, M. A., Raj, S., Seriki, D., Thomson, G., Brown, J., Durairajan, R., Grunwald, I., Guyler, P., Harman, P., Jakeways, M., Khuoge, C., Kundu, A., Loganathan, T., Menon, N., Prabakaran, R. O., Sinha, D., Thompson, V., Tysoe, S., Briley, D., Darby, C., Hands, L., Howard, D., Kuker, W., Schulz, U., Teal, R., Barer, D., Brown, A., Crawford, S., Dunlop, P., Krishnamurthy, R., Majmudar, N., Mitchell, D., Myint, M. P., O'Brien, R., O'Connell, J., Sattar, N., Vetrivel, S., Beard, J., Cleveland, T., Gaines, P., Humphreys, J., Jenkins, A., King, C., Kusuma, D., Lindert, R., Lonsdale, R., Nair, R., Nawaz, S., Okhuoya, F., Turner, D., Venables, G., Dorman, P., Hughes, A., Jones, D., Mendelow, D., Rodgers, H., Raudoniitis, A., Enevoldson, P., Nahser, H., O'Brien, I., Torella, F., Watling, D., White, R., Brown, P., Dutta, D., Emerson, L., Hilltout, P., Kulkarni, S., Morrison, J., Poskitt, K., Slim, F., Smith, S., Tyler, A., Waldron, J., Whyman, M., Bajoriene, M., Baker, L., Colston, A., Eliot-Jones, B., Gramizadeh, G., Lewis-Clarke, C., Mccafferty, L., Oliver, D., Palmer, D., Patil, A., Pegler, S., Ramadurai, G., Roberts, A., Sargent, T., Siddegowda, S., Singh-Ranger, R., Williams, A., Williams, L., Windebank, S., Zuromskis, T., Alwis, L., Angus, J., Asokanathan, A., Fornolles, C., Hardy, D., Hunte, S., Justin, F., Phiri, D., Mitabouana-Kibou, M., Sekaran, L., Sethuraman, S., Tate, M. L., Akyea-Mensah, J., Ball, S., Chrisopoulou, A., Keene, E., Phair, A., Rogers, S., Smyth, J. V., Bicknell, C., Chataway, J., Cheshire, N., Clifton, A., Eley, C., Gibbs, R., Hamady, M., Hazel, B., James, A., Jenkins, M., Khanom, N., Lacey, A., Mireskandari, M., O'Reilly, J., Pereira, A., Sachs, T., Wolfe, J., Davey, P., Rogers, G., Smith, G., Tervit, G., Nichol, I., Parry, A., Young, G., Ashley, S., Barwell, J., Dix, F., Nor, A. M., Parry, C., Birt, A., Davies, P., George, J., Graham, A., Jonker, L., Kelsall, N., Potts, C., Wilson, T., Crinnion, J., Cuenoud, L., Aleksic, N., Babic, S., Ilijevski, N., Radak, Sagic, D., Tanaskovic, S., Colic, M., Cvetic, V., Davidovic, L., Jovanovic, D. R., Koncar, I., Mutavdzic, P., Sladojevic, M., Tomic, I., Debus, E. S., Grzyska, U., Otto, D., Thomalla, G., Barlinn, J., Gerber, J., Haase, K., Hartmann, C., Ludwig, S., Putz, V., Reeps, C., Schmidt, C., Weiss, N., Werth, S., Winzer, S., Gemper, J., Gunther, A., Heiling, B., Jochmann, E., Karvouniari, P., Klingner, C., Mayer, T., Schubert, J., Schulze-Hartung, F., Zanow, J., Bausback, Y., Borger, F., Botsios, S., Branzan, D., Braunlich, S., Holzer, H., Lenzer, J., Piorkowski, C., Richter, N., Schuster, J., Scheinert, D., Schmidt, A., Staab, H., Ulrich, M., Werner, M., Berger, H., Biro, G., Eckstein, H. -H., Kallmayer, M., Kreiser, K., Zimmermann, A., Berekoven, B., Frerker, K., Gordon, V., Torsello, G., Arnold, S., Dienel, C., Storck, M., Biermaier, B., Gissler, H. M., Klotzsch, C., Pfeiffer, T., Schneider, R., Sohl, L., Wennrich, M., Alonso, A., Keese, M., Groden, C., Coster, A., Engelhardt, A., Ratusinski, C. -M., Berg, B., Delle, M., Formgren, J., Gillgren, P., Jarl, L., Kall, T. B., Konrad, P., Nyman, N., Skioldebrand, C., Steuer, J., Takolander, R., Malmstedt, J., Acosta, S., Bjorses, K., Brandt, K., Dias, N., Gottsater, A., Holst, J., Kristmundsson, T., Kuhme, T., Kolbel, T., Lindblad, B., Lindh, M., Malina, M., Ohrlander, T., Resch, T., Ronnle, V., Sonesson, B., Warvsten, M., Zdanowski, Z., Campbell, E., Kjellin, P., Lindgren, H., Nyberg, J., Petersen, B., Plate, G., Parsson, H., Qvarfordt, P., Ignatenko, P., Karpenko, A., Starodubtsev, V., Chernyavsky, M. A., Golovkova, M. S., Komakha, B. B., Zherdev, N. N., Belyasnik, A., Chechulov, P., Kandyba, D., Stepanishchev, I., Csobay-Novak, C., Dosa, E., Entz, L., Nemes, B., Szeberin, Z., Barzo, P., Bodosi, M., Fako, E., Fulop, B., Nemeth, T., Pazdernyik, S., Skoba, K., Voros, E., Chatzinikou, E., Giannoukas, A., Karathanos, C., Koutsias, S., Kouvelos, G., Matsagkas, M., Ralli, S., Rountas, C., Rousas, N., Spanos, K., Brountzos, E., Kakisis, J. D., Lazaris, A., Moulakakis, K. G., Stefanis, L., Tsivgoulis, G., Vasdekis, S., Antonopoulos, C. N., Bellenis, I., Maras, D., Polydorou, A., Polydorou, V., Tavernarakis, A., Ioannou, N., Terzoudi, M., Lazarides, M., Mantatzis, M., Vadikolias, K., Dzieciuchowicz, L., Gabriel, M., Krasinski, Z., Oszkinis, G., Pukacki, F., Slowinski, M., Stanisic, M. -G., Staniszewski, R., Tomczak, J., Zielinski, M., Myrcha, P., Rozanski, D., Drelichowski, S., Iwanowski, W., Koncewicz, K., Bialek, P., Biejat, Z., Czepel, W., Czlonkowska, A., Dowzenko, A., Jedrzejewska, J., Kobayashi, A., Leszczynski, J., Malek, A., Polanski, J., Proczka, R., Skorski, M., Szostek, M., Andziak, P., Dratwicki, M., Gil, R., Nowicki, M., Pniewski, J., Rzezak, J., Seweryniak, P., Dabek, P., Juszynski, M., Madycki, G., Pacewski, B., Raciborski, W., Slowinski, P., Staszkiewicz, W., Bombic, M., Chlouba, V., Fiedler, J., Hes, K., Kostal, P., Sova, J., Kriz, Z., Privara, M., Reif, M., Staffa, R., Vlachovsky, R., Vojtisek, B., Hrbac, T., Kuliha, M., Prochazka, V., Roubec, M., Skoloudik, D., Netuka, D., Steklacova, A., Benes III, V., Buchvald, P., Endrych, L., Sercl, M., Campos, W., Casella, I. B., de Luccia, N., Estenssoro, A. E. V., Presti, C., Puech-Leao, P., Neves, C. R. B., da Silva, E. S., Sitrangulo, C. J., Monteiro, J. A. T., Tinone, G., Bellini Dalio, M., Joviliano, E. E., Pontes Neto, O. M., Serra Ribeiro, M., Cras, P., Hendriks, J. M. H., Hoppenbrouwers, M., Lauwers, P., Loos, C., Yperzeele, L., Geenens, M., Hemelsoet, D., van Herzeele, I., Vermassen, F., Astarci, P., Hammer, F., Lacroix, V., Peeters, A., Verhelst, R., Cirelli, S., Dormal, P., Grimonprez, A., Lambrecht, B., Lerut, P., Thues, E., De Koster, G., Desiron, Q., Maertens de Noordhout, A., Malmendier, D., Massoz, M., Saad, G., Bosiers, M., Callaert, J., Deloose, K., Blanco Canibano, E., Garcia Fresnillo, B., Guerra Requena, M., Morata Barrado, P. C., Muela Mendez, M., Yusta Izquierdo, A., Aparici Robles, F., Blanes Orti, P., Garcia Dominguez, L., Martinez Lopez, R., Miralles Hernandez, M., Tembl Ferrairo, J. I., Chamorro, A., Macho, J., Obach, V., Riambau, V., San Roman, L., Ahlhelm, F. J., Blackham, K., Engelter, S., Eugster, T., Gensicke, H., Gurke, L., Lyrer, P., Mariani, L., Maurer, M., Mujagic, E., Muller, M., Psychogios, M., Stierli, P., Stippich, C., Traenka, C., Wolff, T., Wagner, B., Wiegert, M. M., Clarke, S., Diepers, M., Grochenig, E., Gruber, P., Isaak, A., Kahles, T., Marti, R., Nedeltchev, K., Remonda, L., Tissira, N., Valenca Falcao, M., de Borst, G. J., Lo, R. H., Moll, F. L., Toorop, R., van der Worp, B. H., Vonken, E. J., Kappelle, J. L., Jahrome, O., Vos, F., Schuiling, W., van Overhagen, H., Keunen, R. W. M., Knippenberg, B., Wever, J. J., Lardenoije, J. W., Reijnen, M., Smeets, L., van Sterkenburg, S., Fraedrich, G., Gizewski, E., Gruber, I., Knoflach, M., Kiechl, S., Rantner, B., Abdulamit, T., Bergeron, P., Padovani, R., Trastour, J. -C., Cardon, J. -M., Le Gallou-Wittenberg, A., Allaire, E., Becquemin, J. -P., Cochennec-Paliwoda, F., Desgranges, P., Hosseini, H., Kobeiter, H., Marzelle, J., Almekhlafi, M. A., Bal, S., Barber, P. A., Coutts, S. B., Demchuk, A. M., Eesa, M., Gillies, M., Goyal, M., Hill, M. D., Hudon, M. E., Jambula, A., Kenney, C., Klein, G., Mcclelland, M., Mitha, A., Menon, B. K., Morrish, W. F., Peters, S., Ryckborst, K. J., Samis, G., Save, S., Smith, E. E., Stys, P., Subramaniam, S., Sutherland, G. R., Watson, T., Wong, J. H., Zimmel, L., Flis, V., Matela, J., Miksic, K., Milotic, F., Mrdja, B., Stirn, B., Tetickovic, E., Gasparini, M., Grad, A., Kompara, I., Milosevic, Z., Palmiste, V., Toomsoo, T., Aidashova, B., Kospanov, N., Lyssenko, R., Mussagaliev, D., Beyar, R., Hoffman, A., Karram, T., Kerner, A., Nikolsky, E., Nitecki, S., Andonova, S., Bachvarov, C., Petrov, V., Cvjetko, I., Vidjak, V., Haluzan, D., Petrunic, M., Liu, B., Liu, C. -W., Bartko, D., Beno, P., Rusnak, F., Zelenak, K., Ezura, M., Inoue, T., Kimura, N., Kondo, R., Matsumoto, Y., Shimizu, H., Endo, H., Furui, E., Bakke, S., Krohg-Sorensen, K., Nome, T., Skjelland, M., Tennoe, B., Albuquerque e Castro, J., Alves, G., Bastos Goncalves, F., de Aragao Morais, J., Garcia, A. C., Valentim, H., Vasconcelos, L., Belcastro, F., Cura, F., Zaefferer, P., Abd-Allah, F., Eldessoki, M. H., Heshmat Kassem, H., Soliman Gharieb, H., Colgan, M. P., Haider, S. N., Harbison, J., Madhavan, P., Moore, D., Shanik, G., Kazan, V., Nazzal, M., Ramsey-Williams, V., Burzotta F. (ORCID:0000-0002-6569-9401), Tinelli G. (ORCID:0000-0002-2212-3226), Tshomba Y. (ORCID:0000-0001-7304-7553), Vincenzoni C., Halliday, A., Bulbulia, R., Bonati, L. H., Chester, J., Cradduck-Bamford, A., Peto, R., Pan, H., Potter, J., Henning Eckstein, H., Farrell, B., Flather, M., Mansfield, A., Mihaylova, B., Rahimi, K., Simpson, D., Thomas, D., Sandercock, P., Gray, R., Molyneux, A., Shearman, C. P., Rothwell, P., Belli, A., Herrington, W., Judge, P., Leopold, P., Mafham, M., Gough, M., Cao, P., Macdonald, S., Bari, V., Berry, C., Bradshaw, S., Brudlo, W., Clarke, A., Cox, R., Fathers, S., Gaba, K., Gray, M., Hayter, E., Holliday, C., Kurien, R., Lay, M., le Conte, S., Mcmanus, J., Madgwick, Z., Morris, D., Munday, A., Pickworth, S., Ostasz, W., Poorthuis, M., Richards, S., Teixeira, L., Tochlin, S., Tully, L., Wallis, C., Willet, M., Young, A., Casana, R., Malloggi, C., Odero, A., Silani, V., Parati, G., Malchiodi, G., Malferrari, G., Strozzi, F., Tusini, N., Vecchiati, E., Coppi, G., Lauricella, A., Moratto, R., Silingardi, R., Veronesi, J., Zini, A., Ferrero, E., Ferri, M., Gaggiano, A., Labate, C., Nessi, F., Psacharopulo, D., Viazzo, A., Malacrida, G., Mazzaccaro, D., Meola, G., Modafferi, A., Nano, G., Occhiuto, M. T., Righini, P., Stegher, S., Chiarandini, S., Griselli, F., Lepidi, S., Pozzi Mucelli, F., Naccarato, M., D'Oria, M., Ziani, B., Stella, A., Dieng, M., Faggioli, G., Gargiulo, M., Palermo, S., Pini, R., Puddu, G. M., Vacirca, A., Angiletta, D., Desantis, C., Marinazzo, D., Mastrangelo, G., Regina, G., Pulli, R., Bianchi, P., Cireni, L., Coppi, E., Pizzirusso, R., Scalise, F., Sorropago, G., Tolva, V., Caso, V., Cieri, E., Derango, P., Farchioni, L., Isernia, G., Lenti, M., Parlani, G. B., Pupo, G., Pula, G., Simonte, G., Verzini, F., Carimati, F., Delodovici, M. L., Fontana, F., Piffaretti, G., Tozzi, M., Civilini, E., Poletto, G., Reimers, B., Praquin, B., Ronchey, S., Capoccia, L., Mansour, W., Sbarigia, E., Speziale, F., Sirignano, P., Toni, D., Galeotti, R., Gasbarro, V., Mascoli, F., Rocca, T., Tsolaki, E., Bernardini, G., Demarco, E., Giaquinta, A., Patti, F., Veroux, M., Veroux, P., Virgilio, C., Mangialardi, N., Orrico, M., Di Lazzaro, V., Montelione, N., Spinelli, F., Stilo, F., Cernetti, C., Irsara, S., Maccarrone, G., Tonello, D., Visona, A., Zalunardo, B., Chisci, E., Michelagnoli, S., Troisi, N., Masato, M., Dei Negri, M., Pacchioni, A., Sacca, S., Amatucci, G., Cannizzaro, A., Accrocca, F., Ambrogi, C., Barbazza, R., Marcucci, G., Siani, A., Bajardi, G., Savettieri, G., Argentieri, A., Corbetta, R., Quaretti, P., Thyrion, F. Z., Cappelli, A., Benevento, D., De Donato, G., Mele, M. A., Palasciano, G., Pieragalli, D., Rossi, A., Setacci, C., Setacci, F., Palombo, D., Perfumo, M. C., Martelli, E., Paolucci, A., Trimarchi, S., Grassi, V., Grimaldi, L., La Rosa, G., Mirabella, D., Scialabba, M., Sichel, L., D'Angelo, C. L., Fadda, G. F., Kasemi, H., Marino, M., Burzotta, Francesco, Codispoti, F. A., Ferrante, A., Tinelli, Giovanni, Tshomba, Yamume, Vincenzoni, Claudio, Amis, D., Anderson, D., Catterson, M., Clarke, M., Davis, M., Dixit, A., Dyker, A., Ford, G., Jackson, R., Kappadath, S., Lambert, D., Lees, T., Louw, S., Mccaslin, J., Parr, N., Robson, R., Stansby, G., Wales, L., Wealleans, V., Wilson, L., Wyatt, M., Baht, H., Balogun, I., Burger, I., Cosier, T., Cowie, L., Gunathilagan, G., Hargroves, D., Insall, R., Jones, S., Rudenko, H., Schumacher, N., Senaratne, J., Thomas, G., Thomson, A., Webb, T., Brown, E., Esisi, B., Mehrzad, A., Macsweeney, S., Mcconachie, N., Southam, A., Sunman, W., Abdul-Hamiq, A., Bryce, J., Chetter, I., Ettles, D., Lakshminarayan, R., Mitchelson, K., Rhymes, C., Robinson, G., Scott, P., Vickers, A., Ashleigh, R., Butterfield, S., Gamble, E., Ghosh, J., Mccollum, C. N., Welch, M., Welsh, S., Wolowczyk, L., Donnelly, M., D'Souza, S., Egun, A. A., Gregary, B., Joseph, T., Kelly, C., Punekar, S., Rahi, M. A., Raj, S., Seriki, D., Thomson, G., Brown, J., Durairajan, R., Grunwald, I., Guyler, P., Harman, P., Jakeways, M., Khuoge, C., Kundu, A., Loganathan, T., Menon, N., Prabakaran, R. O., Sinha, D., Thompson, V., Tysoe, S., Briley, D., Darby, C., Hands, L., Howard, D., Kuker, W., Schulz, U., Teal, R., Barer, D., Brown, A., Crawford, S., Dunlop, P., Krishnamurthy, R., Majmudar, N., Mitchell, D., Myint, M. P., O'Brien, R., O'Connell, J., Sattar, N., Vetrivel, S., Beard, J., Cleveland, T., Gaines, P., Humphreys, J., Jenkins, A., King, C., Kusuma, D., Lindert, R., Lonsdale, R., Nair, R., Nawaz, S., Okhuoya, F., Turner, D., Venables, G., Dorman, P., Hughes, A., Jones, D., Mendelow, D., Rodgers, H., Raudoniitis, A., Enevoldson, P., Nahser, H., O'Brien, I., Torella, F., Watling, D., White, R., Brown, P., Dutta, D., Emerson, L., Hilltout, P., Kulkarni, S., Morrison, J., Poskitt, K., Slim, F., Smith, S., Tyler, A., Waldron, J., Whyman, M., Bajoriene, M., Baker, L., Colston, A., Eliot-Jones, B., Gramizadeh, G., Lewis-Clarke, C., Mccafferty, L., Oliver, D., Palmer, D., Patil, A., Pegler, S., Ramadurai, G., Roberts, A., Sargent, T., Siddegowda, S., Singh-Ranger, R., Williams, A., Williams, L., Windebank, S., Zuromskis, T., Alwis, L., Angus, J., Asokanathan, A., Fornolles, C., Hardy, D., Hunte, S., Justin, F., Phiri, D., Mitabouana-Kibou, M., Sekaran, L., Sethuraman, S., Tate, M. L., Akyea-Mensah, J., Ball, S., Chrisopoulou, A., Keene, E., Phair, A., Rogers, S., Smyth, J. V., Bicknell, C., Chataway, J., Cheshire, N., Clifton, A., Eley, C., Gibbs, R., Hamady, M., Hazel, B., James, A., Jenkins, M., Khanom, N., Lacey, A., Mireskandari, M., O'Reilly, J., Pereira, A., Sachs, T., Wolfe, J., Davey, P., Rogers, G., Smith, G., Tervit, G., Nichol, I., Parry, A., Young, G., Ashley, S., Barwell, J., Dix, F., Nor, A. M., Parry, C., Birt, A., Davies, P., George, J., Graham, A., Jonker, L., Kelsall, N., Potts, C., Wilson, T., Crinnion, J., Cuenoud, L., Aleksic, N., Babic, S., Ilijevski, N., Radak, Sagic, D., Tanaskovic, S., Colic, M., Cvetic, V., Davidovic, L., Jovanovic, D. R., Koncar, I., Mutavdzic, P., Sladojevic, M., Tomic, I., Debus, E. S., Grzyska, U., Otto, D., Thomalla, G., Barlinn, J., Gerber, J., Haase, K., Hartmann, C., Ludwig, S., Putz, V., Reeps, C., Schmidt, C., Weiss, N., Werth, S., Winzer, S., Gemper, J., Gunther, A., Heiling, B., Jochmann, E., Karvouniari, P., Klingner, C., Mayer, T., Schubert, J., Schulze-Hartung, F., Zanow, J., Bausback, Y., Borger, F., Botsios, S., Branzan, D., Braunlich, S., Holzer, H., Lenzer, J., Piorkowski, C., Richter, N., Schuster, J., Scheinert, D., Schmidt, A., Staab, H., Ulrich, M., Werner, M., Berger, H., Biro, G., Eckstein, H. -H., Kallmayer, M., Kreiser, K., Zimmermann, A., Berekoven, B., Frerker, K., Gordon, V., Torsello, G., Arnold, S., Dienel, C., Storck, M., Biermaier, B., Gissler, H. M., Klotzsch, C., Pfeiffer, T., Schneider, R., Sohl, L., Wennrich, M., Alonso, A., Keese, M., Groden, C., Coster, A., Engelhardt, A., Ratusinski, C. -M., Berg, B., Delle, M., Formgren, J., Gillgren, P., Jarl, L., Kall, T. B., Konrad, P., Nyman, N., Skioldebrand, C., Steuer, J., Takolander, R., Malmstedt, J., Acosta, S., Bjorses, K., Brandt, K., Dias, N., Gottsater, A., Holst, J., Kristmundsson, T., Kuhme, T., Kolbel, T., Lindblad, B., Lindh, M., Malina, M., Ohrlander, T., Resch, T., Ronnle, V., Sonesson, B., Warvsten, M., Zdanowski, Z., Campbell, E., Kjellin, P., Lindgren, H., Nyberg, J., Petersen, B., Plate, G., Parsson, H., Qvarfordt, P., Ignatenko, P., Karpenko, A., Starodubtsev, V., Chernyavsky, M. A., Golovkova, M. S., Komakha, B. B., Zherdev, N. N., Belyasnik, A., Chechulov, P., Kandyba, D., Stepanishchev, I., Csobay-Novak, C., Dosa, E., Entz, L., Nemes, B., Szeberin, Z., Barzo, P., Bodosi, M., Fako, E., Fulop, B., Nemeth, T., Pazdernyik, S., Skoba, K., Voros, E., Chatzinikou, E., Giannoukas, A., Karathanos, C., Koutsias, S., Kouvelos, G., Matsagkas, M., Ralli, S., Rountas, C., Rousas, N., Spanos, K., Brountzos, E., Kakisis, J. D., Lazaris, A., Moulakakis, K. G., Stefanis, L., Tsivgoulis, G., Vasdekis, S., Antonopoulos, C. N., Bellenis, I., Maras, D., Polydorou, A., Polydorou, V., Tavernarakis, A., Ioannou, N., Terzoudi, M., Lazarides, M., Mantatzis, M., Vadikolias, K., Dzieciuchowicz, L., Gabriel, M., Krasinski, Z., Oszkinis, G., Pukacki, F., Slowinski, M., Stanisic, M. -G., Staniszewski, R., Tomczak, J., Zielinski, M., Myrcha, P., Rozanski, D., Drelichowski, S., Iwanowski, W., Koncewicz, K., Bialek, P., Biejat, Z., Czepel, W., Czlonkowska, A., Dowzenko, A., Jedrzejewska, J., Kobayashi, A., Leszczynski, J., Malek, A., Polanski, J., Proczka, R., Skorski, M., Szostek, M., Andziak, P., Dratwicki, M., Gil, R., Nowicki, M., Pniewski, J., Rzezak, J., Seweryniak, P., Dabek, P., Juszynski, M., Madycki, G., Pacewski, B., Raciborski, W., Slowinski, P., Staszkiewicz, W., Bombic, M., Chlouba, V., Fiedler, J., Hes, K., Kostal, P., Sova, J., Kriz, Z., Privara, M., Reif, M., Staffa, R., Vlachovsky, R., Vojtisek, B., Hrbac, T., Kuliha, M., Prochazka, V., Roubec, M., Skoloudik, D., Netuka, D., Steklacova, A., Benes III, V., Buchvald, P., Endrych, L., Sercl, M., Campos, W., Casella, I. B., de Luccia, N., Estenssoro, A. E. V., Presti, C., Puech-Leao, P., Neves, C. R. B., da Silva, E. S., Sitrangulo, C. J., Monteiro, J. A. T., Tinone, G., Bellini Dalio, M., Joviliano, E. E., Pontes Neto, O. M., Serra Ribeiro, M., Cras, P., Hendriks, J. M. H., Hoppenbrouwers, M., Lauwers, P., Loos, C., Yperzeele, L., Geenens, M., Hemelsoet, D., van Herzeele, I., Vermassen, F., Astarci, P., Hammer, F., Lacroix, V., Peeters, A., Verhelst, R., Cirelli, S., Dormal, P., Grimonprez, A., Lambrecht, B., Lerut, P., Thues, E., De Koster, G., Desiron, Q., Maertens de Noordhout, A., Malmendier, D., Massoz, M., Saad, G., Bosiers, M., Callaert, J., Deloose, K., Blanco Canibano, E., Garcia Fresnillo, B., Guerra Requena, M., Morata Barrado, P. C., Muela Mendez, M., Yusta Izquierdo, A., Aparici Robles, F., Blanes Orti, P., Garcia Dominguez, L., Martinez Lopez, R., Miralles Hernandez, M., Tembl Ferrairo, J. I., Chamorro, A., Macho, J., Obach, V., Riambau, V., San Roman, L., Ahlhelm, F. J., Blackham, K., Engelter, S., Eugster, T., Gensicke, H., Gurke, L., Lyrer, P., Mariani, L., Maurer, M., Mujagic, E., Muller, M., Psychogios, M., Stierli, P., Stippich, C., Traenka, C., Wolff, T., Wagner, B., Wiegert, M. M., Clarke, S., Diepers, M., Grochenig, E., Gruber, P., Isaak, A., Kahles, T., Marti, R., Nedeltchev, K., Remonda, L., Tissira, N., Valenca Falcao, M., de Borst, G. J., Lo, R. H., Moll, F. L., Toorop, R., van der Worp, B. H., Vonken, E. J., Kappelle, J. L., Jahrome, O., Vos, F., Schuiling, W., van Overhagen, H., Keunen, R. W. M., Knippenberg, B., Wever, J. J., Lardenoije, J. W., Reijnen, M., Smeets, L., van Sterkenburg, S., Fraedrich, G., Gizewski, E., Gruber, I., Knoflach, M., Kiechl, S., Rantner, B., Abdulamit, T., Bergeron, P., Padovani, R., Trastour, J. -C., Cardon, J. -M., Le Gallou-Wittenberg, A., Allaire, E., Becquemin, J. -P., Cochennec-Paliwoda, F., Desgranges, P., Hosseini, H., Kobeiter, H., Marzelle, J., Almekhlafi, M. A., Bal, S., Barber, P. A., Coutts, S. B., Demchuk, A. M., Eesa, M., Gillies, M., Goyal, M., Hill, M. D., Hudon, M. E., Jambula, A., Kenney, C., Klein, G., Mcclelland, M., Mitha, A., Menon, B. K., Morrish, W. F., Peters, S., Ryckborst, K. J., Samis, G., Save, S., Smith, E. E., Stys, P., Subramaniam, S., Sutherland, G. R., Watson, T., Wong, J. H., Zimmel, L., Flis, V., Matela, J., Miksic, K., Milotic, F., Mrdja, B., Stirn, B., Tetickovic, E., Gasparini, M., Grad, A., Kompara, I., Milosevic, Z., Palmiste, V., Toomsoo, T., Aidashova, B., Kospanov, N., Lyssenko, R., Mussagaliev, D., Beyar, R., Hoffman, A., Karram, T., Kerner, A., Nikolsky, E., Nitecki, S., Andonova, S., Bachvarov, C., Petrov, V., Cvjetko, I., Vidjak, V., Haluzan, D., Petrunic, M., Liu, B., Liu, C. -W., Bartko, D., Beno, P., Rusnak, F., Zelenak, K., Ezura, M., Inoue, T., Kimura, N., Kondo, R., Matsumoto, Y., Shimizu, H., Endo, H., Furui, E., Bakke, S., Krohg-Sorensen, K., Nome, T., Skjelland, M., Tennoe, B., Albuquerque e Castro, J., Alves, G., Bastos Goncalves, F., de Aragao Morais, J., Garcia, A. C., Valentim, H., Vasconcelos, L., Belcastro, F., Cura, F., Zaefferer, P., Abd-Allah, F., Eldessoki, M. H., Heshmat Kassem, H., Soliman Gharieb, H., Colgan, M. P., Haider, S. N., Harbison, J., Madhavan, P., Moore, D., Shanik, G., Kazan, V., Nazzal, M., Ramsey-Williams, V., Burzotta F. (ORCID:0000-0002-6569-9401), Tinelli G. (ORCID:0000-0002-2212-3226), Tshomba Y. (ORCID:0000-0001-7304-7553), and Vincenzoni C.
- Abstract
Background: Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods: ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings: Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86–1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA
- Published
- 2021
5. External Validation of the Swedvasc Registry: A First-time Individual Cross-matching with the Unique Personal Identity Number
- Author
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Troëng, T., Malmstedt, J., and Björck, M.
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- 2008
- Full Text
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6. A Randomized Prospective Study of Valvulotome Efficacy in In situ Reconstructions
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Malmstedt, J., Takolander, R., and Wahlberg, E.
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- 2005
- Full Text
- View/download PDF
7. Influence of perioperative blood glucose levels on outcome after infrainguinal bypass surgery in patients with diabetes
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Malmstedt, J., Wahlberg, E., Jörneskog, G., and Swedenborg, J.
- Published
- 2006
8. 2-cm versus 4-cm surgical excision margins for primary cutaneous melanoma thicker than 2 mm:long-term follow-up of a multicentre, randomised trial
- Author
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Utjés, Deborah, Malmstedt, J., Teras, Jüri, Drzewiecki, Krzysztof, Gullestad, Hans Petter, Ingvar, Christian, Eriksson, H., Gillgren, P., Utjés, Deborah, Malmstedt, J., Teras, Jüri, Drzewiecki, Krzysztof, Gullestad, Hans Petter, Ingvar, Christian, Eriksson, H., and Gillgren, P.
- Abstract
Background: The optimal surgical excision margins are uncertain for patients with thick (>2 mm) localised cutaneous melanomas. In our previous report of this multicentre, randomised controlled trial, with a median follow-up of 6·7 years, we showed that a narrow excision margin (2 cm vs 4 cm) did not affect melanoma-specific nor overall survival. Here, we present extended follow-up of this cohort. Methods: In this open-label, multicentre randomised controlled trial, we recruited patients from 53 hospitals in Sweden, Denmark, Estonia, and Norway. We enrolled clinically staged patients aged 75 years or younger diagnosed with localised cutaneous melanoma thicker than 2 mm, and with primary site on the trunk or upper or lower extremities. Patients were randomly allocated (1:1) to treatment either with a 2-cm or a 4-cm excision margin. A physician enrolled the patients after histological confirmation of a cutaneous melanoma thicker than 2 mm. Some patients were enrolled by a physician acting as responsible for clinical care and as a trial investigator (follow-up, data collection, and manuscript writing). In other cases physicians not involved in running the trial enrolled patients. Randomisation was done by telephone call to a randomisation office, by sealed envelope, or by computer generated lists using permuted blocks. Patients were stratified according to geographical region. No part of the trial was masked. The primary outcome in this extended follow-up study was overall survival and the co-primary outcome was melanoma-specific survival. All analyses were done on an intention-to-treat basis. The study is registered with ClinicalTrials.gov, number NCT03638492. Findings: Between Jan 22, 1992, and May 19, 2004, 936 clinically staged patients were recruited and randomly assigned to a 4-cm excision margin (n=465) or a 2-cm excision margin (n=471). At a median overall follow-up of 19·6 years (235 months, IQR 200–260), 621 deaths were reported—304 (49%) in the 2-cm gro
- Published
- 2019
9. Dual Antiplatelet Therapy Improves Outcome in Diabetic Patients Undergoing Endovascular Femoropopliteal Stenting for Critical Limb Ischaemia
- Author
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Thott, O., primary, Granath, F., additional, Malmstedt, J., additional, and Wahlgren, C.-M., additional
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- 2017
- Full Text
- View/download PDF
10. The Receptor for Advanced Glycation End Products (Rage) and Its Ligands in Plasma and Infrainguinal Bypass Vein
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Malmstedt, J., primary, Frebelius, S., additional, Lengquist, M., additional, Jörneskog, G., additional, Wang, J., additional, and Swedenborg, J., additional
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- 2016
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11. The Receptor for Advanced Glycation End Products (RAGE) and its Ligands in Plasma and Infrainguinal Bypass Vein
- Author
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Malmstedt, J., primary
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- 2014
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12. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial.
- Author
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Giroux M.-F., Prakash K.G., Serracino-Inglott F., Subramanian G., Symth J.V., Walker M.G., Clarke M., Davis M., Dixit S.A., Dorman P., Dyker A., Ford G., Golkar A., Jackson R., Jayakrishnan V., Lambert D., Lees T., Louw S., Mendelow A.D., Rodgers H., Rose J., Stansby G., Wyatt M., Baker T., Baldwin N., Jones L., Mitchell D., Munro E., Thornton M., Baker D., Davis N., Hamilton G., Platts A., Tibballs J., Beard J., Cleveland T., Dodd D., Gaines P., Lonsdale R., Nair R., Nassef A., Nawaz S., Venables G., Belli A., Clifton A., Cloud G., Halliday A., Markus H., McFarland R., Morgan R., Pereira A., Thompson A., Chataway J., Cheshire N., Gibbs R., Hammady M., Jenkins M., Malik I., Wolfe J., Adiseshiah M., Bishop C., Brew S., Brookes J., Jager R., Kitchen N., Ashleigh R., Butterfield S., Gamble G.E., Nasim A., O'Neill P., Wong J., Edwards R.D., Lees K.R., MacKay A.J., Moss J., Rogers P., Ederle J., Dobson J., Featherstone R.L., Bonati L.H., van der Worp H.B., de Borst G.J., Hauw Lo T., Dorman P.J., Macdonald S., Lyrer P.A., McCollum C., Nederkoorn P.J., Brown M.M., Algra A., Bamford J., Bland M., Hacke W., Mas J.L., McGuire A.J., Sidhu P., Bradbury A., Collins R., Molyneux A., Naylor R., Warlow C., Ferro M., Thomas D., Featherstone R.F., Tindall H., McCabe D., Wallis A., Coward L., Brooks M., Chambers B., Chan A., Chu P., Clark D., Dewey H., Donnan G., Fell G., Hoare M., Molan M., Roberts A., Roberts N., Beiles B., Bladin C., Clifford C., Grigg M., New G., Bell R., Bower S., Chong W., Holt M., Saunder A., Than P.G., Gett S., Leggett D., McGahan T., Quinn J., Ray M., Wong A., Woodruff P., Foreman R., Schultz D., Scroop R., Stanley B., Allard B., Atkinson N., Cambell W., Davies S., Field P., Milne P., Mitchell P., Tress B., Yan B., Beasley A., Dunbabin D., Stary D., Walker S., Cras P., d'Archambeau O., Hendriks J.M.H., Van Schil P., Bosiers M., Deloose K., van Buggenhout E., De Letter J., Devos V., Ghekiere J., Vanhooren G., Astarci P., Hammer F., Lacroix V., Verhelst R., DeJaegher L., Peeters A., Verbist J., Blair J.-F., Caron J.L., Daneault N., Guilbert F., Lanthier S., Lebrun L.-H., Oliva V., Raymond J., Roy D., Soulez G., Weill A., Hill M., Hu W., Hudion M., Morrish W., Sutherland G., Alback A., Harno H., Ijas P., Kaste M., Lepantalo M., Mustanoja S., Paananen T., Porras M., Putaala J., Railo M., Sairanen T., Soinne L., Vehmas A., Vikatmaa P., Goertler M., Halloul Z., Skalej M., Brennan P., Kelly C., Leahy A., Moroney J., Thornton J., Koelemay M.J.W., Reekers J.A.A., Roos Y.B.W.E.M., Hendriks J.M., Koudstaal P.J., Pattynama P.M.T., van der Lugt A., van Dijk L.C., van Sambeek M.R.H.M., van Urk H., Verhagen H.J.M., Bruijninckx C.M.A., de Bruijn S.F., Keunen R., Knippenberg B., Mosch A., Treurniet F., van Dijk L., van Overhagen H., Wever J., de Beer F.C., van den Berg J.S.P., van Hasselt B.A.A.M., Zeilstra D.J., Boiten J., de Mol van Otterloo J.C.A., de Vries A.C., Lycklama a Nijeholt G.J., van der Kallen B.F.W., Blankensteijn J.D., De Leeuw F.E., Schultze Kool L.J., van der Vliet J.A., de Kort G.A.P., Kapelle L.J., Lo T.H., Mali W.P.T.M., Moll F., Verhagen H., Barber P.A., Bourchier R., Hill A., Holden A., Stewart J., Bakke S.J., Krohg-Sorensen K., Skjelland M., Tennoe B., Bialek P., Biejat Z., Czepiel W., Czlonkowska A., Dowzenko A., Jedrzejewska J., Kobayashi A., Lelek M., Polanski J., Kirbis J., Milosevic Z., Zvan B., Blasco J., Chamorro A., Macho J., Obach V., Riambau V., San Roman L., Branera J., Canovas D., Estela J., Gimenez Gaibar A., Perendreu J., Bjorses K., Gottsater A., Ivancev K., Maetzsch T., Sonesson B., Berg B., Delle M., Formgren J., Gillgren P., Kall T.-B., Konrad P., Nyman N., Takolander R., Andersson T., Malmstedt J., Soderman M., Wahlgren C., Wahlgren N., Binaghi S., Hirt L., Michel P., Ruchat P., Engelter S.T., Fluri F., Guerke L., Jacob A.L., Kirsch E., Radue E.-W., Stierli P., Wasner M., Wetzel S., Bonvin C., Kalangos A., Lovblad K., Murith N., Ruefenacht D., Sztajzel R., Higgins N., Kirkpatrick P.J., Martin P., Adam D., Bell J., Bradbury A.W., Crowe P., Gannon M., Henderson M.J., Sandler D., Shinton R.A., Scriven J.M., Wilmink T., D'Souza S., Egun A., Guta R., Punekar S., Seriki D.M., Thomson G., Brennan J.A., Enevoldson T.P., Gilling-Smith G., Gould D.A., Harris P.L., McWilliams R.G., Nasser H.-C., White R., Giroux M.-F., Prakash K.G., Serracino-Inglott F., Subramanian G., Symth J.V., Walker M.G., Clarke M., Davis M., Dixit S.A., Dorman P., Dyker A., Ford G., Golkar A., Jackson R., Jayakrishnan V., Lambert D., Lees T., Louw S., Mendelow A.D., Rodgers H., Rose J., Stansby G., Wyatt M., Baker T., Baldwin N., Jones L., Mitchell D., Munro E., Thornton M., Baker D., Davis N., Hamilton G., Platts A., Tibballs J., Beard J., Cleveland T., Dodd D., Gaines P., Lonsdale R., Nair R., Nassef A., Nawaz S., Venables G., Belli A., Clifton A., Cloud G., Halliday A., Markus H., McFarland R., Morgan R., Pereira A., Thompson A., Chataway J., Cheshire N., Gibbs R., Hammady M., Jenkins M., Malik I., Wolfe J., Adiseshiah M., Bishop C., Brew S., Brookes J., Jager R., Kitchen N., Ashleigh R., Butterfield S., Gamble G.E., Nasim A., O'Neill P., Wong J., Edwards R.D., Lees K.R., MacKay A.J., Moss J., Rogers P., Ederle J., Dobson J., Featherstone R.L., Bonati L.H., van der Worp H.B., de Borst G.J., Hauw Lo T., Dorman P.J., Macdonald S., Lyrer P.A., McCollum C., Nederkoorn P.J., Brown M.M., Algra A., Bamford J., Bland M., Hacke W., Mas J.L., McGuire A.J., Sidhu P., Bradbury A., Collins R., Molyneux A., Naylor R., Warlow C., Ferro M., Thomas D., Featherstone R.F., Tindall H., McCabe D., Wallis A., Coward L., Brooks M., Chambers B., Chan A., Chu P., Clark D., Dewey H., Donnan G., Fell G., Hoare M., Molan M., Roberts A., Roberts N., Beiles B., Bladin C., Clifford C., Grigg M., New G., Bell R., Bower S., Chong W., Holt M., Saunder A., Than P.G., Gett S., Leggett D., McGahan T., Quinn J., Ray M., Wong A., Woodruff P., Foreman R., Schultz D., Scroop R., Stanley B., Allard B., Atkinson N., Cambell W., Davies S., Field P., Milne P., Mitchell P., Tress B., Yan B., Beasley A., Dunbabin D., Stary D., Walker S., Cras P., d'Archambeau O., Hendriks J.M.H., Van Schil P., Bosiers M., Deloose K., van Buggenhout E., De Letter J., Devos V., Ghekiere J., Vanhooren G., Astarci P., Hammer F., Lacroix V., Verhelst R., DeJaegher L., Peeters A., Verbist J., Blair J.-F., Caron J.L., Daneault N., Guilbert F., Lanthier S., Lebrun L.-H., Oliva V., Raymond J., Roy D., Soulez G., Weill A., Hill M., Hu W., Hudion M., Morrish W., Sutherland G., Alback A., Harno H., Ijas P., Kaste M., Lepantalo M., Mustanoja S., Paananen T., Porras M., Putaala J., Railo M., Sairanen T., Soinne L., Vehmas A., Vikatmaa P., Goertler M., Halloul Z., Skalej M., Brennan P., Kelly C., Leahy A., Moroney J., Thornton J., Koelemay M.J.W., Reekers J.A.A., Roos Y.B.W.E.M., Hendriks J.M., Koudstaal P.J., Pattynama P.M.T., van der Lugt A., van Dijk L.C., van Sambeek M.R.H.M., van Urk H., Verhagen H.J.M., Bruijninckx C.M.A., de Bruijn S.F., Keunen R., Knippenberg B., Mosch A., Treurniet F., van Dijk L., van Overhagen H., Wever J., de Beer F.C., van den Berg J.S.P., van Hasselt B.A.A.M., Zeilstra D.J., Boiten J., de Mol van Otterloo J.C.A., de Vries A.C., Lycklama a Nijeholt G.J., van der Kallen B.F.W., Blankensteijn J.D., De Leeuw F.E., Schultze Kool L.J., van der Vliet J.A., de Kort G.A.P., Kapelle L.J., Lo T.H., Mali W.P.T.M., Moll F., Verhagen H., Barber P.A., Bourchier R., Hill A., Holden A., Stewart J., Bakke S.J., Krohg-Sorensen K., Skjelland M., Tennoe B., Bialek P., Biejat Z., Czepiel W., Czlonkowska A., Dowzenko A., Jedrzejewska J., Kobayashi A., Lelek M., Polanski J., Kirbis J., Milosevic Z., Zvan B., Blasco J., Chamorro A., Macho J., Obach V., Riambau V., San Roman L., Branera J., Canovas D., Estela J., Gimenez Gaibar A., Perendreu J., Bjorses K., Gottsater A., Ivancev K., Maetzsch T., Sonesson B., Berg B., Delle M., Formgren J., Gillgren P., Kall T.-B., Konrad P., Nyman N., Takolander R., Andersson T., Malmstedt J., Soderman M., Wahlgren C., Wahlgren N., Binaghi S., Hirt L., Michel P., Ruchat P., Engelter S.T., Fluri F., Guerke L., Jacob A.L., Kirsch E., Radue E.-W., Stierli P., Wasner M., Wetzel S., Bonvin C., Kalangos A., Lovblad K., Murith N., Ruefenacht D., Sztajzel R., Higgins N., Kirkpatrick P.J., Martin P., Adam D., Bell J., Bradbury A.W., Crowe P., Gannon M., Henderson M.J., Sandler D., Shinton R.A., Scriven J.M., Wilmink T., D'Souza S., Egun A., Guta R., Punekar S., Seriki D.M., Thomson G., Brennan J.A., Enevoldson T.P., Gilling-Smith G., Gould D.A., Harris P.L., McWilliams R.G., Nasser H.-C., and White R.
- Abstract
Background: Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. Method(s): The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded adjudication of outcomes. Patients with recently symptomatic carotid artery stenosis were randomly assigned in a 1:1 ratio to receive carotid artery stenting or carotid endarterectomy. Randomisation was by telephone call or fax to a central computerised service and was stratified by centre with minimisation for sex, age, contralateral occlusion, and side of the randomised artery. Patients and investigators were not masked to treatment assignment. Patients were followed up by independent clinicians not directly involved in delivering the randomised treatment. The primary outcome measure of the trial is the 3-year rate of fatal or disabling stroke in any territory, which has not been analysed yet. The main outcome measure for the interim safety analysis was the 120-day rate of stroke, death, or procedural myocardial infarction. Analysis was by intention to treat (ITT). This study is registered, number ISRCTN25337470. Finding(s): The trial enrolled 1713 patients (stenting group, n=855; endarterectomy group, n=858). Two patients in the stenting group and one in the endarterectomy group withdrew immediately after randomisation, and were not included in the ITT analysis. Between randomisation and 120 days, there were 34 (Kaplan-Meier estimate 4.0%) events of disabling stroke or death in the stenting group compared with 27 (3.2%) events in the endarterectomy group (hazard ratio [HR] 1.28, 95% CI 0.77-2.11). The incidence of stroke, death, or procedural myocardial infarction was 8.5% in the stenting group compared with 5.2% in the endarterectomy group (72 vs 44 events; HR 1.69, 1.
- Published
- 2010
13. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial
- Author
-
Ederle, Jörg, Dobson, Joanna, Featherstone, Roland L., Bonati, Leo H., van der Worp, H. Bart, de Borst, Gert J., Hauw Lo, T., Gaines, Peter, Dorman, Paul J., Macdonald, Sumaira, Lyrer, Philippe A., Hendriks, Johanna M., McCollum, Charles, Nederkoorn, Paul J., Brown, Martin M., Algra, A., Bamford, J., Bland, M., Hacke, W., Mas, J.L., McGuire, A.J., Sidhu, P., Bradbury, A., Collins, R., Molyneux, A., Naylor, R., Warlow, C., Ferro, M., Thomas, D., Featherstone, R.F., Tindall, H., McCabe, D.J.H., Wallis, A., Coward, L., Brooks, M., Chambers, B., Chan, A., Chu, P., Clark, D., Dewey, H., Donnan, G., Fell, G., Hoare, M., Molan, M., Roberts, A., Roberts, N., Beiles, B., Bladin, C., Clifford, C., Grigg, M., New, G., Bell, R., Bower, S., Chong, W., Holt, M., Saunder, A., Than, P.G., Gett, S., Leggett, D., McGahan, T., Quinn, J., Ray, M., Wong, A., Woodruff, P., Foreman, R., Schultz, D., Scroop, R., Stanley, B., Allard, B., Atkinson, N., Cambell, W., Davies, S., Field, P., Milne, P., Mitchell, P., Tress, B., Yan, B., Beasley, A., Dunbabin, D., Stary, D., Walker, S., Cras, P., d'Archambeau, O., Hendriks, J.M.H., Van Schil, P., Bosiers, M., Deloose, K., van Buggenhout, E., De Letter, J., Devos, V., Ghekiere, J., Vanhooren, G., Astarci, P., Hammer, F., Lacroix, V., Peeters, A., Verhelst, R., DeJaegher, L., Verbist, J., Blair, J.-F., Caron, J.L., Daneault, N., Giroux, M.-F., Guilbert, F., Lanthier, S., Lebrun, L.-H., Oliva, V., Raymond, J., Roy, D., Soulez, G., Weill, A., Hill, M., Hu, W., Hudion, M., Morrish, W., Sutherland, G., Wong, J., Albäck, A., Harno, H., Ijäs, P., Kaste, M., Lepäntalo, M., Mustanoja, S., Paananen, T., Porras, M., Putaala, J., Railo, M., Sairanen, T., Soinne, L., Vehmas, A., Vikatmaa, P., Goertler, M., Halloul, Z., Skalej, M., Brennan, P., Kelly, C., Leahy, A., Moroney, J., Thornton, J., Koelemay, M.J.W., Reekers, J.A.A., Roos, Y.B.W.E.M., Hendriks, J.M., Koudstaal, P.J., Pattynama, P.M.T., van der Lugt, A., van Dijk, L.C., van Sambeek, M.R.H.M., van Urk, H., Verhagen, H.J.M., Bruijninckx, C.M.A., de Bruijn, S.F., Keunen, R., Knippenberg, B., Mosch, A., Treurniet, F., van Dijk, L., van Overhagen, H., Wever, J., de Beer, F.C., van den Berg, J.S.P., van Hasselt, B.A.A.M., Zeilstra, D.J., Boiten, J., de Mol van Otterloo, J.C.A., de Vries, A.C., Lycklama a Nijeholt, G.J., van der Kallen, B.F.W., Blankensteijn, J.D., De Leeuw, F.E., Schultze Kool, L.J., van der Vliet, J.A., de Kort, G.A.P., Kapelle, L.J., Lo, T.H., Mali, W.P.T.M., Moll, F., Verhagen, H., Barber, P.A., Bourchier, R., Hill, A., Holden, A., Stewart, J., Bakke, S.J., Krohg-Sørensen, K., Skjelland, M., Tennøe, B., Bialek, P., Biejat, Z., Czepiel, W., Czlonkowska, A., Dowzenko, A., Jedrzejewska, J., Kobayashi, A., Lelek, M., Polanski, J., Kirbis, J., Milosevic, Z., Zvan, B., Blasco, J., Chamorro, A., Macho, J., Obach, V., Riambau, V., San Roman, L., Branera, J., Canovas, D., Estela, Jordi, Gimenez Gaibar, A., Perendreu, J., Björses, K., Gottsater, A., Ivancev, K., Maetzsch, T., Sonesson, B., Berg, B., Delle, M., Formgren, J., Gillgren, P., Kall, T.-B., Konrad, P., Nyman, N., Takolander, R., Andersson, T., Malmstedt, J., Soderman, M., Wahlgren, C., Wahlgren, N., Binaghi, S., Hirt, L., Michel, P., Ruchat, P., Engelter, S.T., Fluri, F., Guerke, L., Jacob, A.L., Kirsch, E., Radue, E.-W., Stierli, P., Wasner, M., Wetzel, S., Bonvin, C., Kalangos, A., Lovblad, K., Murith, N., Ruefenacht, D., Sztajzel, R., Higgins, N., Kirkpatrick, P.J., Martin, P., Adam, D., Bell, J., Bradbury, A.W., Crowe, P., Gannon, M., Henderson, M.J., Sandler, D., Shinton, R.A., Scriven, J.M., Wilmink, T., D'Souza, S., Egun, A., Guta, R., Punekar, S., Seriki, D.M., Thomson, G., Brennan, J.A., Enevoldson, T.P., Gilling-Smith, G., Gould, D.A., Harris, P.L., McWilliams, R.G., Nasser, H.-C., White, R., Prakash, K.G., Serracino-Inglott, F., Subramanian, G., Symth, J.V., Walker, M.G., Clarke, M., Davis, M., Dixit, S.A., Dorman, P., Dyker, A., Ford, G., Golkar, A., Jackson, R., Jayakrishnan, V., Lambert, D., Lees, T., Louw, S., Mendelow, A.D., Rodgers, H., Rose, J., Stansby, G., Wyatt, M., Baker, T., Baldwin, N., Jones, L., Mitchell, D., Munro, E., Thornton, M., Baker, D., Davis, N., Hamilton, G., McCabe, D., Platts, A., Tibballs, J., Beard, J., Cleveland, T., Dodd, D., Gaines, P., Lonsdale, R., Nair, R., Nassef, A., Nawaz, S., Venables, G., Belli, A., Clifton, A., Cloud, G., Halliday, A., Markus, H., McFarland, R., Morgan, R., Pereira, A., Thompson, A., Chataway, J., Cheshire, N., Gibbs, R., Hammady, M., Jenkins, M., Malik, I., Wolfe, J., Adiseshiah, M., Bishop, C., Brew, S., Brookes, J., Jäger, R., Kitchen, N., Ashleigh, R., Butterfield, S., Gamble, G.E., Nasim, A., O'Neill, P., Edwards, R.D., Lees, K.R., MacKay, A.J., Moss, J., Rogers, P., Ederle, Jörg, Dobson, Joanna, Featherstone, Roland L., Bonati, Leo H., van der Worp, H. Bart, de Borst, Gert J., Hauw Lo, T., Gaines, Peter, Dorman, Paul J., Macdonald, Sumaira, Lyrer, Philippe A., Hendriks, Johanna M., McCollum, Charles, Nederkoorn, Paul J., Brown, Martin M., Algra, A., Bamford, J., Bland, M., Hacke, W., Mas, J.L., McGuire, A.J., Sidhu, P., Bradbury, A., Collins, R., Molyneux, A., Naylor, R., Warlow, C., Ferro, M., Thomas, D., Featherstone, R.F., Tindall, H., McCabe, D.J.H., Wallis, A., Coward, L., Brooks, M., Chambers, B., Chan, A., Chu, P., Clark, D., Dewey, H., Donnan, G., Fell, G., Hoare, M., Molan, M., Roberts, A., Roberts, N., Beiles, B., Bladin, C., Clifford, C., Grigg, M., New, G., Bell, R., Bower, S., Chong, W., Holt, M., Saunder, A., Than, P.G., Gett, S., Leggett, D., McGahan, T., Quinn, J., Ray, M., Wong, A., Woodruff, P., Foreman, R., Schultz, D., Scroop, R., Stanley, B., Allard, B., Atkinson, N., Cambell, W., Davies, S., Field, P., Milne, P., Mitchell, P., Tress, B., Yan, B., Beasley, A., Dunbabin, D., Stary, D., Walker, S., Cras, P., d'Archambeau, O., Hendriks, J.M.H., Van Schil, P., Bosiers, M., Deloose, K., van Buggenhout, E., De Letter, J., Devos, V., Ghekiere, J., Vanhooren, G., Astarci, P., Hammer, F., Lacroix, V., Peeters, A., Verhelst, R., DeJaegher, L., Verbist, J., Blair, J.-F., Caron, J.L., Daneault, N., Giroux, M.-F., Guilbert, F., Lanthier, S., Lebrun, L.-H., Oliva, V., Raymond, J., Roy, D., Soulez, G., Weill, A., Hill, M., Hu, W., Hudion, M., Morrish, W., Sutherland, G., Wong, J., Albäck, A., Harno, H., Ijäs, P., Kaste, M., Lepäntalo, M., Mustanoja, S., Paananen, T., Porras, M., Putaala, J., Railo, M., Sairanen, T., Soinne, L., Vehmas, A., Vikatmaa, P., Goertler, M., Halloul, Z., Skalej, M., Brennan, P., Kelly, C., Leahy, A., Moroney, J., Thornton, J., Koelemay, M.J.W., Reekers, J.A.A., Roos, Y.B.W.E.M., Hendriks, J.M., Koudstaal, P.J., Pattynama, P.M.T., van der Lugt, A., van Dijk, L.C., van Sambeek, M.R.H.M., van Urk, H., Verhagen, H.J.M., Bruijninckx, C.M.A., de Bruijn, S.F., Keunen, R., Knippenberg, B., Mosch, A., Treurniet, F., van Dijk, L., van Overhagen, H., Wever, J., de Beer, F.C., van den Berg, J.S.P., van Hasselt, B.A.A.M., Zeilstra, D.J., Boiten, J., de Mol van Otterloo, J.C.A., de Vries, A.C., Lycklama a Nijeholt, G.J., van der Kallen, B.F.W., Blankensteijn, J.D., De Leeuw, F.E., Schultze Kool, L.J., van der Vliet, J.A., de Kort, G.A.P., Kapelle, L.J., Lo, T.H., Mali, W.P.T.M., Moll, F., Verhagen, H., Barber, P.A., Bourchier, R., Hill, A., Holden, A., Stewart, J., Bakke, S.J., Krohg-Sørensen, K., Skjelland, M., Tennøe, B., Bialek, P., Biejat, Z., Czepiel, W., Czlonkowska, A., Dowzenko, A., Jedrzejewska, J., Kobayashi, A., Lelek, M., Polanski, J., Kirbis, J., Milosevic, Z., Zvan, B., Blasco, J., Chamorro, A., Macho, J., Obach, V., Riambau, V., San Roman, L., Branera, J., Canovas, D., Estela, Jordi, Gimenez Gaibar, A., Perendreu, J., Björses, K., Gottsater, A., Ivancev, K., Maetzsch, T., Sonesson, B., Berg, B., Delle, M., Formgren, J., Gillgren, P., Kall, T.-B., Konrad, P., Nyman, N., Takolander, R., Andersson, T., Malmstedt, J., Soderman, M., Wahlgren, C., Wahlgren, N., Binaghi, S., Hirt, L., Michel, P., Ruchat, P., Engelter, S.T., Fluri, F., Guerke, L., Jacob, A.L., Kirsch, E., Radue, E.-W., Stierli, P., Wasner, M., Wetzel, S., Bonvin, C., Kalangos, A., Lovblad, K., Murith, N., Ruefenacht, D., Sztajzel, R., Higgins, N., Kirkpatrick, P.J., Martin, P., Adam, D., Bell, J., Bradbury, A.W., Crowe, P., Gannon, M., Henderson, M.J., Sandler, D., Shinton, R.A., Scriven, J.M., Wilmink, T., D'Souza, S., Egun, A., Guta, R., Punekar, S., Seriki, D.M., Thomson, G., Brennan, J.A., Enevoldson, T.P., Gilling-Smith, G., Gould, D.A., Harris, P.L., McWilliams, R.G., Nasser, H.-C., White, R., Prakash, K.G., Serracino-Inglott, F., Subramanian, G., Symth, J.V., Walker, M.G., Clarke, M., Davis, M., Dixit, S.A., Dorman, P., Dyker, A., Ford, G., Golkar, A., Jackson, R., Jayakrishnan, V., Lambert, D., Lees, T., Louw, S., Mendelow, A.D., Rodgers, H., Rose, J., Stansby, G., Wyatt, M., Baker, T., Baldwin, N., Jones, L., Mitchell, D., Munro, E., Thornton, M., Baker, D., Davis, N., Hamilton, G., McCabe, D., Platts, A., Tibballs, J., Beard, J., Cleveland, T., Dodd, D., Gaines, P., Lonsdale, R., Nair, R., Nassef, A., Nawaz, S., Venables, G., Belli, A., Clifton, A., Cloud, G., Halliday, A., Markus, H., McFarland, R., Morgan, R., Pereira, A., Thompson, A., Chataway, J., Cheshire, N., Gibbs, R., Hammady, M., Jenkins, M., Malik, I., Wolfe, J., Adiseshiah, M., Bishop, C., Brew, S., Brookes, J., Jäger, R., Kitchen, N., Ashleigh, R., Butterfield, S., Gamble, G.E., Nasim, A., O'Neill, P., Edwards, R.D., Lees, K.R., MacKay, A.J., Moss, J., and Rogers, P.
- Abstract
Background: Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. Methods: The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded adjudication of outcomes. Patients with recently symptomatic carotid artery stenosis were randomly assigned in a 1:1 ratio to receive carotid artery stenting or carotid endarterectomy. Randomisation was by telephone call or fax to a central computerised service and was stratified by centre with minimisation for sex, age, contralateral occlusion, and side of the randomised artery. Patients and investigators were not masked to treatment assignment. Patients were followed up by independent clinicians not directly involved in delivering the randomised treatment. The primary outcome measure of the trial is the 3-year rate of fatal or disabling stroke in any territory, which has not been analysed yet. The main outcome measure for the interim safety analysis was the 120-day rate of stroke, death, or procedural myocardial infarction. Analysis was by intention to treat (ITT). This study is registered, number ISRCTN25337470. Findings: The trial enrolled 1713 patients (stenting group, n=855; endarterectomy group, n=858). Two patients in the stenting group and one in the endarterectomy group withdrew immediately after randomisation, and were not included in the ITT analysis. Between randomisation and 120 days, there were 34 (Kaplan-Meier estimate 4·0%) events of disabling stroke or death in the stenting group compared with 27 (3·2%) events in the endarterectomy group (hazard ratio [HR] 1·28, 95% CI 0·77-2·11). The incidence of stroke, death, or procedural myocardial infarction was 8·5% in the stenting group compared with 5·2% in the endarterectomy group (72 vs 44 events; HR 1·69, 1·16-2
- Published
- 2010
14. External validation of the Swedvasc registry : a first-time individual cross-matching with the unique personal identity number
- Author
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Troëng, Thomas, Malmstedt, J., Björck, Martin, Troëng, Thomas, Malmstedt, J., and Björck, Martin
- Abstract
OBJECTIVE: To study external validity of the Swedvasc registry concerning numbers of procedures and mortality. MATERIALS AND METHODS: Vascular registry data for carotid, infrainguinal bypass and aortic aneurysm (AAA) procedures were compared to the Swedish Hospital Discharge Register (SHDR) data, and the National Population Registry (for mortality) by matching every individual patient using the unique personal identity numbers (PINs). The time-period studied was 2000-2004 (5 years) for carotid and infrainguinal procedures. A separate analysis was performed for AAA-surgery in 2006. RESULTS: The external validity for carotid, infrainguinal bypass and AAA repair was 93.4%, 93.0% and 93.1%, respectively. The 30-day mortality was 0.86% after carotid and 2.9% after infrainguinal bypass procedures. Mortality was 2.6% after planned and 25.9% after unplanned AAA repair. Although there was a general trend towards inferior outcomes after procedures not registered in the Swedvasc, those procedures were so few that in none of the analyses did the inclusion of non-registered procedures affect general outcomes significantly. Combining data from both registries, the incidence for carotid, infrainguinal bypass and AAA procedures was 7.8, 15.2 and 13.6 per 100,000 person-years, respectively. In the hospital-specific analysis for 2006 it was shown that the non-registered procedures for AAA were localized to one non-compliant county hospital, and small district hospitals not performing elective AAA-surgery but only rare emergency operations. CONCLUSION: The external and internal validity of the Swedvasc registry allows to confidently assess volumes of, and mortality after, vascular surgery in Sweden.
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- 2008
- Full Text
- View/download PDF
15. Twenty years with the Swedvasc Registry.
- Author
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Björck, M, Bergqvist, D, Eliasson, K, Jansson, I, Karlström, L, Kragsterman, B, Lundell, A, Malmstedt, J, Nordanstig, J, Norgren, L, Troëng, T, Björck, M, Bergqvist, D, Eliasson, K, Jansson, I, Karlström, L, Kragsterman, B, Lundell, A, Malmstedt, J, Nordanstig, J, Norgren, L, and Troëng, T
- Published
- 2008
16. Twenty years with the Swedvasc Registry
- Author
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Björck, M., Bergqvist, D., Eliasson, K., Jansson, I., Karlström, L., Kragsterman, B., Lundell, A., Malmstedt, J., Nordanstig, J., Norgren, Lars, Troëng, T., Björck, M., Bergqvist, D., Eliasson, K., Jansson, I., Karlström, L., Kragsterman, B., Lundell, A., Malmstedt, J., Nordanstig, J., Norgren, Lars, and Troëng, T.
- Published
- 2008
- Full Text
- View/download PDF
17. Influence of perioperative blood glucose levels on outcome after infrainguinal bypass surgery in patients with diabetes
- Author
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Malmstedt, J, Wahlberg, Eric, Jörneskog, G, Swedenborg, J, Malmstedt, J, Wahlberg, Eric, Jörneskog, G, and Swedenborg, J
- Abstract
BACKGROUND: High glucose levels are associated with increased morbidity and mortality after coronary surgery and in intensive care. The influence of perioperative hyperglycaemia on the outcome after infrainguinal bypass surgery among diabetic patients is largely unknown. The aim was to determine whether high perioperative glucose levels were associated with increased morbidity after infrainguinal bypass surgery. METHODS: Ninety-one consecutive diabetic patients undergoing primary infrainguinal bypass surgery were identified from a prospective vascular registry. Risk factors, indication for surgery, operative details and outcome data were extracted from the medical records. Exposure to perioperative hyperglycaemia was measured using the area under the curve (AUC) method; the AUC was calculated using all blood glucose readings during the first 48 h after surgery. RESULTS: Multivariable analysis showed that the AUC for glucose (odds ratio (OR) 13.35, first versus fourth quartile), renal insufficiency (OR 4.77) and infected foot ulcer (OR 3.38) was significantly associated with poor outcome (death, major amputation or graft occlusion at 90 days). Similarly, the AUC for glucose (OR 14.45, first versus fourth quartile), female sex (OR 3.49) and tissue loss as indication (OR 3.30) was associated with surgical wound complications at 30 days. CONCLUSION: Poor perioperative glycaemic control was associated with an unfavourable outcome after infrainguinal bypass surgery in diabetic patients.
- Published
- 2006
- Full Text
- View/download PDF
18. Aortic Dissection in Pregnancy: A Life-threatening Disease and a Diagnosis Worth Considering
- Author
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Nasiell, J., primary, Norman, M., additional, Lindqvist, P.G., additional, Malmstedt, J., additional, Bottinga, R., additional, and Blennow, M., additional
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- 2010
- Full Text
- View/download PDF
19. Twenty Years with the Swedvasc Registry
- Author
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Björck, M., primary, Bergqvist, D., additional, Eliasson, K., additional, Jansson, I., additional, Karlström, L., additional, Kragsterman, B., additional, Lundell, A., additional, Malmstedt, J., additional, Nordanstig, J., additional, Norgren, L., additional, and Troëng, T., additional
- Published
- 2008
- Full Text
- View/download PDF
20. Influence of perioperative blood glucose levels on outcome after infrarenal bypass surgery in patients with diabetes
- Author
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Malmstedt, J., primary, Wahlberg, E., additional, and Jorneskog, G., additional
- Published
- 2007
- Full Text
- View/download PDF
21. Plasma levels of cyclic GMP and endothelin in postmenopausal women with unstable coronary artery disease
- Author
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Nielsen, Niels Erik, Ahlner, Johan, Malmstedt, J, Öhman, K. P., Swahn, Eva, Nielsen, Niels Erik, Ahlner, Johan, Malmstedt, J, Öhman, K. P., and Swahn, Eva
- Abstract
Many women with typical anginal chest pain have normal coronary angiograms, which may be due to altered endothelial function. We evaluated the endothelial markers cyclic GMP (cGMP) and immunoreactive endothelin (ir-ET) regarding presence of coronary atherosclerosis in women with clinical signs of unstable coronary artery disease (CAD). Plasma levels of cGMP and ir-ET were determined in 118 patients and 84 controls. Ischaemia was evaluated at an exercise test. Of the patients 20% had normal vessels, 14% insignificant CAD and 66% significant stenosis at coronary angiography. Mean (95% CI) concentration of cGMP (nmol/l) was higher in patients than in controls (5.05 (4.53; 5.58) vs. 3.79 (3.34; 4.23)). Separating patients according to daily intake of nitroglycerin, only patients with this medication had significantly higher cGMP level (5.73 (4.88; 6.58)), whereas the difference between those without (4.35 (3.76; 4.94)) and controls disappeared. Patients with ischaemia at exercise test had higher cGMP level than those without (6.01 (5.13; 6.88) vs. 4.30 (3.66; 4.94)), even after adjusting for nitroglycerin treatment. ir-ET (pmol/l) was lower in patients with normal vessels than patients with coronary atherosclerosis (0.83 (0.78; 0.88) vs. 0.98 (0.92; 1.04)) and than the control group (0.91 (0.87; 0.94)). The difference between the control group and patients with atherosclerosis was also significant. Patients with unstable CAD and long-term nitroglycerin treatment have increased cGMP level. Patients with exercise-induced ischaemia have higher cGMP level than those without, irrespective of nitroglycerin treatment, which may reflect a general compensatory mechanism. Patients with normal vessels have low level of ir-ET, indicating different mechanisms for ischaemia/angina in these patients compared with patients with atherosclerosis.
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- 1999
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22. Plasma levels of cyclic GMP and endothelin in postmenopausal women with unstable coronary artery disease
- Author
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Nielsen, N E, primary, Ahlner, J, additional, Malmstedt, J, additional, Öhman, K P, additional, and Swahn, E., additional
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- 1999
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23. Outcome after leg bypass surgery for critical limb ischemia is poor in patients with diabetes: a population-based cohort study.
- Author
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Malmstedt J, Leander K, Wahlberg E, Karlström L, Alfredsson L, and Swedenborg J
- Abstract
OBJECTIVE: Our aim was to assess the risk of major amputation or death after leg bypass surgery for critical limb ischemia in patients with diabetes versus those without. RESEARCH DESIGN AND METHODS: We did a population-based cohort study by linking nationwide databases in Sweden. We identified 1,840 patients in the Swedish Vascular Registry who had their first leg bypass procedure for critical lower-limb ischemia between 1 January 2001 and 31 December 2003-742 with and 1,098 without diabetes. Our primary end point was first major amputation of the limb on which bypass was done or death. Individuals were followed up until 31 December 2005 through the National Hospital Patient Registry and the Cause-of-Death Registry. RESULTS: Incidence of ipsilateral amputation or death was higher in patients with diabetes than in patients without (30.2 vs. 22 events/100 person-years; crude hazard ratio [HR] 1.32 [95% CI 1.17-1.50]). Similarly, individuals with diabetes had a shorter amputation-free survival period than individuals without (2.3 years, range 1.9-2.8 vs. 3.4 years, range 3.1-3.7). Adjustment for demographic characteristics, comorbidities, and risk factors for amputation or death did not substantially affect the risk (HR 1.46 [95% CI 1.26-1.69]). The effect was more pronounced in male (1.75 [1.47-2.08]) than in female (1.35 [1.11-1.64]) patients after adjustment for age. CONCLUSIONS: Diabetes is associated with lower amputation-free survival after leg bypass for critical limb ischemia. Patients with diabetes and limb ischemia need intensified treatment of diabetes-related risk factors to improve outcome. [ABSTRACT FROM AUTHOR]
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- 2008
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24. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy
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Alison Halliday, Richard Bulbulia, Leo H Bonati, Johanna Chester, Andrea Cradduck-Bamford, Richard Peto, Hongchao Pan, John Potter, Hans Henning Eckstein, Barbara Farrell, Marcus Flather, Averil Mansfield, Boby Mihaylova, Kazim Rahimi, David Simpson, Dafydd Thomas, Peter Sandercock, Richard Gray, Andrew Molyneux, Cliff P Shearman, Peter Rothwell, Anna Belli, Will Herrington, Parminder Judge, Peter Leopold, Marion Mafham, Michael Gough, Piergiorgio Cao, Sumaira MacDonald, Vasha Bari, Clive Berry, S Bradshaw, Wojciech Brudlo, Alison Clarke, Robin Cox, Susan Fathers, Kamran Gaba, Mo Gray, Elizabeth Hayter, Constance Holliday, Rijo Kurien, Michael Lay, Steffi le Conte, Jessica McManus, Zahra Madgwick, Dylan Morris, Andrew Munday, Sandra Pickworth, Wiktor Ostasz, Michiel Poorthuis, Sue Richards, Louisa Teixeira, Sergey Tochlin, Lynda Tully, Carol Wallis, Monique Willet, Alan Young, Renato Casana, Chiara Malloggi, Andrea Odero Jr, Vincenzo Silani, Gianfranco Parati, Giuseppe Malchiodi, Giovanni Malferrari, Francesco Strozzi, Nicola Tusini, Enrico Vecchiati, Gioacchino Coppi, Antonio Lauricella, Roberto Moratto, Roberto Silingardi, Jessica Veronesi, Andrea Zini, Emanuele Ferrero, Michelangelo Ferri, Andrea Gaggiano, Carmelo Labate, Franco Nessi, Daniele Psacharopulo, Andrea Viazzo, Giovanni Malacrida, Daniela Mazzaccaro, Giovanni Meola, Alfredo Modafferi, Giovanni Nano, Maria Teresa Occhiuto, Paolo Righini, Silvia Stegher, Stefano Chiarandini, Filippo Griselli, Sandro Lepidi, Fabio Pozzi Mucelli, Marcello Naccarato, Mario D'Oria, Barbara Ziani, Andrea Stella, Mortalla Dieng, Gianluca Faggioli, Mauro Gargiulo, Sergio Palermo, Rodolfo Pini, Giovanni Maria Puddu, Andrea Vacirca, Domenico Angiletta, Claudio Desantis, Davide Marinazzo, Giovanni Mastrangelo, Guido Regina, Raffaele Pulli, Paolo Bianchi, Lea Cireni, Elisabetta Coppi, Rocco Pizzirusso, Filippo Scalise, Giovanni Sorropago, Valerio Tolva, Valeria Caso, Enrico Cieri, Paola DeRango, Luca Farchioni, Giacomo Isernia, Massimo Lenti, Gian Battista Parlani, Guglielmo Pupo, Grazia Pula, Gioele Simonte, Fabio Verzini, Federico Carimati, Maria Luisa Delodovici, Federico Fontana, Gabriele Piffaretti, Matteo Tozzi, Efrem Civilini, Giorgio Poletto, Bernhard Reimers, Barbara Praquin, Sonia Ronchey, Laura Capoccia, Wassim Mansour, Enrico Sbarigia, Francesco Speziale, Pasqualino Sirignano, Danilo Toni, Roberto Galeotti, Vincenzo Gasbarro, Francesco Mascoli, Tiberio Rocca, Elpiniki Tsolaki, Giulia Bernardini, Ester DeMarco, Alessia Giaquinta, Francesco Patti, Massimiliano Veroux, Pierfrancesco Veroux, Carla Virgilio, Nicola Mangialardi, Matteo Orrico, Vincenzo Di Lazzaro, Nunzio Montelione, Francesco Spinelli, Francesco Stilo, Carlo Cernetti, Sandro Irsara, Giuseppe Maccarrone, Diego Tonello, Adriana Visonà, Beniamino Zalunardo, Emiliano Chisci, Stefano Michelagnoli, Nicola Troisi, Maela Masato, Massimo Dei Negri, Andrea Pacchioni, Salvatore Saccà, Giovanni Amatucci, Alfredo Cannizzaro, Federico Accrocca, Cesare Ambrogi, Renzo Barbazza, Giustino Marcucci, Andrea Siani, Guido Bajardi, Giovanni Savettieri, Angelo Argentieri, Riccardo Corbetta, Attilio Odero, Pietro Quaretti, Federico Z Thyrion, Alessandro Cappelli, Domenico Benevento, Gianmarco De Donato, Maria Agnese Mele, Giancarlo Palasciano, Daniela Pieragalli, Alessandro Rossi, Carlo Setacci, Francesco Setacci, Domenico Palombo, Maria Cecilia Perfumo, Edoardo Martelli, Aldo Paolucci, Santi Trimarchi, Viviana Grassi, Luigi Grimaldi, Giuliana La Rosa, Domenico Mirabella, Matteo Scialabba, Leonildo Sichel, Costantino L D'Angelo, Gian Franco Fadda, Holta Kasemi, Mario Marino, Francesco Burzotta, Francesco Alberto Codispoti, Angela Ferrante, Giovanni Tinelli, Yamume Tshomba, Claudio Vincenzoni, Deborah Amis, Dawn Anderson, Martin Catterson, Mike Clarke, Michelle Davis, Anand Dixit, Alexander Dyker, Gary Ford, Ralph Jackson, Sreevalsan Kappadath, David Lambert, Tim Lees, Stephen Louw, James McCaslin, Noala Parr, Rebecca Robson, Gerard Stansby, Lucy Wales, Vera Wealleans, Lesley Wilson, Michael Wyatt, Hardeep Baht, Ibrahim Balogun, Ilse Burger, Tracy Cosier, Linda Cowie, Gunaratnam Gunathilagan, David Hargroves, Robert Insall, Sally Jones, Hannah Rudenko, Natasha Schumacher, Jawaharlal Senaratne, George Thomas, Audrey Thomson, Tom Webb, Ellen Brown, Bernard Esisi, Ali Mehrzad, Shane MacSweeney, Norman McConachie, Alison Southam, Wayne Sunman, Ahmed Abdul-Hamiq, Jenny Bryce, Ian Chetter, Duncan Ettles, Raghuram Lakshminarayan, Kim Mitchelson, Christopher Rhymes, Graham Robinson, Paul Scott, Alison Vickers, Ray Ashleigh, Stephen Butterfield, Ed Gamble, Jonathan Ghosh, Charles N McCollum, Mark Welch, Sarah Welsh, Leszek Wolowczyk, Mary Donnelly, Stephen D'Souza, Anselm A Egun, Bindu Gregary, Thomas Joseph, Christine Kelly, Shuja Punekar, M Asad Rahi, Sonia Raj, Dare Seriki, George Thomson, James Brown, Ragunath Durairajan, Iris Grunwald, Paul Guyler, Paula Harman, Matthew Jakeways, Christopher Khuoge, Ashish Kundu, Thayalini Loganathan, Nisha Menon, Raji O Prabakaran, Devesh Sinha, Vicky Thompson, Sharon Tysoe, Dennis Briley, Chris Darby, Linda Hands, Dominic Howard, Wilhelm Kuker, Ursula Schulz, Rachel Teal, David Barer, Andrew Brown, Susan Crawford, Paul Dunlop, Ramesh Krishnamurthy, Nikhil Majmudar, Duncan Mitchell, Min P Myint, Richard O'Brien, Janice O'Connell, Naweed Sattar, Shanmugam Vetrivel, Jonathan Beard, Trevor Cleveland, Peter Gaines, John Humphreys, Alison Jenkins, Craig King, Daniel Kusuma, Ralph Lindert, Robbie Lonsdale, Raj Nair, Shah Nawaz, Faith Okhuoya, Douglas Turner, Graham Venables, Paul Dorman, Andrea Hughes, Deborah Jones, David Mendelow, Helen Rodgers, Aidas Raudoniitis, Peter Enevoldson, Hans Nahser, Imelda O'Brien, Francesco Torella, Dave Watling, Richard White, Pauline Brown, Dipankar Dutta, Lorraine Emerson, Paula Hilltout, Sachin Kulkarni, Jackie Morrison, Keith Poskitt, Fiona Slim, Sarah Smith, Amanda Tyler, Joanne Waldron, Mark Whyman, Milda Bajoriene, Lucy Baker, Amanda Colston, Bekky Eliot-Jones, Gita Gramizadeh, Catherine Lewis-Clarke, Laura McCafferty, Deborah Oliver, Debbie Palmer, Abhijeet Patil, Suzannah Pegler, Gopi Ramadurai, Aisling Roberts, Tracey Sargent, Shivaprasad Siddegowda, Ravi Singh-Ranger, Akintunde Williams, Lucy Williams, Steve Windebank, Tadas Zuromskis, Lanka Alwis, Jane Angus, Asaipillai Asokanathan, Caroline Fornolles, Diana Hardy, Sophy Hunte, Frances Justin, Duke Phiri, Marie Mitabouana-Kibou, Lakshmanan Sekaran, Sakthivel Sethuraman, Margaret L Tate, Joyce Akyea-Mensah, Stephen Ball, Angela Chrisopoulou, Elizabeth Keene, Alison Phair, Steven Rogers, John V Smyth, Colin Bicknell, Jeremy Chataway, Nicholas Cheshire, Andrew Clifton, Caroline Eley, Richard Gibbs, Mohammad Hamady, Beth Hazel, Alex James, Michael Jenkins, Nyma Khanom, Austin Lacey, Maz Mireskandari, Joanna O'Reilly, Antony Pereira, Tina Sachs, John Wolfe, Philip Davey, Gill Rogers, Gemma Smith, Gareth Tervit, Ian Nichol, Andrew Parry, Gavin Young, Simon Ashley, James Barwell, Francis Dix, Azlisham M Nor, Chris Parry, Angela Birt, Paul Davies, Jim George, Anne Graham, Leon Jonker, Nicci Kelsall, Caroline Potts, Toni Wilson, Jamie Crinnion, Larissa Cuenoud, Nikola Aleksic, Srdan Babic, Nenad Ilijevski, Đorde Radak, Dragan Sagic, Slobodan Tanaskovic, Momcilo Colic, Vladimir Cvetic, Lazar Davidovic, Dejana R Jovanovic, Igor Koncar, Perica Mutavdžic, Miloš Sladojevic, Ivan Tomic, Eike S Debus, Ulrich Grzyska, Dagmar Otto, Götz Thomalla, Jessica Barlinn, Johannes Gerber, Kathrin Haase, Christian Hartmann, Stefan Ludwig, Volker Pütz, Christian Reeps, Christine Schmidt, Norbert Weiss, Sebastian Werth, Simon Winzer, Janine Gemper, Albrecht Günther, Bianka Heiling, Elisabeth Jochmann, Panagiota Karvouniari, Carsten Klingner, Thomas Mayer, Julia Schubert, Friederike Schulze-Hartung, Jürgen Zanow, Yvonne Bausback, Franka Borger, Spiridon Botsios, Daniela Branzan, Sven Bräunlich, Henryk Hölzer, Janin Lenzer, Christopher Piorkowski, Nadine Richter, Johannes Schuster, Dierk Scheinert, Andrej Schmidt, Holger Staab, Matthias Ulrich, Martin Werner, Hermann Berger, Gábor Biró, Hans-Henning Eckstein, Michael Kallmayer, Kornelia Kreiser, Alexander Zimmermann, Bärbel Berekoven, Klaus Frerker, Vera Gordon, Giovanni Torsello, Sebastian Arnold, Cora Dienel, Martin Storck, Bernhard Biermaier, Hans Martin Gissler, Christof Klötzsch, Tomas Pfeiffer, Ralph Schneider, Leander Söhl, Michael Wennrich, Angelika Alonso, Michael Keese, Christoph Groden, Andreas Cöster, Andreas Engelhardt, Christoph-Maria Ratusinski, Bengt Berg, Martin Delle, Johan Formgren, Peter Gillgren, Lotta Jarl, Torbjörn B Kall, Peter Konrad, Niklas Nyman, Claes Skiöldebrand, Johnny Steuer, Rabbe Takolander, Jonas Malmstedt, Stefan Acosta, Katarina Björses, Kerstin Brandt, Nuno Dias, Anders Gottsäter, Jan Holst, Thorarinn Kristmundsson, Tobias Kühme, Tilo Kölbel, Bengt Lindblad, Mats Lindh, Martin Malina, Tomas Ohrlander, Tim Resch, Viola Rönnle, Björn Sonesson, Margareta Warvsten, Zbigniew Zdanowski, Erik Campbell, Per Kjellin, Hans Lindgren, Johan Nyberg, Björn Petersen, Gunnar Plate, Håkan Pärsson, Peter Qvarfordt, Pavel Ignatenko, Andrey Karpenko, Vladimir Starodubtsev, Mikhail A Chernyavsky, Maria S Golovkova, Boris B Komakha, Nikolay N Zherdev, Andrey Belyasnik, Pavel Chechulov, Dmitry Kandyba, Igor Stepanishchev, Csaba Csobay-Novák, Edit Dósa, László Entz, Balázs Nemes, Zoltán Szeberin, Pál Barzó, Mihaly Bodosi, Eniko Fákó, Béla Fülöp, Tamás Németh, Szilárd Pazdernyik, Krisztina Skoba, Erika Vörös, Eleni Chatzinikou, Athanasios Giannoukas, Christos Karathanos, Stylianos Koutsias, Georgios Kouvelos, Miltiadis Matsagkas, Styliani Ralli, Christos Rountas, Nikolaos Rousas, Konstantinos Spanos, Elias Brountzos, John D Kakisis, Andreas Lazaris, Konstantinos G Moulakakis, Leonidas Stefanis, Georgios Tsivgoulis, Spyros Vasdekis, Constantine N Antonopoulos, Ion Bellenis, Dimitrios Maras, Antonios Polydorou, Victoria Polydorou, Antonios Tavernarakis, Nikolaos Ioannou, Maria Terzoudi, Miltos Lazarides, Michalis Mantatzis, Kostas Vadikolias, Lukasz Dzieciuchowicz, Marcin Gabriel, Zbigniew Krasinski, Grzegorz Oszkinis, Fryderyk Pukacki, Maciej Slowinski, Michal-Goran Stanišic, Ryszard Staniszewski, Jolanta Tomczak, Maciej Zielinski, Piotr Myrcha, Dorota Rózanski, Stanislaw Drelichowski, Wojciech Iwanowski, Katarzyna Koncewicz, Pawel Bialek, Zbigniew Biejat, Wojciech Czepel, Anna Czlonkowska, Anatol Dowzenko, Julia Jedrzejewska, Adam Kobayashi, Jerzy Leszczynski, Andrzej Malek, Jerzy Polanski, Robert Proczka, Maciej Skorski, Mieczyslaw Szostek, Piotr Andziak, Maciej Dratwicki, Robert Gil, Miroslaw Nowicki, Jaroslaw Pniewski, Jaroslaw Rzezak, Piotr Seweryniak, Pawel Dabek, Michal Juszynski, Grzegorz Madycki, Bartosz Pacewski, Witold Raciborski, Piotr Slowinski, Walerian Staszkiewicz, Martin Bombic, Vladimír Chlouba, Jirí Fiedler, Karel Hes, Petr Koštál, Jindrich Sova, Zdenek Kríž, Mojmír Prívara, Michal Reif, Robert Staffa, Robert Vlachovský, Bohuslav Vojtíšek, Tomáš Hrbác, Martin Kuliha, Václav Procházka, Martin Roubec, David Školoudík, David Netuka, Anna Šteklácová, Vladimír Beneš III, Pavel Buchvald, Ladislav Endrych, Miroslav Šercl, Walter Campos Jr, Ivan B Casella, Nelson de Luccia, André E V Estenssoro, Calógero Presti, Pedro Puech-Leão, Celso R B Neves, Erasmo S da Silva, Cid J Sitrângulo Jr, José A T Monteiro, Gisela Tinone, Marcelo Bellini Dalio, Edwaldo E Joviliano, Octávio M Pontes Neto, Mauricio Serra Ribeiro, Patrick Cras, Jeroen M H Hendriks, Mieke Hoppenbrouwers, Patrick Lauwers, Caroline Loos, Laetitia Yperzeele, Mia Geenens, Dimitri Hemelsoet, Isabelle van Herzeele, Frank Vermassen, Parla Astarci, Frank Hammer, Valérie Lacroix, André Peeters, Robert Verhelst, Silvana Cirelli, Pol Dormal, Annelies Grimonprez, Bart Lambrecht, Philipe Lerut, Eddy Thues, Guy De Koster, Quentin Desiron, Alain Maertens de Noordhout, Danielle Malmendier, Mireille Massoz, Georges Saad, Marc Bosiers, Joren Callaert, Koen Deloose, Estrella Blanco Cañibano, Beatriz García Fresnillo, Mercedes Guerra Requena, Pilar C Morata Barrado, Miguel Muela Méndez, Antonio Yusta Izquierdo, Fernando Aparici Robles, Paula Blanes Orti, Luis García Dominguez, Rafael Martínez López, Manuel Miralles Hernández, José I Tembl Ferrairo, Ángel Chamorro, Juan Macho, Víctor Obach, Vincent Riambau, Luis San Román, Frank J Ahlhelm, Kristine Blackham, Stefan Engelter, Thomas Eugster, Henrik Gensicke, Lorenz Gürke, Philippe Lyrer, Luigi Mariani, Marina Maurer, Edin Mujagic, Mandy Müller, Marios Psychogios, Peter Stierli, Christoph Stippich, Christopher Traenka, Thomas Wolff, Benjamin Wagner, Martina M Wiegert, Sandra Clarke, Michael Diepers, Ernst Gröchenig, Philipp Gruber, Andrej Isaak, Timo Kahles, Regula Marti, Krassen Nedeltchev, Luca Remonda, Nadir Tissira, Martina Valença Falcão, Gert J de Borst, Rob H Lo, Frans L Moll, Raechel Toorop, Bart H van der Worp, Evert J Vonken, Jaap L Kappelle, Ommid Jahrome, Floris 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Miksic, Franko Milotic, Božidar Mrdja, Barbara Stirn, Erih Tetickovic, Mladen Gasparini, Anton Grad, Ingrid Kompara, Zoren Miloševic, Veronika Palmiste, Toomas Toomsoo, Balzhan Aidashova, Nursultan Kospanov, Roman Lyssenko, Daulet Mussagaliev, Rafi Beyar, Aaron Hoffman, Tony Karram, Arthur Kerner, Eugenia Nikolsky, Samy Nitecki, Silva Andonova, Chavdar Bachvarov, Vesko Petrov, Ivan Cvjetko, Vinko Vidjak, Damir Halužan, Mladen Petrunic, Bao Liu, Chang-Wei Liu, Daniel Bartko, Peter Beno, František Rusnák, Kamil Zelenák, Masayuki Ezura, Takashi Inoue, Naoto Kimura, Ryushi Kondo, Yasushi Matsumoto, Hiroaki Shimizu, Hidenori Endo, Eisuke Furui, Søren Bakke, Kristen Krohg-Sørensen, Terje Nome, Mona Skjelland, Bjørn Tennøe, João Albuquerque e Castro, Gonçalo Alves, Frederico Bastos Gonçalves, José de Aragão Morais, Ana C Garcia, Hugo Valentim, Leonor Vasconcelos, Fernando Belcastro, Fernando Cura, Patricio Zaefferer, Foad Abd-Allah, Mohamed H Eldessoki, Hussein Heshmat Kassem, Haytham Soliman Gharieb, Mary P Colgan, Syed N Haider, Joe Harbison, Prakash Madhavan, Dermot Moore, Gregor Shanik, Viviane Kazan, Munier Nazzal, Vicki Ramsey-Williams, ACST-2 Collaborative Group, Group, ACST-2 Collaborative, Halliday A., Bulbulia R., Bonati L.H., Chester J., Cradduck-Bamford A., Peto R., Pan H., Potter J., Henning Eckstein H., Farrell B., Flather M., Mansfield A., Mihaylova B., Rahimi K., Simpson D., Thomas D., Sandercock P., Gray R., Molyneux A., Shearman C.P., Rothwell P., Belli A., Herrington W., Judge P., Leopold P., Mafham M., Gough M., Cao P., MacDonald S., Bari V., Berry C., Bradshaw S., Brudlo W., Clarke A., Cox R., Fathers S., Gaba K., Gray M., Hayter E., Holliday C., Kurien R., Lay M., le Conte S., McManus J., Madgwick Z., Morris D., Munday A., Pickworth S., Ostasz W., Poorthuis M., Richards S., Teixeira L., Tochlin S., Tully L., Wallis C., Willet M., Young A., Casana R., Malloggi C., Odero A., Silani V., Parati G., Malchiodi G., Malferrari G., Strozzi F., Tusini N., 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S., Lambert D., Lees T., Louw S., McCaslin J., Parr N., Robson R., Stansby G., Wales L., Wealleans V., Wilson L., Wyatt M., Baht H., Balogun I., Burger I., Cosier T., Cowie L., Gunathilagan G., Hargroves D., Insall R., Jones S., Rudenko H., Schumacher N., Senaratne J., Thomas G., Thomson A., Webb T., Brown E., Esisi B., Mehrzad A., MacSweeney S., McConachie N., Southam A., Sunman W., Abdul-Hamiq A., Bryce J., Chetter I., Ettles D., Lakshminarayan R., Mitchelson K., Rhymes C., Robinson G., Scott P., Vickers A., Ashleigh R., Butterfield S., Gamble E., Ghosh J., McCollum C.N., Welch M., Welsh S., Wolowczyk L., Donnelly M., D'Souza S., Egun A.A., Gregary B., Joseph T., Kelly C., Punekar S., Rahi M.A., Raj S., Seriki D., Thomson G., Brown J., Durairajan R., Grunwald I., Guyler P., Harman P., Jakeways M., Khuoge C., Kundu A., Loganathan T., Menon N., Prabakaran R.O., Sinha D., Thompson V., Tysoe S., Briley D., Darby C., Hands L., Howard D., Kuker W., Schulz U., Teal R., Barer D., Brown A., Crawford S., Dunlop P., Krishnamurthy R., Majmudar N., Mitchell D., Myint M.P., O'Brien R., O'Connell J., Sattar N., Vetrivel S., Beard J., Cleveland T., Gaines P., Humphreys J., Jenkins A., King C., Kusuma D., Lindert R., Lonsdale R., Nair R., Nawaz S., Okhuoya F., Turner D., Venables G., Dorman P., Hughes A., Jones D., Mendelow D., Rodgers H., Raudoniitis A., Enevoldson P., Nahser H., O'Brien I., Torella F., Watling D., White R., Brown P., Dutta D., Emerson L., Hilltout P., Kulkarni S., Morrison J., Poskitt K., Slim F., Smith S., Tyler A., Waldron J., Whyman M., Bajoriene M., Baker L., Colston A., Eliot-Jones B., Gramizadeh G., Lewis-Clarke C., McCafferty L., Oliver D., Palmer D., Patil A., Pegler S., Ramadurai G., Roberts A., Sargent T., Siddegowda S., Singh-Ranger R., Williams A., Williams L., Windebank S., Zuromskis T., Alwis L., Angus J., Asokanathan A., Fornolles C., Hardy D., Hunte S., Justin F., Phiri D., Mitabouana-Kibou M., Sekaran L., Sethuraman S., Tate M.L., Akyea-Mensah J., Ball S., Chrisopoulou A., Keene E., Phair A., Rogers S., Smyth J.V., Bicknell C., Chataway J., Cheshire N., Clifton A., Eley C., Gibbs R., Hamady M., Hazel B., James A., Jenkins M., Khanom N., Lacey A., Mireskandari M., O'Reilly J., Pereira A., Sachs T., Wolfe J., Davey P., Rogers G., Smith G., Tervit G., Nichol I., Parry A., Young G., Ashley S., Barwell J., Dix F., Nor A.M., Parry C., Birt A., Davies P., George J., Graham A., Jonker L., Kelsall N., Potts C., Wilson T., Crinnion J., Cuenoud L., Aleksic N., Babic S., Ilijevski N., Radak, Sagic D., Tanaskovic S., Colic M., Cvetic V., Davidovic L., Jovanovic D.R., Koncar I., Mutavdzic P., Sladojevic M., Tomic I., Debus E.S., Grzyska U., Otto D., Thomalla G., Barlinn J., Gerber J., Haase K., Hartmann C., Ludwig S., Putz V., Reeps C., Schmidt C., Weiss N., Werth S., Winzer S., Gemper J., Gunther A., Heiling B., Jochmann E., Karvouniari P., Klingner C., Mayer T., Schubert J., Schulze-Hartung F., Zanow J., Bausback Y., Borger F., Botsios S., Branzan D., Braunlich S., Holzer H., Lenzer J., Piorkowski C., Richter N., Schuster J., Scheinert D., Schmidt A., Staab H., Ulrich M., Werner M., Berger H., Biro G., Eckstein H.-H., Kallmayer M., Kreiser K., Zimmermann A., Berekoven B., Frerker K., Gordon V., Torsello G., Arnold S., Dienel C., Storck M., Biermaier B., Gissler H.M., Klotzsch C., Pfeiffer T., Schneider R., Sohl L., Wennrich M., Alonso A., Keese M., Groden C., Coster A., Engelhardt A., Ratusinski C.-M., Berg B., Delle M., Formgren J., Gillgren P., Jarl L., Kall T.B., Konrad P., Nyman N., Skioldebrand C., Steuer J., Takolander R., Malmstedt J., Acosta S., Bjorses K., Brandt K., Dias N., Gottsater A., Holst J., Kristmundsson T., Kuhme T., Kolbel T., Lindblad B., Lindh M., Malina M., Ohrlander T., Resch T., Ronnle V., Sonesson B., Warvsten M., Zdanowski Z., Campbell E., Kjellin P., Lindgren H., Nyberg J., Petersen B., Plate G., Parsson H., Qvarfordt P., Ignatenko P., Karpenko A., Starodubtsev V., Chernyavsky M.A., Golovkova M.S., Komakha B.B., Zherdev N.N., Belyasnik A., Chechulov P., Kandyba D., Stepanishchev I., Csobay-Novak C., Dosa E., Entz L., Nemes B., Szeberin Z., Barzo P., Bodosi M., Fako E., Fulop B., Nemeth T., Pazdernyik S., Skoba K., Voros E., Chatzinikou E., Giannoukas A., Karathanos C., Koutsias S., Kouvelos G., Matsagkas M., Ralli S., Rountas C., Rousas N., Spanos K., Brountzos E., Kakisis J.D., Lazaris A., Moulakakis K.G., Stefanis L., Tsivgoulis G., Vasdekis S., Antonopoulos C.N., Bellenis I., Maras D., Polydorou A., Polydorou V., Tavernarakis A., Ioannou N., Terzoudi M., Lazarides M., Mantatzis M., Vadikolias K., Dzieciuchowicz L., Gabriel M., Krasinski Z., Oszkinis G., Pukacki F., Slowinski M., Stanisic M.-G., Staniszewski R., Tomczak J., Zielinski M., Myrcha P., Rozanski D., Drelichowski S., Iwanowski W., Koncewicz K., Bialek P., Biejat Z., Czepel W., Czlonkowska A., Dowzenko A., Jedrzejewska J., Kobayashi A., Leszczynski J., Malek A., Polanski J., Proczka R., Skorski M., Szostek M., Andziak P., Dratwicki M., Gil R., Nowicki M., Pniewski J., Rzezak J., Seweryniak P., Dabek P., Juszynski M., Madycki G., Pacewski B., Raciborski W., Slowinski P., Staszkiewicz W., Bombic M., Chlouba V., Fiedler J., Hes K., Kostal P., Sova J., Kriz Z., Privara M., Reif M., Staffa R., Vlachovsky R., Vojtisek B., Hrbac T., Kuliha M., Prochazka V., Roubec M., Skoloudik D., Netuka D., Steklacova A., Benes III V., Buchvald P., Endrych L., Sercl M., Campos W., Casella I.B., de Luccia N., Estenssoro A.E.V., Presti C., Puech-Leao P., Neves C.R.B., da Silva E.S., Sitrangulo C.J., Monteiro J.A.T., Tinone G., Bellini Dalio M., Joviliano E.E., Pontes Neto O.M., Serra Ribeiro M., Cras P., Hendriks J.M.H., Hoppenbrouwers M., Lauwers P., Loos C., Yperzeele L., Geenens M., Hemelsoet D., van Herzeele I., Vermassen F., Astarci P., Hammer F., Lacroix V., Peeters A., Verhelst R., Cirelli S., Dormal P., Grimonprez A., Lambrecht B., Lerut P., Thues E., De Koster G., Desiron Q., Maertens de Noordhout A., Malmendier D., Massoz M., Saad G., Bosiers M., Callaert J., Deloose K., Blanco Canibano E., Garcia Fresnillo B., Guerra Requena M., Morata Barrado P.C., Muela Mendez M., Yusta Izquierdo A., Aparici Robles F., Blanes Orti P., Garcia Dominguez L., Martinez Lopez R., Miralles Hernandez M., Tembl Ferrairo J.I., Chamorro A., Macho J., Obach V., Riambau V., San Roman L., Ahlhelm F.J., Blackham K., Engelter S., Eugster T., Gensicke H., Gurke L., Lyrer P., Mariani L., Maurer M., Mujagic E., Muller M., Psychogios M., Stierli P., Stippich C., Traenka C., Wolff T., Wagner B., Wiegert M.M., Clarke S., Diepers M., Grochenig E., Gruber P., Isaak A., Kahles T., Marti R., Nedeltchev K., Remonda L., Tissira N., Valenca Falcao M., de Borst G.J., Lo R.H., Moll F.L., Toorop R., van der Worp B.H., Vonken E.J., Kappelle J.L., Jahrome O., Vos F., Schuiling W., van Overhagen H., Keunen R.W.M., Knippenberg B., Wever J.J., Lardenoije J.W., Reijnen M., Smeets L., van Sterkenburg S., Fraedrich G., Gizewski E., Gruber I., Knoflach M., Kiechl S., Rantner B., Abdulamit T., Bergeron P., Padovani R., Trastour J.-C., Cardon J.-M., Le Gallou-Wittenberg A., Allaire E., Becquemin J.-P., Cochennec-Paliwoda F., Desgranges P., Hosseini H., Kobeiter H., Marzelle J., Almekhlafi M.A., Bal S., Barber P.A., Coutts S.B., Demchuk A.M., Eesa M., Gillies M., Goyal M., Hill M.D., Hudon M.E., Jambula A., Kenney C., Klein G., McClelland M., Mitha A., Menon B.K., Morrish W.F., Peters S., Ryckborst K.J., Samis G., Save S., Smith E.E., Stys P., Subramaniam S., Sutherland G.R., Watson T., Wong J.H., Zimmel L., Flis V., Matela J., Miksic K., Milotic F., Mrdja B., Stirn B., Tetickovic E., Gasparini M., Grad A., Kompara I., Milosevic Z., Palmiste V., Toomsoo T., Aidashova B., Kospanov N., Lyssenko R., Mussagaliev D., Beyar R., Hoffman A., Karram T., Kerner A., Nikolsky E., Nitecki S., Andonova S., Bachvarov C., Petrov V., Cvjetko I., Vidjak V., Haluzan D., Petrunic M., Liu B., Liu C.-W., Bartko D., Beno P., Rusnak F., Zelenak K., Ezura M., Inoue T., Kimura N., Kondo R., Matsumoto Y., Shimizu H., Endo H., Furui E., Bakke S., Krohg-Sorensen K., Nome T., Skjelland M., Tennoe B., Albuquerque e Castro J., Alves G., Bastos Goncalves F., de Aragao Morais J., Garcia A.C., Valentim H., Vasconcelos L., Belcastro F., Cura F., Zaefferer P., Abd-Allah F., Eldessoki M.H., Heshmat Kassem H., Soliman Gharieb H., Colgan M.P., Haider S.N., Harbison J., Madhavan P., Moore D., Shanik G., Kazan V., Nazzal M., Ramsey-Williams V., and Gargiulo M
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Male ,medicine.medical_specialty ,Time Factors ,Time Factor ,medicine.medical_treatment ,Carotid Stenosi ,MEDLINE ,Carotid endarterectomy ,Rate ratio ,Risk Assessment ,Asymptomatic ,law.invention ,Randomized controlled trial ,law ,Risk Factors ,carotid artery stenting (CAS) ,carotid endarterectomy (CEA) ,Stent ,medicine ,Humans ,Carotid Stenosis ,Stroke ,Endarterectomy ,Aged ,Endarterectomy, Carotid ,business.industry ,carotid artery ,Risk Factor ,Articles ,General Medicine ,trial ,medicine.disease ,Settore MED/22 - CHIRURGIA VASCOLARE ,Surgery ,Stenosis ,Treatment Outcome ,Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,Female ,Stents ,Human medicine ,medicine.symptom ,business ,Human - Abstract
Summary Background Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86–1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91–1·32; p=0·21). Interpretation Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable. Funding UK Medical Research Council and Health Technology Assessment Programme.
- Published
- 2021
25. Impact of injury mechanism on early wound closure in patients with acute conflict-related extremity wounds: A prospective cohort analysis from two civilian hospitals in Iraq and Jordan.
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Haque G, Haweizy R, Bashaireh K, Malmstedt J, and Älgå A
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- Humans, Male, Jordan, Prospective Studies, Female, Adult, Iraq, Blast Injuries, Wound Healing, Young Adult, Bombs, War-Related Injuries, Middle Aged, Extremities injuries, Cohort Studies, Wounds, Gunshot epidemiology
- Abstract
Background: Gunshots and bomb blasts are important causes of extremity injuries in conflict zones, yet little research exists on the characteristics and outcomes of these injuries in civilian populations., Methods: We performed a prospective cohort analysis utilizing data from a randomized trial conducted at two civilian hospitals in Jordan and Iraq in 2015-2019. Adults who presented ≤72 h of sustaining an extremity injury were included. We used mechanism of injury (gunshot/bomb blast) as the exposure and wound closure by day 5 as the primary outcome measure., Results: The population predominantly comprised young men (n = 163, 94% male, and median age 29 years) injured by gunshots (61%) or bomb blasts (39%). Compared with the gunshot group, more participants in the bomb blast group had concomitant injuries (32/63 [51%] vs. 11/100 [11%], p < 0.001) and vascular injuries (9/63 [14%] vs. 4/100 [4%], p = 0.02). The wounds were larger in the bomb blast group compared with the gunshot group (median area 86 cm
2 [IQR 24-161] vs. 21 cm2 [IQR 7-57], p < 0.001). Compared with the bomb blast group, significantly more participants in the gunshot group achieved wound closure by day 5 (74/100 [74%] vs. 16/63 [25%], p < 0.001). This difference remained after controlling for confounding factors (odds ratio 4.7, 95% confidence interval 1.6-13.7)., Conclusions: In civilians with conflict-related extremity injuries, bomb blast wounds had a lower likelihood of achieving closure within 5 days than gunshot wounds, independent of other factors, such as wound size and vascular injuries., Trial Registration: ClinicalTrials.gov, NCT02444598. Registered 14-05-2015, https://classic., Clinicaltrials: gov/ct2/show/NCT02444598., (© 2024 The Author(s). World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).)- Published
- 2024
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26. Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL)-2 Trial: Analysis of the Timing and Causes of Death in Participants Randomised to an Infrapopliteal Vein Bypass or Best Endovascular Treatment First Revascularisation Strategy.
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Bradbury AW, Hall J, Moakes CA, Popplewell M, Meecham L, Bate GR, Kelly L, Diamantopoulos A, Ganeshan A, Houlind K, Malmstedt J, Patel JV, Saratzis A, and Zayed H
- Abstract
Objective: The Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL)-2 trial enrolled participants with chronic limb threatening ischaemia who required an infrapopliteal, with or without a femoropopliteal, revascularisation procedure to restore limb perfusion. Participants randomised to a vein bypass (VB) first revascularisation strategy were over one third more likely than those randomised to a best endovascular treatment (BET) first revascularisation strategy to die from any cause during a median follow up of 40.0 (interquartile range 20.9, 60.6) months. The aim of the present study was to describe the timing and causes of death in BASIL-2 as a first step towards trying to better understand why randomisation to a VB first revascularisation strategy was associated with this excess mortality., Methods: A 10 person international panel comprising vascular and endovascular surgeons as well as vascular interventional radiologists, who had all been principal investigators in BASIL-2, took part in a modified Delphi consensus exercise to adjudicate the primary cause of death and, in particular, whether the cause was primarily cardiac or non-cardiac., Results: In 151 of 168 deaths (89.9%), the Delphi panel achieved a consensus regarding the cause of death being probably cardiac or non-cardiac. In the BET group, 16 of 77 deaths (21%) were classified as probably cardiac compared with 32 of 91 (35%) in the VB group (unadjusted subdistribution hazard ratio 2.16, 95% confidence interval [CI] 1.20 - 3.87; unadjusted cause specific hazard ratio 2.15, 95% CI 1.19 - 3.90). At the point of randomisation, 64 of 344 (18.6%), 40 of 342 (11.7%), and 37 of 344 (10.8%) participants had a previous myocardial infarction (MI), percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG), respectively. There was no evidence of varying treatment effects for cause of death in subgroup analyses of previous PCI, CABG, or MI., Conclusion: The excess mortality observed in the VB first revascularisation strategy group in BASIL-2 was largely due to deaths that were adjudicated by the Delphi panel as probably primarily cardiac. These excess cardiac deaths were observed throughout follow up and there was no evidence of non-proportional hazards. Further work is ongoing to try to better understand the reasons for these findings., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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27. Prophylactic Negative-Pressure Wound Therapy After Laparotomy: Ongoing Discussion Following High-Quality Systematic Review.
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Älgå A and Malmstedt J
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- Humans, Laparotomy adverse effects, Surgical Wound Infection prevention & control, Surgical Wound Dehiscence prevention & control, Longitudinal Studies, Negative-Pressure Wound Therapy
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- 2023
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28. A vein bypass first versus a best endovascular treatment first revascularisation strategy for patients with chronic limb threatening ischaemia who required an infra-popliteal, with or without an additional more proximal infra-inguinal revascularisation procedure to restore limb perfusion (BASIL-2): an open-label, randomised, multicentre, phase 3 trial.
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Bradbury AW, Moakes CA, Popplewell M, Meecham L, Bate GR, Kelly L, Chetter I, Diamantopoulos A, Ganeshan A, Hall J, Hobbs S, Houlind K, Jarrett H, Lockyer S, Malmstedt J, Patel JV, Patel S, Rashid ST, Saratzis A, Slinn G, Scott DJA, Zayed H, and Deeks JJ
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- Male, Humans, Female, Aged, Chronic Limb-Threatening Ischemia, Ischemia surgery, Risk Factors, Perfusion, Pain, Treatment Outcome, Ocimum basilicum, Angioplasty, Balloon, Coronary, Peripheral Arterial Disease complications, Peripheral Arterial Disease surgery
- Abstract
Background: Chronic limb-threatening ischaemia is the severest manifestation of peripheral arterial disease and presents with ischaemic pain at rest or tissue loss (ulceration, gangrene, or both), or both. We compared the effectiveness of a vein bypass first with a best endovascular treatment first revascularisation strategy in terms of preventing major amputation and death in patients with chronic limb threatening ischaemia who required an infra-popliteal, with or without an additional more proximal infra-inguinal, revascularisation procedure to restore limb perfusion., Methods: Bypass versus Angioplasty for Severe Ischaemia of the Leg (BASIL)-2 was an open-label, pragmatic, multicentre, phase 3, randomised trial done at 41 vascular surgery units in the UK (n=39), Sweden (n=1), and Denmark (n=1). Eligible patients were those who presented to hospital-based vascular surgery units with chronic limb-threatening ischaemia due to atherosclerotic disease and who required an infra-popliteal, with or without an additional more proximal infra-inguinal, revascularisation procedure to restore limb perfusion. Participants were randomly assigned (1:1) to receive either vein bypass (vein bypass group) or best endovascular treatment (best endovascular treatment group) as their first revascularisation procedure through a secure online randomisation system. Participants were excluded if they had ischaemic pain or tissue loss considered not to be primarily due to atherosclerotic peripheral artery disease. Most vein bypasses used the great saphenous vein and originated from the common or superficial femoral arteries. Most endovascular interventions comprised plain balloon angioplasty with selective use of plain or drug eluting stents. Participants were followed up for a minimum of 2 years. Data were collected locally at participating centres. In England, Wales, and Sweden, centralised databases were used to collect information on amputations and deaths. Data were analysed centrally at the Birmingham Clinical Trials Unit. The primary outcome was amputation-free survival defined as time to first major (above the ankle) amputation or death from any cause measured in the intention-to-treat population. Safety was assessed by monitoring serious adverse events up to 30-days after first revascularisation. The trial is registered with the ISRCTN registry, ISRCTN27728689., Findings: Between July 22, 2014, and Nov 30, 2020, 345 participants (65 [19%] women and 280 [81%] men; median age 72·5 years [62·7-79·3]) with chronic limb-threatening ischaemia were enrolled in the trial and randomly assigned: 172 (50%) to the vein bypass group and 173 (50%) to the best endovascular treatment group. Major amputation or death occurred in 108 (63%) of 172 patients in the vein bypass group and 92 (53%) of 173 patients in the best endovascular treatment group (adjusted hazard ratio [HR] 1·35 [95% CI 1·02-1·80]; p=0·037). 91 (53%) of 172 patients in the vein bypass group and 77 (45%) of 173 patients in the best endovascular treatment group died (adjusted HR 1·37 [95% CI 1·00-1·87]). In both groups the most common causes of morbidity and death, including that occurring within 30 days of their first revascularisation, were cardiovascular (61 deaths in the vein bypass group and 49 in the best endovascular treatment group) and respiratory events (25 deaths in the vein bypass group and 23 in the best endovascular treatment group; number of cardiovascular and respiratory deaths were not mutually exclusive)., Interpretation: In the BASIL-2 trial, a best endovascular treatment first revascularisation strategy was associated with a better amputation-free survival, which was largely driven by fewer deaths in the best endovascular treatment group. These data suggest that more patients with chronic limb-threatening ischaemia who required an infra-popliteal, with or without an additional more proximal infra-inguinal, revascularisation procedure to restore limb perfusion should be considered for a best endovascular treatment first revascularisation strategy., Funding: UK National Institute of Health Research Health Technology Programme., Competing Interests: Declaration of interests AWB reports salary part paid by a National Institute for Health (NIHR) and Care Research Health Technology Assessment (HTA) BASIL-2 grant; payment expert advice and testimony from NHS Resolution, His Majesty's Coroners, National Crime Agency, UK, Scotland, Wales, and Northern Ireland Governments, and various law firms, outside of the submitted work; and payment to his institution and personal honoraria for committee work from NIHR HTA and NICE. GRB reports salary part paid by a NIHR HTA BASIL-2 grant; the BASIL-2 grant also paid mileage for visiting patients in the BASIL-2 trial for follow-up assessments. AD reports honoraria from Boston Scientific, Cordis, Medalliance, and Abbott. KH reports honoraria from Le Maitre and Bayer. STR reports payment for expert testimony from McCollum Consultants; consulting fees from 3M, Bayer, and Avita; speaker fees from 3M, Bayer, Avita, and Terumo; travel support Bayer and Terumo; and is an advisory board member for 3M, Bayer, and Avita. AS reports honoraria and institutional grant support from Shockwave and Abbott and unpaid committee work for NICE. HZ reports an institutional grant from Abbott and honoraria from Limflow, Abbott, Boston Scientific, Bentley, Cook Medical, and Medtronic. All other authors declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
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- 2023
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29. Wound specific quality of life after blast or gunshot injury: Validation of the wound QoL instrument.
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Älgå A, Malmstedt J, and Fagerdahl AM
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- Adult, Humans, Male, Female, Reproducibility of Results, Surveys and Questionnaires, Self Report, Psychometrics methods, Quality of Life, Wounds, Gunshot
- Abstract
Background: Acute blast or gunshot wounds have a negative effect on the patients' health related quality of life (HRQoL). No validated instrument exists to assess the HRQoL of patients with such wounds. Therefore, we aimed to test and validate a subscale of an existing HRQoL instrument among patients with acute blast or gunshot wounds., Methods: We used data from a randomized controlled trial comparing negative pressure wound therapy with standard treatment of civilian adults with acute extremity blast or gunshot wounds. We evaluated the reliability (internal consistency, stability) and validity of the body subscale of the Wound QoL instrument using the World Health Organisation 20 question self-reporting questionnaire as gold standard., Results: A total of 152 participants were included in the study. The participants were predominantly (93.4%) male, and median age was 29.0 years (IQR 21.0-34.0). The internal consistency was acceptable while a test-retest analysis indicated instability in the Wound QoL instrument. The content validity of the instrument was considered satisfactory; however, the criterion validity was found to be insufficient., Conclusions: Our results indicate that Wound QoL is a promising instrument for the assessment of wound specific HRQoL among patients with acute blast or gunshot wounds. Further testing and validation is needed., Competing Interests: The authors have declared that no competing interests exist.
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- 2022
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30. Health-related quality of life and prosthesis use among patients amputated due to peripheral arterial disease - a one-year follow-up.
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Torbjörnsson E, Ottosson C, Boström L, Blomgren L, Malmstedt J, and Fagerdahl AM
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- Amputation, Surgical, Follow-Up Studies, Humans, Quality of Life, Walking, Amputees rehabilitation, Artificial Limbs, Peripheral Arterial Disease surgery
- Abstract
Purpose: A major amputation affects the patients' independence, well-being and HRQoL. However, prosthesis use and the impact on the patient's HRQoL are scarcely described. The aim was to compare HRQoL between walker and non-walker amputees. Secondary aim was to evaluate prosthesis use and habits., Method: Ninety-eight patients with a major amputation due to peripheral arterial disease were included during 2014-2018. They were interviewed using EQ-5D-3L (HRQoL), Stanmore Harold Wood mobility grade (prosthesis use) and Houghton scale (prosthesis habits)., Results: Seventy-three patients completed the one-year follow-up, out of them 56 got a prosthesis. Twenty-three used it to walk both inside and outside. EQ-5D-3L at follow-up was increased in all patients in comparison to baseline (0.16 versus 0.59, p < 0.001). Patients walking with prosthesis had the largest improvement (0.12 versus 0.78, p < 0.001). A sub-analysis aiming to study the importance of independent movement showed an improved HRQoL at follow-up among those classified as prosthesis-user (p<0.001) and walker (p<0.001), but not among non-prosthesis users ( p = 0.245)., Conclusion: Learning how to use, not exclusively to walk with, a prosthesis after an amputation is important for the patients' HRQoL. At follow-up, patients using their prosthesis to walk or to move to a wheelchair, showed an improved HRQoL compared to baseline.IMPLICATIONS FOR REHABILITATION Walking ability with a prosthesis is important for the patient's perceived HRQoL after an amputation.Rehabilitation of amputees should focus on independence and movability and not only on walking ability.Wider use of prescribing prostheses after an amputation also to those predicted as non-walkers, may increase the number of patients with independence and improved HRQoL.When using their prosthesis for independent movement, patients who were otherwise unable to walk due to their amputation were able to achieve HRQoL comparable to walking amputees.
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- 2022
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31. Cost analysis of negative-pressure wound therapy versus standard treatment of acute conflict-related extremity wounds within a randomized controlled trial.
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Älgå A, Löfgren J, Haweizy R, Bashaireh K, Wong S, Forsberg BC, von Schreeb J, and Malmstedt J
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- Adult, Extremities, Female, Health Care Costs, Humans, Male, Wound Healing, Negative-Pressure Wound Therapy
- Abstract
Background: Clinical outcomes after negative-pressure wound therapy (NPWT) and standard treatment of conflict-related extremity wounds are similar. In resource-limited settings, cost affects the choice of treatment. We aimed to estimate treatment-related costs of NPWT in comparison with standard treatment for conflict-related extremity wounds., Methods: We derived outcome data from a randomized, controlled superiority trial that enrolled adult (≥ 18 years) patients with acute (≤ 72 h) conflict-related extremity wounds at two civilian hospitals in Jordan and Iraq. Primary endpoint was mean treatment-related healthcare costs (adjusted to 2019 US dollars)., Results: Patients were enrolled from June 9, 2015, to October 24, 2018. A total of 165 patients (155 men [93.9%]; 10 women [6.1%]; and median [IQR] age, 28 [21-34] years) were included in the analysis. The cost per patient treated with NPWT was $142 above that of standard treatment. Overall, results were robust in a sensitivity analysis., Conclusions: With similar clinical outcomes compared to standard care, our results do not support the use of NPWT in routine treatment of conflict-related extremity wounds at civilian hospitals in resource scarce settings. Trial registration NCT02444598., (© 2022. The Author(s).)
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- 2022
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32. Risk factors for reamputations in patients amputated after revascularization for critical limb-threatening ischemia.
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Torbjörnsson E, Fagerdahl AM, Blomgren L, Boström L, Ottosson C, and Malmstedt J
- Subjects
- Aged, Female, Follow-Up Studies, Humans, Incidence, Male, Postoperative Complications epidemiology, Reoperation, Retrospective Studies, Sweden epidemiology, Amputation, Surgical adverse effects, Ischemia surgery, Lower Extremity blood supply, Postoperative Complications surgery, Vascular Surgical Procedures methods
- Abstract
Objective: Despite vascular intervention, patients with critical limb-threatening ischemia (CLTI) have a high risk of amputation. Furthermore, this group has a high risk for stump complications and reamputation. The primary aim of this study was to identify risk factors predicting reamputation after a major lower limb amputation in patients revascularized because of CLTI. The secondary aim was to investigate mortality after major lower limb amputation., Methods: There were 288 patients who underwent a major ipsilateral amputation after revascularization because of CLTI in Stockholm, Sweden, during 2007 to 2013. The main outcome was ipsilateral reamputation., Results: Of 288 patients, 50 patients had a reamputation and 222 died during the 11-year follow-up. Patients with ischemic pain as an indication for primary amputation had nearly four times higher risk for a reamputation compared with those with a nonhealing ulcer (subdistribution hazard ratio, 3.55; confidence interval, 1.55-8.17). Higher age was associated with an increased risk for death in the multivariable analysis (hazard ratio, 1.03; confidence interval, 1.02-1.04)., Conclusions: Patients with ischemic pain as an indication for amputation have an elevated risk of reamputation. Ischemic pain may be indicative of a more extensive and proximal ischemia compared with patients with foot tissue loss. An extended evaluation of the preoperative circulation before amputation may facilitate the choice of amputation level and could lead to a reduction of reamputations., (Copyright © 2020 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
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33. Pseudoxanthoma Elasticum and Isolated Iliac Artery Occlusion.
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Gillgren P and Malmstedt J
- Subjects
- Arterial Occlusive Diseases diagnostic imaging, Arterial Occlusive Diseases physiopathology, Arterial Occlusive Diseases surgery, Humans, Male, Middle Aged, Pseudoxanthoma Elasticum diagnosis, Treatment Outcome, Vascular Grafting, Vascular Patency, Arterial Occlusive Diseases etiology, Iliac Artery diagnostic imaging, Iliac Artery physiopathology, Iliac Artery surgery, Pseudoxanthoma Elasticum complications
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- 2020
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34. Risk factors for amputation are influenced by competing risk of death in patients with critical limb ischemia.
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Torbjörnsson E, Blomgren L, Fagerdahl AM, Boström L, Ottosson C, and Malmstedt J
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- Aged, Female, Humans, Ischemia mortality, Limb Salvage, Male, Peripheral Arterial Disease mortality, Registries, Retrospective Studies, Risk Factors, Sweden, Amputation, Surgical, Ischemia surgery, Lower Extremity blood supply, Peripheral Arterial Disease surgery
- Abstract
Objective: Patients with critical limb ischemia (CLI) have a high risk of amputation and death. Death is a competing risk that affects the estimated amputation risk. Our aim was to find the specific risk factors for amputation for patients with CLI using competing risk analyses and compared these results with those from standard Cox regression analysis., Methods: Patients who had undergone revascularization for CLI (2009-2013, with follow-up data until 2017) in Stockholm were identified from the Swedish National Registry for Vascular Surgery. The main outcome was major amputation. The risk factors for amputation were assessed using competing risk analysis and compared with the risk factors for amputation-free survival identified using Cox proportional hazards regression analysis., Results: Of 855 patients with CLI, 178 had required a major amputation and 415 had died during the 8-year follow-up period. In the competing risk regression, age (subdistribution hazard ratio [sub-HR], 0.98; 95% confidence interval [CI], 0.97-1.00), ambulatory status (independent vs bedridden; sub-HR, 4.10; 95% CI, 2.14-7.86), and ischemic wound vs rest pain (sub-HR, 3.03; 95% CI, 1.72-5.36) were associated with amputation, considering death as a competing risk. In contrast, Cox regression analysis identified female vs male (hazard ratio [HR], 0.77; 95% CI, 0.64-0.94), age (HR, 1.02; 95% CI, 1.01-1.03), renal impairment (HR, 2.08; 95% CI, 1.61-2.67), ambulatory status (independent vs bedridden; HR, 3.45; 95% CI, 2.30-5.18), and ischemic wound vs rest pain (HR, 2.41; 95% CI, 1.78-3.25) as risk factors., Conclusions: The risk factors associated with amputation differed when analyzing the data using competing risk regression vs Cox regression. The differences between the analyses indicated that a risk exists for biased estimates using standard survival methods when a strong competing risk such as death is present., (Copyright © 2019 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
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35. Magical Thinking and Challenging Cultures: Management of Arterial Graft Infections.
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Padberg FT and Malmstedt J
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- Arteries, Humans, Thinking, Vascular Surgical Procedures, Infections, Magic
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- 2020
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36. Negative pressure wound therapy versus standard treatment in patients with acute conflict-related extremity wounds: a pragmatic, multisite, randomised controlled trial.
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Älgå A, Haweizy R, Bashaireh K, Wong S, Lundgren KC, von Schreeb J, and Malmstedt J
- Subjects
- Adult, Female, Humans, Iraq, Jordan, Male, Treatment Outcome, Young Adult, Extremities injuries, Negative-Pressure Wound Therapy, War-Related Injuries therapy
- Abstract
Background: In armed conflict, injuries among civilians are usually complex and commonly affect the extremities. Negative pressure wound therapy (NPWT) is an alternative to standard treatment of acute conflict-related extremity wounds. We aimed to compare the safety and effectiveness of NPWT with that of standard treatment., Methods: In this pragmatic, randomised, controlled superiority trial done at two civilian hospitals in Jordan and Iraq, we recruited patients aged 18 years or older, presenting with a conflict-related extremity wound within 72 h after injury. Participants were assigned (1:1) to receive either NPWT or standard treatment. We used a predefined, computer-generated randomisation list with three block sizes. Participants and their treating physicians were not masked to treatment allocation. The primary endpoint was wound closure by day 5. The coprimary endpoint was net clinical benefit, defined as a composite of wound closure by day 5 and freedom from any bleeding, wound infection, sepsis, or amputation of the index limb. Analysis was by intention to treat. The trial is registered with ClinicalTrials.gov, number NCT02444598, and is closed to accrual., Findings: Between June 9, 2015, and Oct 24, 2018, 174 patients were randomly assigned to either the NPWT group (n=88) or the standard treatment group (n=86). Five patients in the NPWT group and four in the standard treatment group were excluded from the intention-to-treat analysis. By day 5, 41 (49%) of 83 participants in the NPWT group and 49 (60%) of 82 participants in the standard treatment group had closed wounds, with an absolute difference of 10 percentage points (95% CI -5 to 25, p=0·212; risk ratio [RR] 0·83, 95% CI 0·62 to 1·09). Net clinical benefit was seen in 33 (41%) of 81 participants in the NPWT group and 34 (44%) of 78 participants in the standard treatment group, with an absolute difference of 3 percentage points (95% CI -12 to 18, p=0·750; RR 0·93, 95% CI 0·65 to 1·35). There was one in-hospital death in the standard treatment group and none in the NPWT group. The proportion of participants with sepsis, bleeding leading to blood transfusion, and limb amputation did not differ between groups., Interpretation: NPWT did not yield superior clinical outcomes compared with standard treatment for acute conflict-related extremity wounds. The results of this study not only question the use of NPWT, but also question the tendency for new and costly treatments to be introduced into resource-limited conflict settings without supporting evidence for their effectiveness. This study shows that high-quality, randomised trials in challenging settings are possible, and our findings support the call for further research that will generate context-specific evidence., Funding: The Stockholm County Council, the Swedish National Board of Health and Welfare, and Médecins Sans Frontières., (Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
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- 2020
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37. 2-cm versus 4-cm surgical excision margins for primary cutaneous melanoma thicker than 2 mm: long-term follow-up of a multicentre, randomised trial.
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Utjés D, Malmstedt J, Teras J, Drzewiecki K, Gullestad HP, Ingvar C, Eriksson H, and Gillgren P
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- Aged, Denmark, Estonia, Female, Humans, Intention to Treat Analysis, Lower Extremity surgery, Male, Margins of Excision, Melanoma pathology, Middle Aged, Mortality, Norway, Skin Neoplasms pathology, Survival Analysis, Sweden, Torso surgery, Treatment Outcome, Upper Extremity surgery, Melanoma, Cutaneous Malignant, Lower Extremity pathology, Melanoma mortality, Melanoma surgery, Skin Neoplasms mortality, Skin Neoplasms surgery, Torso pathology, Upper Extremity pathology
- Abstract
Background: The optimal surgical excision margins are uncertain for patients with thick (>2 mm) localised cutaneous melanomas. In our previous report of this multicentre, randomised controlled trial, with a median follow-up of 6·7 years, we showed that a narrow excision margin (2 cm vs 4 cm) did not affect melanoma-specific nor overall survival. Here, we present extended follow-up of this cohort., Methods: In this open-label, multicentre randomised controlled trial, we recruited patients from 53 hospitals in Sweden, Denmark, Estonia, and Norway. We enrolled clinically staged patients aged 75 years or younger diagnosed with localised cutaneous melanoma thicker than 2 mm, and with primary site on the trunk or upper or lower extremities. Patients were randomly allocated (1:1) to treatment either with a 2-cm or a 4-cm excision margin. A physician enrolled the patients after histological confirmation of a cutaneous melanoma thicker than 2 mm. Some patients were enrolled by a physician acting as responsible for clinical care and as a trial investigator (follow-up, data collection, and manuscript writing). In other cases physicians not involved in running the trial enrolled patients. Randomisation was done by telephone call to a randomisation office, by sealed envelope, or by computer generated lists using permuted blocks. Patients were stratified according to geographical region. No part of the trial was masked. The primary outcome in this extended follow-up study was overall survival and the co-primary outcome was melanoma-specific survival. All analyses were done on an intention-to-treat basis. The study is registered with ClinicalTrials.gov, number NCT03638492., Findings: Between Jan 22, 1992, and May 19, 2004, 936 clinically staged patients were recruited and randomly assigned to a 4-cm excision margin (n=465) or a 2-cm excision margin (n=471). At a median overall follow-up of 19·6 years (235 months, IQR 200-260), 621 deaths were reported-304 (49%) in the 2-cm group and 317 (51%) in the 4-cm group (unadjusted HR 0·98, 95% CI 0·83-1·14; p=0·75). 397 deaths were attributed to cutaneous melanoma-192 (48%) in the 2-cm excision margin group and 205 (52%) in the 4-cm excision margin group (unadjusted HR 0·95, 95% CI 0·78-1·16, p=0·61)., Interpretation: A 2-cm excision margin was safe for patients with thick (>2 mm) localised cutaneous melanoma at a follow-up of median 19·6 years. These findings support the use of 2-cm excision margins in current clinical practice., Funding: The Swedish Cancer Society, Stockholm Cancer Society, the Swedish Society for Medical Research, Radiumhemmet Research funds, Stockholm County Council, Wallström funds., (Copyright © 2019 Elsevier Ltd. All rights reserved.)
- Published
- 2019
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38. Negative-Pressure Wound Therapy Versus Standard Treatment of Adult Patients With Conflict-Related Extremity Wounds: Protocol for a Randomized Controlled Trial.
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Älgå A, Wong S, Haweizy R, Conneryd Lundgren K, von Schreeb J, and Malmstedt J
- Abstract
Background: In armed conflict, injuries commonly affect the extremities and contamination with foreign material often increases the risk of infection. The use of negative-pressure wound therapy has been described in the treatment of acute conflict-related wounds, but reports are retrospective and with limited follow-up., Objective: The objective of this study is to investigate the effectiveness and safety of negative-pressure wound therapy use in the treatment of patients with conflict-related extremity wounds., Methods: This is a multisite, superiority, pragmatic randomized controlled trial. We are considering for inclusion patients 18 years of age and older who are presenting with a conflict-related extremity wound within 72 hours after injury. Patients are block randomly assigned to either negative-pressure wound therapy or standard treatment in a 1:1 ratio. The primary end point is wound closure by day 5. Secondary end points include length of stay, wound infection, sepsis, wound complications, death, and health-related quality of life. We will explore economic outcomes, including direct health care costs and cost effectiveness, in a substudy. Data are collected at baseline and at each dressing change, and participants are followed for up to 3 months. We will base the primary statistical analysis on intention-to-treat., Results: The trial is ongoing. Patient enrollment started in June 2015. We expect to publish findings from the trial by the end of 2019., Conclusions: To the best of our knowledge, there has been no randomized trial of negative-pressure wound therapy in this context. We expect that our findings will increase the knowledge to establish best-treatment strategies., Trial Registration: ClinicalTrials.gov NCT02444598; http://clinicaltrials.gov/ct2/show/NCT02444598 (Archived by WebCite at http://www.webcitation.org/72hjI2XNX)., International Registered Report Identifier (irrid): DERR1-10.2196/12334., (©Andreas Älgå, Sidney Wong, Rawand Haweizy, Kalle Conneryd Lundgren, Johan von Schreeb, Jonas Malmstedt. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 26.11.2018.)
- Published
- 2018
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39. Infection with high proportion of multidrug-resistant bacteria in conflict-related injuries is associated with poor outcomes and excess resource consumption: a cohort study of Syrian patients treated in Jordan.
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Älgå A, Wong S, Shoaib M, Lundgren K, Giske CG, von Schreeb J, and Malmstedt J
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- Adult, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Bacteremia drug therapy, Bacteremia microbiology, Bacteria drug effects, Bacteria isolation & purification, Cohort Studies, Drug Resistance, Multiple, Bacterial drug effects, Female, Humans, Jordan, Logistic Models, Male, Retrospective Studies, Syria, Wounds and Injuries mortality, Bacteremia diagnosis, Wounds and Injuries microbiology
- Abstract
Background: Armed conflicts are a major contributor to injury and death globally. Conflict-related injuries are associated with a high risk of wound infection, but it is unknown to what extent infection directly relates to sustainment of life and restoration of function. The aim of this study was to investigate the outcome and resource consumption among civilians receiving acute surgical treatment due to conflict-related injuries. Patients with and without wound infections were compared., Methods: We performed a cohort study using routinely collected data from 457 consecutive Syrian civilians that received surgical treatment for acute conflict-related injuries during 2014-2016 at a Jordanian hospital supported by Médecins Sans Frontières. We defined wound infection as clinical signs of infection verified by a positive culture. We used logistic regression models to evaluate infection-related differences in outcome and resource consumption., Results: Wound infection was verified in 49/457 (11%) patients. Multidrug-resistance (MDR) was detected in 36/49 (73%) of patients with infection. Among patients with infection, 11/49 (22%) were amputated, compared to 37/408 (9%) without infection, crude relative risk = 2.62 (95% confidence interval 1.42-4.81). Infected patients needed 12 surgeries on average, compared to five in non-infected patients (p < .00001). Mean length of stay was 77 days for patients with infection, and 35 days for patients without infection (p = .000001)., Conclusions: Among Syrian civilians, infected conflict-related wounds had a high prevalence of MDR bacteria. Wound infection was associated with poor outcomes and high resource consumption. These results could guide the development of antibiotic protocols and adaptations of surgical management to improve care for wound infections in conflict-related injuries., Trial Registration: ClinicalTrials.gov ( NCT02744144 ). Registered April 13, 2016. Retrospectively registered.
- Published
- 2018
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40. Long-Term Outcome After Carotid Artery Stenting: A Population-Based Matched Cohort Study.
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Jonsson M, Lindström D, Gillgren P, Wanhainen A, and Malmstedt J
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- Aged, Carotid Stenosis complications, Cohort Studies, Female, Humans, Male, Registries, Stroke etiology, Treatment Outcome, Carotid Stenosis surgery, Stents, Stroke prevention & control
- Abstract
Background and Purpose: Long-term outcome after carotid artery stenting (CAS), a less invasive technique than carotid endarterectomy (CEA), for prevention of stroke, is unclear. The aim was to assess long-term outcomes after CAS, compared with CEA, in a nationwide cohort study., Methods: All patients registered in the national Swedish Vascular Registry (Swedvasc) treated with primary CAS between 2005 and 2012 were identified. For every CAS, 2 CEA controls, matched for sex, age, procedure year, and indication (symtomatic/asymtomatic), were chosen. Postoperative stroke was identified by cross-matching the cohort with the InPatient Registry and charts review. Primary end point was ipsilateral stroke or death >30 days postoperatively., Results: A total of 1157 patients were included, 409 CAS and 748 CEA; 73% men with mean age 70 years and 69% were symptomatic. Risk factor profile was similar between the 2 groups. Median follow-up time was 4.1 years. Ipsilateral stroke or death of >30 days postoperatively occurred in 95 of 394 in the CAS group versus 120 of 724 in the CEA group (adjusted hazard ratio, 1.59; 95% confidence interval, 1.15-2.18). The corresponding adjusted rates for death, ipsilateral stroke of >30 days, and any stroke or death of >30 days were 25.7% versus 18.6% (hazard ratio, 1.20; 95% confidence interval, 0.84-1.72), 9.4% versus 2.9% (hazard ratio, 3.40; 95% confidence interval, 1.53-7.53), 34.2% versus 23.6% (hazard ratio, 1.49; 95% confidence interval, 1.10-2.00) for the CAS group versus CEA group, respectively., Conclusions: In this nationwide cohort study, CAS was associated with an increased long-term risk of ipsilateral stroke and death during after the perioperative phase when compared with CEA., (© 2016 American Heart Association, Inc.)
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- 2016
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41. The receptor for advanced glycation end products and risk of peripheral arterial disease, amputation or death in type 2 diabetes: a population-based cohort study.
- Author
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Malmstedt J, Kärvestedt L, Swedenborg J, and Brismar K
- Subjects
- Aged, Biomarkers blood, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 mortality, Diabetic Angiopathies blood, Diabetic Angiopathies diagnosis, Diabetic Angiopathies mortality, Diabetic Angiopathies surgery, Disease Progression, Disease-Free Survival, Female, Humans, Incidence, Kaplan-Meier Estimate, Lysine analogs & derivatives, Lysine blood, Male, Middle Aged, Peripheral Arterial Disease blood, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease mortality, Peripheral Arterial Disease surgery, Proportional Hazards Models, Risk Assessment, Risk Factors, S100A12 Protein blood, Sweden epidemiology, Time Factors, Amputation, Surgical, Diabetes Mellitus, Type 2 complications, Diabetic Angiopathies etiology, Peripheral Arterial Disease etiology, Receptor for Advanced Glycation End Products blood
- Abstract
Background: Patients with type 2 diabetes have a high risk for early and extensive development of peripheral arterial disease (PAD) and this excess risk is not explained by increased burden of traditional atherosclerotic risk factors. Activation of the receptor for advanced glycation end products (RAGE) could be one additional mechanism for accelerated PAD and increased risk for amputation and death. We investigated the association between RAGE plasma components and the risk for PAD, amputation and death in patients with type 2 diabetes. We also estimated the rate of amputation-free survival and survival without PAD., Methods: We investigated if plasma levels of carboxymethyl-lysine, S100A12 and endosecretory RAGE (esRAGE) were associated with two endpoints: survival without development of PAD and survival without amputation in a 12 years prospective population-based cohort of 146 patients with type 2 diabetes, free from PAD at inclusion. Influence of baseline plasma levels of RAGE ligands (individually and combined by a RAGE-score) were evaluated for both endpoints in the Cox-regression analysis., Results: 106 patients survived without amputation and 93 survived without signs of PAD during follow up. Higher levels of S100A12 and RAGE-score were associated with increased risk for amputation or death, hazard ratios (HR) 1.29; 95% confidence interval (CI) [1.04, 1.59] and 1.79; 95% CI [1.07, 2.99] and with increased risk for PAD or death, HR 1.22; 95% CI [1.00, 1.49] and 1.56; [1.00, 2.44] after adjustment for age and sex. The effect was decreased after adjustment for Framingham cardiovascular disease score: risk for amputation or death, HR 1.17; 95% CI [0.94, 1.46] and 1.54; [0.95, 2.49], and risk for PAD or death, HR 1.12; 95% CI [0.91, 1.38] and 1.38; [0.91, 2.11] for S100A12 and RAGE-score respectively. The incidence for amputation or death was 2.8 per 100 person-years; 95% CI [2.0, 3.7] and the incidence rate for PAD or death was 3.6 per 100 person-years; 95% CI [2.7, 4.8]., Conclusion: Higher plasma levels of S100A12 and the combined effect (RAGE-score) of esRAGE, carboxymethyl-lysine and S100A12 seem to be associated with shorter PAD- and amputation-free survival in patients with type 2 diabetes. This may indicate a role for S100A12 in PAD by activation of the RAGE system.
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- 2015
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42. Analyte flux at a biomaterial-tissue interface over time: implications for sensors for type 1 and 2 diabetes mellitus.
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Ekberg NR, Brismar K, Malmstedt J, Hedblad MA, Adamson U, Ungerstedt U, and Wisniewski N
- Subjects
- Adult, Aged, Biopsy, Biosensing Techniques methods, Glucose analysis, Glycerol analysis, Glycerol metabolism, Humans, Inflammation metabolism, Insulin Resistance physiology, Lactates analysis, Lactates metabolism, Middle Aged, Mitochondria physiology, Monitoring, Physiologic instrumentation, Monitoring, Physiologic methods, Pyruvates analysis, Pyruvates metabolism, Skin chemistry, Skin pathology, Urea analysis, Urea metabolism, Biocompatible Materials, Biosensing Techniques instrumentation, Diabetes Mellitus, Type 1 metabolism, Diabetes Mellitus, Type 2 metabolism, Foreign Bodies, Glucose metabolism, Skin metabolism
- Abstract
Objective: The very presence of an implanted sensor (a foreign body) causes changes in the adjacent tissue that may alter the analytes being sensed. The objective of this study was to investigate changes in glucose availability and local tissue metabolism at the sensor-tissue interface in patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM)., Method: Microdialysis was used to model implanted sensors. Capillary glucose and subcutaneous (sc) microdialysate analytes were monitored in five T1DM and five T2DM patients. Analytes included glucose, glycolysis metabolites (lactate, pyruvate), a lipolysis metabolite (glycerol), and a protein degradation byproduct (urea). On eight consecutive days, four measurements were taken during a period of steady state blood glucose., Results: Microdialysate glucose and microdialysate-to-blood-glucose ratio increased over the first several days in all patients. Although glucose recovery eventually stabilized, the lactate levels continued to rise. These trends were explained by local inflammatory and microvascular changes observed in histological analysis of biopsy samples. Urea concentrations mirrored glucose trends. Urea is neither produced nor consumed in sc tissue, and so the initially increasing urea trend is explained by increased local capillary presence during the inflammatory process. Pyruvate in T2DM microdialysate was significantly higher than in T1DM, an observation that is possibly explained by mitochondrial dysfunction in T2DM. Glycerol in T2DM microdialysate (but not in T1DM) was higher than in healthy volunteers, which is likely explained by sc insulin resistance (insulin is a potent antilipolytic hormone). Urea was also higher in microdialysate of patients with diabetes mellitus compared to healthy volunteers. Urea is a byproduct of protein degradation, which is known to be inhibited by insulin. Therefore, insulin deficiency or resistance may explain the higher urea levels. To our knowledge, this is the first histological evaluation of a human tissue biopsy containing an implanted glucose monitoring device., Conclusions: Monitoring metabolic changes at a material-tissue interface combined with biopsy histology helped to formulate an understanding of physiological changes adjacent to implanted glucose sensors. Microdialysate glucose trends were similar over 1-week in T1DM and T2DM; however, differences in other analytes indicated wound healing and metabolic activities in the two patient groups differ. We propose explanations for the specific observed differences based on differential insulin insufficiency/resistance and mitochondrial dysfunction in T1DM versus T2DM., (© 2010 Diabetes Technology Society.)
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- 2010
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43. Comment on "Perioperative blood glucose monitoring and control in major vascular surgery patients".
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Malmstedt J and Swedenborg J
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- Blood Glucose metabolism, Diabetes Mellitus blood, Humans, Hypoglycemic Agents adverse effects, Perioperative Care, Treatment Outcome, Blood Glucose drug effects, Diabetes Mellitus drug therapy, Hypoglycemic Agents therapeutic use, Vascular Surgical Procedures adverse effects
- Published
- 2010
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44. Aortic dissection in pregnancy: a life-threatening disease and a diagnosis of worth considering.
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Nasiell J, Norman M, Lindqvist PG, Malmstedt J, Bottinga R, and Blennow M
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- Adult, Aortic Dissection epidemiology, Aortic Aneurysm epidemiology, Fatal Outcome, Female, Humans, Maternal Mortality, Pregnancy, Pregnancy Complications, Cardiovascular epidemiology, Sweden epidemiology, Aortic Dissection diagnosis, Aortic Aneurysm diagnosis, Pregnancy Complications, Cardiovascular diagnosis
- Abstract
Acute aortic dissection is a life-threatening disease. To increase the awareness of this diagnosis as a cause of feto-maternal mortality during pregnancy, we have analyzed risk factors using information from five pregnant women admitted for acute aortic dissection to the Karolinska University Hospital over an eight-year period (1999-2007). Four of the women died and only one survived. One fetus was stillborn and all newborn infants showed signs of asphyxia at birth. Of the women, who were on average five years above the mean age for delivery in Sweden, three had hypertension, two had first-degree relatives with aortic dissection which had occurred during the second half of pregnancy (gestational age at diagnosis 26-41 weeks). The most common presenting symptoms were severe back, abdominal and leg pain, and confusion. If a rapid diagnosis is not made, the risk of mortality for both mother and fetus is high. The incidence of aortic rupture during pregnancy in Sweden appears to be 14.5/1,000,000 and the case maternal fatality ratio 4.4/1,000,000.
- Published
- 2009
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45. Outcomes of endovascular abdominal aortic aneurysm repair compared with open surgical repair in high-risk patients: results from the Swedish Vascular Registry.
- Author
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Wahlgren CM and Malmstedt J
- Subjects
- Aged, Aortic Aneurysm, Abdominal diagnosis, Aortic Aneurysm, Abdominal mortality, Cause of Death trends, Female, Follow-Up Studies, Humans, Male, Middle Aged, Multivariate Analysis, Proportional Hazards Models, Prospective Studies, Risk Factors, Survival Rate trends, Sweden epidemiology, Treatment Outcome, Angioscopy methods, Aortic Aneurysm, Abdominal surgery, Elective Surgical Procedures methods, Registries
- Abstract
Background: The management of infrarenal aortic aneurysms in high-risk patients remains a challenge. Endovascular aneurysm repair (EVAR) is associated with superior short-term mortality rates but unclear long-term results and has not been shown to improve survival in patients unfit for open repair (OR). The aim of this population-based study was to evaluate the outcome after elective EVAR compared with OR in a high-risk patient cohort., Methods: Prospectively collected data from January 2000 to December 2006 were retrieved from the Swedish Vascular Registry. The high-risk cohort was defined as age >or=60 years, American Anesthesiologists Association (ASA) class 3 or 4, and at least one cardiac, pulmonary, or renal comorbidity. These criteria were met by 217 of 1000 EVAR patients and 483 of 2831 OR patients. Primary end points were 30-day and 1-year all-cause mortality. Kaplan-Meier curves for survival and multivariate Cox regression analyses were performed., Results: The crude 30-day and 1-year all-cause mortality rates for EVAR vs OR for the whole treatment group (n = 3831) were 1.8% vs 2.8% and 8.0% vs 7.2%, respectively. In the high-risk cohort (n = 700), EVAR patients were approximately 2 years older and renal insufficiency and diabetes mellitus were more common, and smoking was more prevalent in the OR group. About two-thirds of EVAR procedures were performed at university hospitals and one-half of OR procedures were performed at county hospitals. In the high-risk cohort, there was no difference in mortality at 30-days (EVAR, 4.6% vs OR, 3.3%), but OR had lower 1-year mortality (8.5% vs 15.9%; P = .003). More bleeding complications occurred in the EVAR group, but more pulmonary complications occurred in the OR group; however, there was no difference in cardiac, cerebrovascular, or renal complications. The mean follow-up was 3.4 years. EVAR was associated with increased mortality risk after adjusting for age, ASA class, and comorbidities (hazard ratio, 1.50; 95% confidence interval, 1.07-2.12; P = .02). Kaplan-Meier survival analysis showed a lower mortality rate for patients undergoing OR, which remained during follow-up (P = .001)., Conclusions: Elective OR of aortic aneurysms seems to have a better outcome compared with EVAR in this specific, population-based, high-risk patient cohort after adjusting for covariates. We cannot confirm the benefit of EVAR from previous registry studies with a similar high-risk definition. In clinical practice, OR may be at least as good as EVAR in high-risk patients fit for surgery.
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- 2008
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46. High 18F-FDG Uptake in synthetic aortic vascular grafts on PET/CT in symptomatic and asymptomatic patients.
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Wassélius J, Malmstedt J, Kalin B, Larsson S, Sundin A, Hedin U, and Jacobsson H
- Subjects
- Aged, Aged, 80 and over, Aneurysm therapy, Aorta diagnostic imaging, Aortic Aneurysm, Abdominal therapy, Diagnostic Imaging methods, Female, Humans, Male, Middle Aged, Radiopharmaceuticals, Aorta pathology, Blood Vessel Prosthesis, Fluorodeoxyglucose F18 pharmacokinetics, Positron-Emission Tomography methods, Tomography, X-Ray Computed methods
- Abstract
Unlabelled: Graft infection is a serious complication to vascular surgery. The aim of this study was to assess (18)F-FDG uptake in vascular grafts in patients with or without symptoms of graft infection., Methods: In all 2,045 patients examined by PET/CT at our clinic, 16 patients with synthetic aortic grafts were identified and reevaluated for (18)F-FDG accumulation. Clinical and biochemical data were obtained from patient records., Results: High (18)F-FDG uptake was found in 10 of 12 grafts in the patients who underwent open surgery and in 1 of 4 grafts in patients who underwent endovascular aneurysm repair. On the basis of biochemical and clinical data, it was concluded that 1 of the 16 patients had a graft infection at the time of investigation., Conclusion: (18)F-FDG uptake in vascular grafts was found in the vast majority of patients without graft infection. The risk of a false-positive diagnosis of graft infection by (18)F-FDG PET/CT is evident.
- Published
- 2008
- Full Text
- View/download PDF
47. [No fatal cases/stroke cases following surgery in asymptomatic carotid stenosis. Five-year results presented in a nation-wide register].
- Author
-
Bergqvist D, Björck M, Eliason K, Forssell C, Jansson I, Karlström L, Lundell A, Malmstedt J, Norgren L, and Troëng T
- Subjects
- Humans, Postoperative Complications epidemiology, Postoperative Complications etiology, Registries, Stroke prevention & control, Sweden epidemiology, Treatment Outcome, Vascular Surgical Procedures adverse effects, Vascular Surgical Procedures standards, Vascular Surgical Procedures statistics & numerical data, Carotid Stenosis surgery
- Published
- 2006
48. Aorto-carotid bypass for cerebral malperfusion after aortic dissection surgery: a case report.
- Author
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Sartipy U, Malmstedt J, Holm P, Owall A, and Dellgren G
- Subjects
- Aortic Dissection complications, Aorta surgery, Aortic Aneurysm complications, Carotid Arteries surgery, Humans, Male, Middle Aged, Treatment Outcome, Aortic Dissection surgery, Aortic Aneurysm surgery, Cerebral Revascularization methods, Cerebrovascular Disorders etiology, Cerebrovascular Disorders surgery, Vascular Surgical Procedures adverse effects, Vascular Surgical Procedures methods
- Abstract
Malperfusion syndrome may complicate the postoperative course in patients who have undergone surgery for aortic dissection. In these cases, open surgery or endovascular intervention may be required. We present a case of postoperative onset of intermittent severe neurological symptoms after surgery for type A aortic dissection. Progressive dissection of the carotid arteries was diagnosed, and treatment options were discussed. A successful aorto-carotid bypass was performed by cardiac and vascular surgeons in collaboration. All neurological symptoms were completely resolved. We advocate a high degree of vigilance for signs of cerebral malperfusion in the intensive care unit. Early intervention can result in a successful outcome, as illustrated by this case report.
- Published
- 2006
- Full Text
- View/download PDF
49. [She delivered weavers' children - midwife Anna Norin].
- Author
-
Malmstedt J
- Subjects
- History, 18th Century, History, 19th Century, Sweden, Midwifery history
- Published
- 1982
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