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Abstract: Objective: To compare 1-year potencies’ of heparin-bonded PTFE [(Hb-PTFE) (Propaten®)] grafts with those of ordinary polytetraflouroethylene (PTFE) grafts in a blinded, randomised, clinically controlled, multi-centre study. Materials and methods: Eleven Scandinavian centres enrolled 569 patients with chronic functional or critical lower limb ischaemia who were scheduled to undergo femoro–femoral bypass or femoro–poplitaeal bypass. The patients were randomised 1:1 stratified by centre. Patency was assessed by duplex ultrasound scanning. A total of 546 patients (96%) completed the study with adequate follow-up. Results: Perioperative bleeding was, on average, 370 ml with PTFE grafts and 399 ml with Heparin-bonded PTFE grafts (p = 0.32). Overall, primary patency after 1 year was 86.4% for Hb-PTFE grafts and 79.9% for PTFE grafts (OR = 0.627, 95% CI: 0.398; 0.989, p = 0.043). Secondary patency was 88% in Hb-PTFE grafts and 81% in PTFE grafts (OR = 0.569 (0.353; 0.917, p = 0.020)). Subgroup analyses revealed that significant reduction in risk (50%) was observed when Hb-PTFE was used for femoro–poplitaeal bypass (OR = 0.515 (0.281; 0.944, p = 0.030)), and a significant reduction in risk (50%) was observed with Hb-PTFE in cases with critical ischaemia (OR = 0.490 (0.249; 0.962, p = 0.036)). Conclusion: The Hb-PTFE graft significantly reduced the overall risk of primary graft failure by 37%. Risk reduction was 50% in femoro–poplitaeal bypass cases and in cases with critical ischaemia. [Copyright &y& Elsevier]

Objective/background: The objective was to observe for 1 year all patients in Norway operated on for symptomatic carotid stenosis with respect to (i) the time from the index event to surgery and neurological events during this time; (ii) the level in the healthcare system causing delay of surgical treatment; and (iii) the possible relationship between peri-operative use of platelet inhibitors and neurological events while awaiting surgery., Methods: This was a prospective national multicentre study of a consecutive series of symptomatic patients. Patients were eligible for inclusion when referred for surgery. An index event was defined as the neurological event prompting contact with the healthcare system. All 15 departments in Norway performing carotid endarterectomy (CEA) participated., Results: Three hundred and seventy one patients were eligible for inclusion between 1 April 2014 and 31 March 2015, and 368 patients (99.2%) were included. Fifty-four percent of the patients contacted their general practitioner on the day of the index event. Primary healthcare referred 84.2% of the patients to hospital on the same day as examined. In hospital median time from admission to referral for vascular surgery was 3 days. Median time between referral to the operating unit and actual CEA was 5 days. Overall, 61.7% of the patients were operated on within 2 weeks of the index event. Twelve patients (3.3%) suffered a new neurological event while awaiting surgery. The percentage of patients on dual antiplatelet therapy was lower (25.0%) in this group than among the other patients (62.6%) (p = .008). The combined 30 day mortality and stroke rate was 3.8%., Conclusion: This national study with almost complete inclusion and follow-up shows that the delays occur mainly at patient level and in hospital. The delay is associated with new neurological events. Dual antiplatelet therapy is associated with reduced risk of having a new neurological event before surgery., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: In Norway, repair of abdominal aortic aneurysms is performed in more than 800 patients annually. Open repair is an established procedure, but an increasing number of patients have undergone endovascular repair during the last decades. The paper delivers an up to date discussion of infrarenal abdominal aortic aneurysm repair., Materials and Methods: A systematic search was performed in Pubmed and literature containing the search terms "abdominal aortic aneurysm" and "mortality" (from 2004 to 2009) was retrieved. The review is based on randomized, multi-centre and registry studies examining complications and mortality in endovascular and open repair., Results: Perioperative mortality is lower in endovascular repair. The initial survival benefit is not sustained over time. The mortality rate is still high in ruptured abdominal aortic aneurysms, but endovascular repair may improve mortality in selected patients., Interpretation: Even though perioperative mortality associated with endovascular repair is lower than that of open repair, questions concerning benefit and selection of patients are still left unanswered.

Background: Our aim was to find quality indicators like frequency of complications and reoperations in addition to post-operative status and patient satisfaction., Material and Methods: 57 patients underwent a follow-up after 5.8 years on average. Most were female and mean age at operation was 60.8 years. Information was obtained from patient records and questionnaires returned by 88.7% of 53 remaining patients., Results: The perioperative complication rate was 15.8%. Most were light and there was no mortality. Six out of ten patients were satisfied, whereas one of three was not. One out of eight regretted the procedure. Postoperatively three out of five reported a persistent but usually light back problem; the majority of these patients were satisfied. One out of four had changed to less strenuous work; near half of the patients had qualified for a permanent disability pension. Three patients had been reoperated., Interpretation: Our results compare well with other studies, which are reported and briefly discussed.