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Biomedical subjects

A Trippestad

Publications and source records attributed to A Trippestad.

At least 37 records · Page 2Linked to original sources
PubMed1987

Four years' results of a prospective, randomized clinical trial comparing polytetrafluoroethylene and modified human umbilical vein for below-knee femoropopliteal bypass.

Polytetrafluoroethylene (PTFE) (Gore-Tex) and human umbilical vein (Biograft) arterial grafts were compared for below-knee femoropopliteal bypass grafting in a prospective randomized clinical trial. One hundred five patients (105 limbs) entered the trial. Seventy-six percent suffered from rest pain, ulceration, or gangrene. The median postoperative ankle-arm blood pressure index was 0.36. Twenty-three limbs had three patent tibial arteries, 46 limbs had two tibial arteries, 31 limbs had one patent artery, and five limbs had isolated popliteal segments. Thirty-four percent were repeat operations. Fifty-five patients were allocated to receive PTFE grafts and 50 to receive human umbilical vein grafts. The two groups were comparable as to preoperative risk factors and operative and postoperative treatment. During the first 4 years (maximum 1609 days) 40 PTFE grafts and 24 umbilical veins occluded. At 1 year the PTFE patency rate was 53% and at 4 years was 22%. For umbilical vein the corresponding figures were 74% and 42% (p = 0.005, Gehan test). During follow-up the incidence of PTFE failure was on the average 2.1 times higher than that of umbilical vein failure (95% confidence limits 1.2 to 3.4).

Aged↗
PubMed1985

Late rupture of knitted Dacron double velour arterial prostheses. Report on four cases.

Late fibre breakage with longitudinal tears occurred in 4 patients of a series of some 300 implanted knitted Dacron double velour arterial prostheses. The four patients all received their grafts for occlusive aortoiliac disease in the year 1978, and the rupture was found 4 to 6 years later. Three of the failures occurred in axillo-bifemoral bypass grafts, whereas the fourth patient had a bifurcated aortic prosthesis. Dilatation was significant in the latter graft only. Structural weakness might appear during production, during later handling, or possibly as a result of interference from infected material or host factors. The cause of graft failures in the present series could not be ascertained. Whatever type of knitted Dacron used, a 2-3% incidence of graft deterioration might be expected. Therefore regular, life-long follow-up of patients with Dacron arterial prostheses seems warranted.

Aged↗
PubMed1985

Dilatation and rupture of Dacron arterial grafts.

Dilatation and rupture of Dacron vascular grafts have been infrequently reported in the literature. Graft rupture occurred in five patients of a series of some 300 Cooley double velour knitted Dacron arterial prostheses implanted at Haukeland Hospital. An incidence of 3% graft ruptures has been reported in the literature. It is important that this complication is recognized and properly treated by the vascular surgeon. Regular life-long follow-up examinations of all patients with vascular prostheses are recommended.

Arteries↗
PubMed1983

A randomized clinical trial of PTFE versus human umbilical vein for femoropopliteal bypass surgery. Preliminary results.

PTFE (Goretex) and modified human umbilical vein (Biograft) vascular grafts were compared in femorodistal popliteal artery bypass surgery in a randomized clinical multicentre trial. During 18 months 104 patients (104 limbs) entered the trial. Twenty-five patients suffered from claudication, 54 suffered rest pain and 25 patients had ulceration or gangrene. The median preoperative ankle-arm blood pressure index was 0 . 34. Twenty-three limbs had 3 patent tibial arteries, 45 limbs had 2 tibial arteries, 31 limbs had 1 tibial artery while 5 limbs had an isolated popliteal segment. Thirty-six of the operations were redo-operations. Fifty-four patients were allocated to PTFE and 50 to umbilical vein. During follow-up (maximum 650 days) 24 PTFE grafts occluded against 12 umbilical veins. The 1-year patency rate was 40 per cent in the PTFE group against 75 per cent in the umbilical vein group (P = 0 . 014, Gehans test). During the first year the PTFE failure rate was on average 3 . 1 times higher than that of the umbilical vein.

Aged↗
PubMed1982

Time and cause of death for 301 patients operated on for abdominal aortic aneurysms.

Time and cause of death were studied in 301 patients operated on for an abdominal aortic aneurysm (AA). The hospital mortality rate was 4% for electively operated patients, 19% for patients with impending rupture, and 58% for those with a ruptured aneurysm. The one- and five-year survival rates were 94% and 68% for the elective group, 70% and 44% for those with impending rupture, and 41% and 31% for patients with a ruptured aneurysm. Of all inpatient deaths, 20% were caused by multi-organ failure. Cardiovascular deaths accounted for 71% of all deaths in patients with AA. 'Sudden death' (cause not known) occurred in 6.6% of all deaths, and in 18% of the late deaths. Although survival probabilities for patients operated on for AA are good if the patients survive the operation and the immediate postoperative period, we found that the majority of deaths were caused by cardiovascular diseases.

Aorta, Abdominal↗
PubMed1982

Salvage of the severely ischaemic limb by intra-arterial prostacyclin (PGI2) infusion. A case report.

A 75-year-old male patient with impending gangrene of the left lower limb due to advanced arteriosclerosis was treated with intra-arterial infusion of prostacyclin (PGI2). Pain at rest disappeared completely soon after treatment was started. Blood flow to the extremity measured by a Doppler velocity meter increased significantly during PGI2 infusion. Although some reduction in flow was found after termination of the infusion, the flow values up to 6 weeks after treatment were still markedly higher than pretreatment levels.

Aged↗
PubMed1982

Abdominal aortic aneurysms: survival analysis of four hundred thirty-four patients.

Cases of 434 patients who underwent surgery for abdominal aortic aneurysms in five surgical departments in Norway have been studied with respect to survival patterns and survival probabilities. Of these, 200 patients (median age 63 years) had elective surgery, 173 patients (median age 69 years) had ruptured aneurysms, and 61 patients (median age 67 years) had impending rupture (i.e., emergency operations were performed, but no rupture was found). The hospital mortality rates in the groups were 3.5%, 59%, and 24.6%, respectively. The general probabilities of survival of these groups have been compared with those of a demographically similar population (standard population). Patients who had elective surgery had a slightly, but significantly, lower survival probabilities than did the standard population, whereas the patients who underwent emergency surgery and who survived the first postoperative month showed no increased risk of dying as compared with the standard population. For the elective surgery group, age had a significant effect on survival, whereas the period of operation did not. In the group with ruptured aneurysms both the age of the patient and the period of operation had significant effects on survival, whereas no such effects were found for patients with impending rupture. The survival probabilities for patients surviving the operation were generally good, with a high 5-year survival rate. The mortality rate for patients with ruptured aneurysms decreased significantly from period I (surgery performed before 1976) to period II (surgery performed in 1976 or later). The survival probabilities for patients of advanced age were relatively good, even for patients who had emergency surgery.

Adult↗
PubMed1981

Umbilical vein grafts and PTFE grafts for femoro-popliteal bypass. Preliminary results.

This retrospective, multiple-center study includes 172 PTFE (Gore-Tex) and 35 umbilical vein grafts (Bio-graft) used for femoro-popliteal bypass grafting. The one-year patency rate was approximately 63% in both groups. Until further experience is accumulated, autogenous saphenous vein should probably be the first choice for femoro-popliteal bypass grafting. Prosthetic grafts should preferably be used when the saphenous vein is absent or insufficient.

Aged↗
PubMed1980

Incidences of fatal postoperative pulmonary embolism after prophylaxis with dextran 70 and low-dose heparin: an international multicentre study.

A total of 4352 patients were admitted to a prospective' randomised multicentre trial comparing the prophylactic efficacy of dextran 70 and low-dose heparin against fatal pulmonary embolism after elective operations for general, orthopaedic, urological, and gynaecological conditions. Out of 3984 patients correctly admitted, 1993 were allocated to receive dextran 70 and 1991 to receive low-dose heparin. Withdrawal of prophylaxis because of bleeding or technical difficulties occurred more often in the heparin group, but allergic reactions were more common in the dextran group. Of the 75 patients who died within 30 days after operation, 38 had been given dextran and 37 low-dose heparin. Necropsy was performed in 33 and 32 of these cases respectively. In six patients in each group pulmonary embolism was the sole or a contributory cause of death. Of these, five patients in the dextran group and two in the heparin group had received a full course of prophylaxis. There was no statistically significant difference between the two treatment groups in the incidence of fatal pulmonary embolism after a full course of prophylaxis.

Aged↗
PubMed1979

Ureteral obstruction by aorto-iliac aneurysms--a common complication?

During a 4-year-period, 5 cases of ureteral obstruction by aorto-iliac aneurysm were detected. Over the same period 50 aorto-iliac aneurysms were resected. One of the 5 patients was not operated on. In the remaining 4, the aneurysm was resected and replaced by a Dacron bifurcation graft. Nephrectomy was performed in the first 2 patients. Autotransplantation of the remaining kidney was carried out in one case following enucleation of a hypernephroma ex vivo. In the other 2 patients, ureterolysis and intraperitoneal transposition of the ureter was performed in conjunction with resection of the aneurysm. One of the latter patients suffered from uraemia due to a non-functioning kidney on the other side. Ureteral obstruction appears to be a relatively common complication of aorto-iliac aneurysm. Elective evaluation of patients with aortic aneurysms should include late aortograms visualizing the ureters.

Adult↗
PubMed1978

Aortic rupture in a patient with elastosis perforans serpiginosa (Lutz-Miescher).

A case of aortic rupture in a 30-year-old women with a rare skin disease, elastosis perforans serpiginosa, is presented. Skin lesions are characterized by marked elastic tissue changes. Multiple large arteries and the distal part of the aorta were thinwalled also with aneurysm-like dilatations. Focal fibroelastosis and degenerative changes were present in the vessel walls. The changes in the aorta made the surgical treatment difficult.

Adult↗
PubMed1976

Rat intestinal glycoprotein lowering bactericidal activity of serum on 32P-labelled E. coli.

A glycoprotein fraction, by which the 32P-releasing activity of serum on labelled E. coli is lowered, was isolated from caecum content of germfree rats. The glycoprotein contained 83.1% sulphate, and 16.1% protein. The molecular weight ranged from 3.2 X 10(5) to 2.4 X 10(6), and the iso-electric point from pH 0.9 to 3.0. Physiologically, it may play a role in the interaction(s) between the host and its intestinal flora.

Animals↗
PubMed1975

Influence of methylprednisolone on complement activity in germfree rats and on antibody activity to Escherichia coli in monocontaminated rats.

By means of radio-isotope technique, the influence of methylprednisolone treatment on opsonic and bactericidal serum activities against E. coli was studied on germfree and monocontaminated rats. Based on the present results it seems unlikely that methylprednisolone impairs the production of complement components. A slight suppression of antibody activity was only found in markedly wasted monocontaminated rats treated with very high doses of methylprednisolone from the day before contamination.

Animals↗