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Biomedical subjects

D Bergqvist

Publications and source records attributed to D Bergqvist.

At least 523 records · Page 29Linked to original sources

Percutaneous transluminal angioplasty of arteriosclerotic lesions in the pelvis and lower extremities.

The experience of percutaneous transluminal angioplasty (PTA) in 66 patients (71 stenoses) with arteriosclerotic lesions in the pelvic and lower extremity arteries is reported. The PTA was technically successful in 70 stenoses. Complications were seen in eleven patients. The follow-up time was 19 months (2-44). The frequency of recurrencies was clearly related to the location of stenosis, the more distal the lesion the higher the recurrency rate. The immediate roentgenologic result had no prognostic value to protect recurrencies. To conclude PTA is an alternative to surgery in patients with short stenoses in the iliac arteries, but very strict indications should be used when lesions are localized below the inguinal ligament.

Adult↗

Prostacyclin (PGI2) and plasminogen activator (PA) activity in umbilical vein grafts. An experimental study.

Glutaraldehyde-tanned human umbilical cord vein grafts (Dardik Biograft, Meadox) (HUV) measuring 6 cm in length and 5-6 mm in diameter were placed in the carotid arteries (CA) or jugular veins (JV) of sheep and the anastomoses were made end-to-end. Sections from the anastomotic sites and mid-graft were submitted to prostacyclin (PGI2) (radioimmunoassay) and plasminogen activator, PA, (histochemical) assays. Anastomotic PGI2 production from 6 grafts placed in the CA and removed 10 days later was similar to that of control arteries. The midgraft PGI2 synthesis tended to be less but the difference was not statistically significant. Anastomotic PGI2 from 11 grafts placed in the CA and removed 90 days later was also similar but the midgraft production was significantly less (p less than 0.025). From the distal anastomoses and mid portion of grafts placed in the jugular veins and removed 10 days later PGI2 synthesis was significantly less than that of control veins (p less than 0.025 and p less than 0.005 respectively) but no difference between the proximal anastomosis and control veins was observed. In none of 11 HUV removed on the 10th postoperative day was there any PA in the neointima; however, in 6 out of the 9 HUV removed on the 90th postoperative day, PA was demonstrated in the neointima. In conclusion, PGI2 synthesis similar to that of control vessels but less from the mid-graft regions. Neointima gained the ability to produce plasminogen activator.

Animals↗

Arteriosclerosis in popliteal artery trifurcation as a predictor for myocardial infarction after arterial reconstructive operation.

The frequency of myocardial infarction and mortality within 30 days after lower limb vascular reconstruction, in relation to the extent of atherosclerotic lesions in the trifurcation of the popliteal artery, have been retrospectively analyzed in 158 consecutive patients reconstructed in the aortoiliac region and 239 consecutive patients undergoing femorodistal bypass. Among the patients without trifurcational disease (TFD) none had myocardial infarction develop postoperatively, as compared with four of the 50 patients with TFD in the aortoiliac series (p less than 0.05) and 18 of the 174 patients with TFD in the femorodistal series (p less than 0.05). In nine instances, the cause of death was myocardial infarction. The strong correlation between postoperative myocardial infarction and the presence of TFD, may be due to a direct correlation between coronary artery disease and TFD. The finding is of practical importance in the selection of treatment for patients with circulatory disorders of the lower limbs. The finding facilitates the preoperative identification of patients liable to have myocardial infarction develop. Indications for operation can be made more stringent and optimal intraoperative and postoperative monitoring can be instituted.

Acute Kidney Injury↗

Extraanatomic vascular reconstruction in patients with aorto-iliac arteriosclerosis.

During an 11-year period 117 extraanatomic reconstructions were made for aorto-iliac arteriosclerosis; 36 axillofemoral and 81 femorofemoral crossover bypasses. The patients were old and had several factors making them poor risks for surgery. Axillofemoral grafts were more often used in patients with malignant disease. Postoperative mortality was 10% without difference between the two types of reconstruction. Both early and late complications were significantly more frequent in patients with axillofemoral bypass. Reoperations for occlusion and symptoms from the donor side also were significantly more common among axillofemoral patients. Life table analysis showed a higher survival and patency rate among patients with crossover grafts.

Aged↗

Reduced thrombogenic characteristics of expanded polytetrafluoroethylene and polyurethane arterial grafts after heparin bonding.

The effect of bonding of heparin, via a glutaraldehyde-stabilized ionic complex, on the early thrombogenicity of polyurethane (PU) and expanded polytetrafluoroethylene (PTFE) (Gore-tex) as well as covalent bonding of heparin on PTFE was studied in vivo. Grafts 6 cm long and 4 mm in diameter were placed in the carotid arteries of sheep and perfused for 4 hours at 25 ml/min in order to accelerate thrombus formation. The thrombogenicity was determined by calculation of the percent of the luminal surface free of thrombus and patency. In addition, 32P-labelled platelet accumulation was determined in some of the grafts. The stabilized ionic bonding of heparin significantly reduced the early thrombogenicity of PU but had little effect on PTFE grafts; but the thrombogenicity of the latter was markedly decreased following covalent bonding of heparin. A regional distribution of platelet accumulation was found with the distal anastomoses showing the highest platelet deposition. By choice of an appropriate method of heparinization, a significant reduction of the thrombogenicity of PU and PTFE grafts was achieved.

Animals↗

Aneurysms of the popliteal artery.

A retrospective study of 13 patients with 18 popliteal artery aneurysms has been undertaken. The patients were seen under a period of 12 years. Six of the patients had extrapopliteal aneurysms as well. Seven of the popliteal aneurysms presented as vascular emergencies, due to occlusion of the popliteal artery. In this group the amputation rate was 57%. In the elective group no amputation was necessary nor did any patient suffer from claudication during follow-up. Ultrasonography is a good tool for demonstrating the nature of the disease. Usually a short exclusion bypass is enough to reconstruct the area. A popliteal aneurysm, if not occluded and asymptomatic, is an indication to operate because of the threat to the limb in case of embolism or thrombosis.

Adult↗

Anticoagulant effects of two types of low molecular weight heparin administered subcutaneously.

Two types of LMW heparin were prepared by gel filtration of standard heparin (LMW fraction) and by degradation of heparin by nitrous acid (LMW fragment), respectively. The effects on factor Xa inhibition (XaI), APTT, platelet aggregation and AT III level of these preparations were studied after subcutaneous administration to humans and compared with those of standard heparin. At a dose of 5000 IU (XaI) the LMW fraction and LMW fragment induced peak plasma XaI activity of 0.32 IU/ml and 0.41 IU/ml respectively, compared to 0.07 IU/ml for heparin. Still 11.5 h after administration both LMW preparations gave higher activities than heparin ever induced. Following administration of 10,000 IU (XaI) of the LMW fragment the plasma peak XaI activity was 0.81 IU/ml. This prolonged the APTT from 36 sec to 46 sec only. The half-lives of the XaI activity in plasma were between 3 and 4 hours. No effect on platelet aggregation or AT-III level was demonstrated.

Adult↗

The effect of dihydroergotamine on platelets, coagulation and fibrinolysis, studied in healthy humans and in dogs.

The effect of dihydroergotamine (DHE) on platelets, coagulation and fibrinolysis was studied in healthy volunteers ex vivo before and after intravenous administration (0.5 mg). In addition, the effect of DHE in different concentrations on platelet aggregation was evaluated in vitro. Haematocrit was found to increase, as did factor VIII:C and antithrombin III - though the latter increases were not significant when correction was made for the altered haematocrit. Though platelet function ex vivo was unchanged, inhibition of adrenaline induced platelet aggregation was noted in vitro when the plasma concentrations of added DHE were higher than those obtained with clinically relevant doses. No effect on fibrinolysis was noted.

Adult↗

Comparison of plasminogen activator activity in human arteries and veins.

Biopsy specimens were obtained from 138 arteries and concomitant veins in different anatomic regions of both healthy subjects and patients undergoing surgery of various kinds. A fibrin slide technique was used to determine plasminogen activator (PA) activity, no significant difference being found between activity in arteries and that in veins, other than in epigastric veins where it was significantly greater. Arterial PA activity was similar in both healthy and uraemic subjects, and was unaffected by uraemia due to diabetes or other renal disorder, and by such factors as age and sex. Correlation between arterial activity and that in concomitant veins was found for all the anatomic regions studied.

Adolescent↗

The effect of serotonin inhibition on initial microvessel hemostasis and platelet aggregation in vivo.

The role of serotonin (5-HT) in initial microvascular hemostasis is not fully understood. This study was made to evaluate the effect on hemostatic plug formation and laser-induced arteriolar microembolism of different substances which counteract the effect of 5-HT. Hemostatic plug formation time and stability was measured in the rabbit mesenteric microcirculation and laser-induced embolism in the rabbit ear chamber. Ketanserine, a selective 5-HT2-receptor blocker shortened arteriolar hemostatic plug formation time. Dihydroergotamine, an unselective blocker (with 5-HT-and alpha-adrenergic receptor affinity) increased venular hemostatic plug formation time and also decreased the hemostatic plug stability. Laser-induced platelet embolism was unaltered after both ketanserine and dihydroergotamine administration. The magnitude of these changes seems to exclude an important effect of 5-HT in initial microvessel hemostasis or on platelet activity.

Animals↗

The pharmacokinetics of subcutaneous dihydroergotamine with and without a dextran 70 infusion.

The pharmacokinetics of subcutaneous dihydroergotamine (DHE) with or without dextran 70 infusion was evaluated in a single- and multiple-dose study in 30 patients. Radioimmunoassay was used to measure plasma DHE and the anthrone method to determine the dextran concentration. In the single-dose study no significant interaction between DHE and dextran was noted with respect to their plasma levels. The absorption of s.c. DHE was rapid and the disappearance curve followed a biphasic pattern, t0.5 alpha being 1.4 and 2.0 h, t0.5 beta 22 and 21 h for DHE and DHE/dextran 70, respectively. In the multi-dose study the trough level of DHE initially had a tendency to rise, in accordance with simulated plasma concentration curves. DHE trough levels were about 0.5 ng/ml and were well above the assumed minimum effective value to induce venoconstriction (0.06 ng/ml). Dextran concentrations were significantly higher when DHE was co-administered, possibly, due to changes in plasma volume. It is concluded that DHE 0.5 mg s.c. twice daily will give an adequate plasma concentration and that there was no important interaction between it and infused dextran 70.

Adult↗

Venous function in the leg after postoperative thrombosis diagnosed with 125I-fibrinogen uptake test.

The 125I-fibrinogen uptake test (FUT) has been widely used in the past decade to detect postoperative thrombosis. FUT has been shown to correlate well with phlebography, and positive FUT is associated with a high frequency of pulmonary embolism. The long-term venous function of the leg after FUT-detected postoperative thrombosis, however, is inadequately documented. In 179 patients who had been studied after operation with FUT, a follow-up evaluation of FUT as an indicator of risk for development of deep venous insufficiency was made four to five years later. The patients replied to a questionnaire, were clinically examined, and underwent venous strain-gauge plethysmography, venous pressure measurement, and, in some cases, phlebography. No statistically significant differences were found in any of the parameters between legs that had been FUT-positive and those that were FUT-negative at the time of the operation. The frequency of deep venous insufficiency thus was equal in FUT-positive and FUT-negative legs. It was also independent of the site of FUT-detected thrombus in the leg.

Aged↗

Patients with abdominal trauma and fatal outcome: analysis of a 30-year series.

Patients with blunt abdominal trauma and fatal outcome during 30 years in a well-defined rural Swedish area have been analyzed. There were 127 patients. Several facts indicate that more severe trauma has been appearing more often during this period The mortality rate has, however, been stable, but the patients have become older. More patients die from pulmonary complications than from the trauma itself. One very important development is the significant decrease in mortality among children.

Abdominal Injuries↗

The influence of oral contraceptives on activated factor X inhibitor (XaI)-activity: a prospective study.

A prospective study of activated factor X inhibitor (XaI)-activity has been performed in women randomly allocated to contraceptive pills containing 30 micrograms + 150 micrograms (63 women) or 50 micrograms + 250 micrograms (44 women) ethinyl oestradiol and levonorgestrel, and a reference group of 35 women using other contraceptive methods. The XaI-activity was measured six times during 1 year of observation. There was a significant reduction of XaI-activity after 1 month of oestrogen consumption but there was no significant difference between 30 and 50 micrograms users. The maximal reduction during the observation period was 12% in both groups. There was positive correlation between the pretreatment value and the maximal reduction in the same patient, but the activity did not fall below the normal range (75-125% of normal human plasma).

Adult↗

Decreased acute thrombogenicity of human umbilical veins after heparin and alcohol treatment.

Nine glutaraldehyde-tanned human umbilical veins (GAUV) were incubated in heparin followed by storage in ethyl alcohol 50% (HAUV). These grafts were compared to five GAUV flushed with a heparinized solution without subsequent treatment in alcohol (HsAUV) and four nonheparinized GAUV (NHUV) placed in the contralateral carotid arteries of dogs for approximately 3 h. The thrombogenicity was evaluated by measuring the platelet adhesion and aggregation (51Cr), fibrinogen accumulation (125I-fibrinogen), the thrombus-free surface and the thrombus weight. The HAUV had the lowest 51Cr radioactivity. The means of thrombus-free surface and thrombus weight for the grafts were as follows: HAUV, 82% and 0.3 g (n = 9); HsAUV, 53% and 0.6 g (n = 5); NHUV, 13% and 1.2 g (n = 4). The HAUV showed a lower thrombogenicity than both the NHUV and the HsAUV grafts.

Animals↗