Biomedical subjects

Henning Rud Andersen

Publications and source records attributed to Henning Rud Andersen.

23 records · Page 2Linked to original sources

PubMed2003

Catheter-based 32P beta-radiation after stent implantation in porcine coronary arteries: role of source-centering and geographical miss.

The present study examined the role of source-centering and geographical miss in vascular brachytherapy. After implantation of 13 mm long stents, 38 coronary arteries in 13 pigs were randomly assigned to centered brachytherapy (n = 13), eccentric brachytherapy (n = 13), or no radiation (n = 12). Geographical miss was avoided by careful placement of a 27 mm (32)P beta-radiation source. Restenosis was quantified by angiography, histomorphometry, and intravascular ultrasound at 28 days. Source-centering led to a significant (P < 0.001) reduction of in-stent area stenosis (centered radiation, 12% +/- 5%; eccentric radiation, 37% +/- 21%; control arteries, 41% +/- 13%). Despite 7 mm coverage of the edge segments, radiation was found to induce edge stenosis due to neointima formation and constrictive vascular remodeling. We conclude that centered radiation was superior to eccentric radiation in reducing in-stent luminal narrowing while radiation-induced edge stenosis was still observed despite extension of the radiation zone to 7 mm beyond the stent edges.

Animals↗

PubMed2003

Danish multicenter randomized study on fibrinolytic therapy versus acute coronary angioplasty in acute myocardial infarction: rationale and design of the DANish trial in Acute Myocardial Infarction-2 (DANAMI-2).

BACKGROUND: Randomized trials have indicated that primary coronary angioplasty performed in patients admitted directly to highly-experienced angioplasty centers offers certain advantages over intravenous fibrinolytic therapy. However, the large majority of patients with acute myocardial infarction are submitted to hospitals without a catheterization laboratory. This means that additional transportation will be necessary for many patients if a strategy of acute coronary angioplasty is to be introduced as routine treatment. The delay of treatment caused by transportation might negate (part of) the benefits of primary angioplasty compared to fibrinolytic therapy given immediately at the local hospital. STUDY DESIGN: The DANish trial in Acute Myocardial Infarction-2 (DANAMI-2) is the first large-scale study to clarify, in a whole community, which of the 2 treatment strategies is best. A total of 1900 patients with ST-elevation myocardial infarction are to be randomized: 800 patients will be admitted to invasive hospitals and 1100 patients will be admitted to referral hospitals. Half of the 1100 patients admitted to referral hospitals will immediately be transferred to an invasive center to be treated with primary angioplasty. IMPLICATIONS: If acute transfer from a local hospital to an angioplasty center is the superior strategy, primary angioplasty should be offered to all patients as routine treatment on a community basis.

Angioplasty, Balloon, Coronary↗

PubMed2003

Myocardial cooling for reperfusion injury protection achieved by organ specific hypothermic autologous perfusion.

OBJECTIVE: Whole body hypothermia has been suggested to reduce myocardial injury in patients with ST-segment elevation myocardial infarction. Because of the large human thermal mass, induction of generalized hypothermia is slow and the technique has encountered considerable side effects. The aim was to develop and validate a method for regional cooling during myocardial reperfusion using hypothermic autologous blood. DESIGN: In a myocardial ischemia-reperfusion pig model (n = 10), arterial blood was cooled in a closed circuit, and returned to the myocardium during reperfusion either through a perfusion catheter or through the guiding catheter. Myocardial temperatures were recorded using temperature electrodes. RESULTS: Stabile regional myocardial cooling was induced without complications within 4 min. Both flow rate and blood temperature had significant impact on temperature in the reperfused myocardium but did not influence systemic temperature. CONCLUSION: A method for organ specific hypothermic autologous arterial blood reperfusion has been developed and validated. The method is a simple and much faster alternative to systemic cooling and may have the potential to reduce myocardial injury in patients with acute myocardial infarction.

Animals↗

PubMed2002

Establishing primary angioplasty as the preferred treatment for acute myocardial infarction.

OBJECTIVE: To report procedural results and mortality rates from the first 4 years after establishing primary angioplasty as the preferred treatment for acute myocardial infarction in a single Scandinavian centre. DESIGN AND RESULTS: From August 1995 to October 1999 all patients with the diagnosis of suspected acute myocardial infarction (n = 529, mean age 62 +/- 13 years, 72% men), either transferred (73%) or directly admitted to our institution for coronary angiography with the intention of performing primary percutaneous coronary intervention (primary PCI), were prospectively registered. Procedural success in terms of residual stenosis < or = 30% and a final Thrombolysis in Myocardial Infarction (TIMI) 3 flow was achieved in 94 and 85% of patients treated, respectively. In-hospital delay and procedure times decreased significantly during the 4-year study period. A low in-hospital mortality was observed in each of the 4 years studied (8.7, 8.7, 7.7 and 6.0%). CONCLUSION: In a centre with both directly admitted and transferred patients primary angioplasty can be established as the preferred treatment for acute myocardial infarction with an initially low complication and mortality rate. During the first years after implementing the primary angioplasty programme a learning effect can be anticipated with reductions in procedural times.

Acute Disease↗

PubMed2002

Long genuine coronary artery lesions treated with stiff tubular or flexible coiled stents. A randomized angiographic follow-up study.

OBJECTIVE: To investigate effects of stent flexibility on 6 months' clinical and angiographic outcome in long stented lesions. DESIGN: A total of 44 genuine coronary artery lesions (lesion length >20 mm and < or =30 mm) were randomized to implantation with a 30 mm long flexible coiled stainless steel stent (Freedom Force, Global Therapeutics) (n = 23) or a 30 mm long stiff tubular stainless steel stent (Crown, Johnson & Johnson) (n = 21). RESULTS: Target vessel revascularization was performed in 10 patients (45%) in the Freedom Force stent group, and in 7 patients (33%) in the Crown stent group (ns). No significant differences concerning minimum lumen diameter (MLD), early gain, late loss or binary restenosis rate were seen. In the Freedom Force stent group all restenoses were located within the stent. In the Crown stent group three (27%) of the restenoses were located at the edge of the stent (ns). CONCLUSION: In a limited number of patients no significant differences could be detected in clinical or angiographic parameters between patients treated with long tubular or long coiled stents.

Aged↗