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J E Lorentzen

Publications and source records attributed to J E Lorentzen.

At least 19 recordsLinked to original sources
PubMed1992

[Excimer laser-assisted balloon angioplasty of the femoro-popliteal segment].

In the Department of Vascular Surgery RK, The University Hospital in Copenhagen, the authors have treated 16 patients with ischaemia in the lower limb by means of laser-assisted balloon angioplasty. A pulsed ultraviolet excimer-laser was employed. It proved possible to break down the occluding arterial lesion in 12 patients (75%). In one patient, this was not followed-up by balloon angioplasty and, in another patient, the reconstruction closed on the first day after operation. The primary success of the procedure, defined as breaking down of the occlusion with the laser-catheter followed by balloon angioplasty and an increase in the ankle/brachial index of greater than 15%, was found to be 10/16 or 62%. The remaining four patients, in whom it did not prove possible to break down the arterial lesion with laser, were treated by means of conventional vascular surgical reconstruction. On follow-up examination after an average of nine months, nine out of the ten patients (90%) still had a patent reconstruction after laser-assisted balloon angioplasty. This new endovascular laser-procedure appears to be suitable for selected patients, but must be assessed more meticulously before it is possible to determine its future placing in the vascular surgical therapeutic armamentarium.

Aged↗
PubMed1992

In situ saphenous vein bypass surgery in diabetic patients.

From 1986 through to 1990 a total of 483 consecutive in situ infra-inguinal vein bypass procedures were performed in 444 patients, of whom 112 (25%) were diabetics (57 insulin dependent diabetes mellitus and 55 non-insulin-dependent diabetes mellitus). Based on a prospective vascular data registry this material was analysed to determine the influence of diabetes on the outcome. Preoperative risk factors were equally distributed among diabetic and non-diabetic patients, except for smoking habits (diabetics: 48%; non-diabetics: 64%, p = 0.002) and cardiac disease (diabetics: 45%; non-diabetics: 29%, p = 0.005). Indication for surgery was gangrene or ulceration in 57% of diabetics, as opposed to 36% in non-diabetic patients (p = 0.0002). A femoro-popliteal bypass was performed in 18% of patients, whereas 82% received an infrapopliteal procedure, of which 42% were to the distal third of the calf or foot. Diabetic patients had a significantly lower distal anastomosis than non-diabetic patients (p = 0.0001). The overall 3-year primary and secondary patency rates were 58 and 64%, respectively, with no differences between non-diabetics, non-insulin-dependent diabetics and insulin-dependent diabetics. Neither did limb survival differ among the three groups. However, the rate of minor amputations was significantly higher in insulin-dependent compared with non-insulin-dependent diabetics, who in turn had a higher rate than non-diabetic patients (p less than 0.00001). A markedly decreased survival rate was found in diabetics (p less than 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Surgery of ruptured abdominal aortic aneurysm. Are the results compatible with the effort?].

During 1979-1988 218 patients were operated on for ruptured abdominal aortic aneurysm. On admission 110 patients (50%) were in shock. Patients with a systolic blood pressure less than 100 mmHg, anuria on admission, peroperative bleeding of more than five litres and aged more than 70 years had an increased mortality. The intraoperative mortality was 15% and the postoperative mortality 21%. The perioperative mortality decreased from 45% in 1979 to 32% in 1988. The most frequent complications were renal failure and respiratory insufficiency, both were associated with a mortality of more than 50%. The five year survival was 48%. This study has revealed that patients with ruptured abdominal aortic aneurysm have an acceptable prognosis. The investigation emphasizes the importance of early diagnosis and elective operation to avoid rupture.

Aged↗
PubMed1991

[Mortality and survival after surgery for abdominal aortic aneurysm. A 10-year follow-up].

From 1979-1988, 656 patients were operated for abdominal aortic aneurysm. The perioperative mortality was 18%. The mortalities for elective, symptomatic and ruptured aneurysms were 5%, 17% and 38% respectively. The overall five year survival rate was 58%. In 87% of the patients one or more risk factor was found. Survival was unaffected in patients with a single risk factor, whereas patients with two or more risk factors had lower five year survival. Postoperative organ failure increased the perioperative mortality and the five year survival in patients with multiorgan failure was 20%. In view of the fact that 56% of the patients are operated on as emergencies, this study stresses the importance of early diagnosis and elective treatment.

Adult↗
PubMed1991

[Registration of postoperative wound complications at a department of vascular surgery].

During the period 1 March 1987 to 31 December 1988, current registration of all vascular surgical operations in the Department of Vascular Surgery RK, Rigshospitalet, was undertaken employing a PC-based programme (DANOP-DATA). A total of 1,898 primary vascular surgical operations were performed on 1,335 patients. During the entire period, 48 (2.5%) patients with wound infection were registered. In half of these, the infection was superficial and in the remainder the infection was deep. Comparison between 1987 and 1988 revealed a non-significant tendency towards a lower incidence of infection in 1988. Significantly more wound infections were found after non-sterile operations (p = 0.005). Significantly more deep infections were found on employing synthetic vascular prostheses (p less than 0.00001) and with inguinal incisions (less than 0.05). No significant connection could be found with age, duration of preoperative hospitalization, duration of operation and the degree of planning of the operation. The authors find that computer-based monitoring of the surgical activity is a good which renders current assessment and analysis of the pattern of complications possible. The authors did not find that DANOP-DATA was sufficient for registration in a special department for vascular surgery and a programmel (KARBASE) has been developed which is more suitable for this purpose.

Adolescent↗
PubMed1991

[Infrainguinal bypass surgery of occlusive arteriosclerosis of the lower extremities using polytetrafluoroethylene (PTFE) vascular prostheses].

During the past 15 years, PTFE vascular prostheses have been employed as an alternative graft material in patients with peripheral arteriosclerosis of the lower extremity and no suitable autogenous saphenous vein for employment as a bypass route. PTFE is a porous polymer of teflon which becomes incorporated into the tissue by invasion of fibroblasts into the material after implantation. The result of the operation as indicated by the patency of the prosthesis depends on the length of the bypassed occluded arterial segment, the quality of the artery where the distal anastomosis is made, the preoperative fall in pressure in the extremity, coagulopathy and the development of intimal hyperplasia. The results after short bypass operations are insignificantly different from the results after the use of autologous saphenous vein. The use of PTFE in infrainguinal bypass operations is an acceptable alternative to autogenous saphenous vein.

Aged↗
PubMed1991

The effect of arteriovenous fistulas on in situ saphenous vein bypasses.

Intraoperative identification and later development of arteriovenous fistulas were investigated prospectively in 70 in situ saphenous vein bypass procedures. Surveillance was performed by completion arteriography and intra- and postoperative continuous wave Doppler examination. The intraoperative Doppler examination identified 89% of those branches with sufficient flow to opacify the deep venous system on completion arteriogram. Half of the missed fistulas underwent spontaneous thrombosis, and in only one case did the arteriovenous fistula lead to hemodynamic symptoms demanding surgical closure of the fistula. Pursuing a policy of selectively ligating fistulas that only fill the deep venous system on completion arteriography led to an additional nine arteriovenous fistulas. Developed over an average follow-up of six months, four patients presented symptoms of edema and swelling and were relieved upon closure of the fistulas. The incidence of bypass thrombosis did not differ significantly among patients with remaining arteriovenous fistulas, patients who developed fistulas during follow-up, and patients who had no signs of arteriovenous fistulas. It seems justified to continue selective intraoperative ligation of arteriovenous fistulas based on continuous wave Doppler.

Adult↗
PubMed1991

Gentamycin beads in the treatment of localised vascular graft infection--long term results in 17 cases.

Seventeen patients were treated by the implantation of gentamycin beads for localised Szilagyi type III prosthetic graft infection. Three patients had a pan prosthetic infection and half of the remaining patients were cured, but three of these died from other causes within 3 months. The mean observation time of the four survivors was 20 months (7-39 months). One of the seven patients, in whom the gentamycin beads failed, died of infection, giving a total mortality rate of 6% (1.5-29%). The remaining patients were cured after resection of the infected segment of the prosthesis at a mean follow-up of 22 months (8-37 months).

Aged↗
PubMed1991

Clinical and pharmacokinetic evaluation of gentamycin containing collagen in groin wound infections after vascular reconstruction.

Fourteen patients with localised groin wound graft infection after vascular reconstruction were included in this study to evaluate the clinical effect and the pharmacokinetic profile of gentamycin containing collagen for local antibiotic treatment. All patients were treated by surgical revision and the implantation of one collagen sponge containing 130 mg gentamycin in addition to systemic antibiotics. At follow-up (median 10 months, range 6-15 months), 13 of the 14 patients were cured with a patent reconstruction, giving a success rate in this series of 93%. The pharmacokinetic study showed a very high initial gentamycin concentration in wound fluid, which neatly exceeded the MIC values for most bacteria normally considered resistant to gentamycin. These high MIC values were sustained for 2 to 3 days. In conclusion, this study demonstrated a good clinical effect of gentamycin containing collagen with a high cure rate. In the wound fluid an initial high concentration of gentamycin was achieved which lasted for 2-3 days.

Aged↗
PubMed1977

Fractures of the neck of the talus.

One hundred and twenty-three patients with fracture of the neck of the talus were followed up over an average of 22 months. Ffity-four fractures were undisplaced, 53 associated with subtaler dislocation, and 16 associated with dislocation of the talus in both ankle joint and subtalar joint. Of the total 123 patients, 21% (26/123) developed avascular necrosis, 31% (38/123) developed talo-crural and 47% (58/123) subtalar osteoarthrosis. Fifteen per cent (18/123) of the fractures united with considerable deformity, and four per cent (5/123) exhibited non-union of the neck. Out of 63 patients with isolated fracture of the neck of the talus, 65% (41/63) reported moderate or severe complaints, and 52% (33/63) complained of functional disability often resulting in a change to lighter work. Even among the 54 undisplaced cases there were unexpected numbers of late sequelae, such as osteoarthrosis, subjective complaints and disablement.

Adolescent↗