Biomedical subjects

O Røder

Publications and source records attributed to O Røder.

7 recordsLinked to original sources

PubMed2001

Endovascular treatment of severe symptomatic stenosis of the internal carotid artery: early and late outcome.

OBJECTIVES: To report a 6 year experience with carotid percutaneous transluminal angioplasty (CPTA) in a selected group of patients. MATERIAL AND METHOD: We retrospectively reviewed our experience after performing 54 CPTAs, with (n=18) or without (n=36) stent deployment, over a period of 6 years from 1993 to 1999. All patients, except one, suffered from focal hemispheric neurologic symptoms. During the same time period 284 patients underwent carotid endarterectomy. The selection of the 54 patients (16%) for CPTA was based on the carotid angiogram and the sole inclusion criterion for endovascular treatment was a short, concentric, and smooth stenosis of more than 70% without ulceration or severe calcification. All patients who had a patent internal carotid artery after the last control were invited for a clinical duplex examination and all duplex examinations were carried out by a single experienced observer. RESULTS: Early outcome (<30 days): CPTA was judged technically successful in 50 cases (93%). Ten patients (18%) experienced a neurological event in relation to the procedure and one patient (2%) suffered a major stroke. One stent occluded within 30 days. LATE OUTCOME: Forty-six patients (85%) entered the follow-up study after a median of 34 months (range 1-80 months). Six patients (13%) had recurrent symptoms. The colour-duplex examination (n=45) showed internal carotid artery occlusion in 2 patients (5%), and restenosis (>70%) in 10 patients (22%). We found no significant difference in the reoccurrence of neurological symptoms or the rate of restenosis between patients treated with and without stent (Log Rank 0.28, p=0,59). ICA was patent without restenosis in 60% after 48 months in patients treated with CPTA alone, and in 76% after 3 months in patients treated with a stent (N.S.). CONCLUSION: CPTA in a selected group of patients has a mortality and major stroke rate comparable to that of carotid endarterectomy. However, the risk of transient neurological events was high, as well as the incidence of restenosis (>70%) after 3 years. We still consider CPTA an experimental procedure. The indications for this treatment must be clarified if CPTA should be an alternative to surgery with a comparable neurological complication rate.

Adult↗

PubMed1999

Volume flow estimation by colour duplex.

OBJECTIVE: To assess the accuracy of volume blood flow using a digitised colour duplex scanner. DESIGN: Observer-blinded experimental study. MATERIALS AND METHODS: Method comparison was performed with linear regression analysis of 89 paired observations in 11 anaesthetised pigs. A Siemens Sonoline Elegra ultrasound system was used for transcutaneous volume flow estimation using invasive transit time flowmetry by Cardiomed as a reference. RESULTS: For the individual measurement we found a standard error of the estimate (SEE) of 22 ml/min. For the regression line, however, the SEE was only 0.2 ml/min. CONCLUSIONS: Digitised colour-duplex sonography has a volume flow measurement error that is too high for single measurements in the individual patient for the method to be useful in clinical decision making, but sufficient for examinations of groups and comparison of groups.

Animals↗

PubMed1997

Inflammatory aortic aneurysms: regression of fibrosis after aneurysm surgery.

OBJECTIVES: To evaluate the fate of perianeurysmal fibrosis (PF) following aneurysm surgery. METHODS: In this single centre study, pre- and postoperative abdominal CT-scans on 21 consecutive patients with inflammatory abdominal aortic aneurysms were compared. CT-scans of 10 randomly chosen patients operated on for abdominal aortic aneurysms without PF in the same period, served as reference group. RESULTS: Preoperative thickness of PF was assessed as > 1 cm in 11 and < 1 cm in 10 patients. Ureterolysis was performed in seven patients where the fibrosis caused ureteral obstruction. Postoperative CT-scans performed at a median of 24 (range 3-108) months after surgery showed complete regression of the fibrosis in 29%, partial regression in 57% and no change in 14% of the patients. Progression of the fibrosis or persistence of hydronephrosis was not seen. No sign of fibrosis were seen in the 10 controls. CONCLUSION: This study supports the findings that PF tends to regress after repair of the abdominal aortic aneurysm.

Aged↗

PubMed1994

Abdominal aortic aneurysm surgery: survival and quality of life in patients requiring prolonged postoperative intensive therapy.

The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553 patients, 51 (9%) of whom died within the first 48 hours. Of the 502 patients who survived for more than 48 hours, 109 required ICU therapy for more than 48 hours, whereas 393 patients were in the ICU for less than 48 hours. The incidence of preoperative risk factors was similar for the two groups. The cumulated survival rates for the two groups were 68% and 92% at 1 months, 52% and 88% at 1 year, and 60% and 33% at 6 years, respectively. This significant difference was primarily related to renal, pulmonary, and cardiac complications. However, assessment of the most severe complications and risk factors combined failed to permit identification of patients in whom the perioperative survival rate was 0%. Even 20% of patients with multiorgan failure survived for 6 months. Of those patients who needed ICU therapy for more than 48 hours, 41 (38%) were alive at the end of 1988. In response to a questionnaire, 78% stated that their quality of life had improved or was unchanged after surgery and had resumed working. These data justify a therapeutically aggressive approach, including ICU therapy following AAA surgery, despite failure of one or more organ systems.

Aortic Aneurysm, Abdominal↗

PubMed1980

Polyglycolic acid, silk, and topical ampicillin. Their use in hernia repair and cholecystectomy.

The effect of topical ampicillin sodium and polyglycolic acid and silk sutures on the recurrence of an existing hernia or an incisional hernia and on infection rates in clean abdominal wounds (herniotomies and simple cholecystectomies) was studied in a triple-blind, randomized trial with 398 consecutive patients. One infection, three suture sinuses, and two incisional hernias occurred among 113 patients with cholecystectomies, while the corresponding rates in 285 patients with hernia repairs were 11 infections, no suture sinuses, and three recurrent hernias. No effect of ampicillin could be demonstrated, nor was any difference between polyglycolic acid and silk sutures shown. No interaction between the antibiotic and suture material was found, and no side effects were observed. Wound infection was significantly more frequent in patients with postoperative seromas or hematomas.

Adult↗

PubMed1979

Palpatory estimation of liver size. Within- and between-observer variation.

A study based upon 23 patients revealed substantial within- and between-observer variation, when 14 senior and junior surgeons under blindfold conditions were requested to measure the distance from the thoracic cage to the lower border of the liver in the midclavicular and midsternal lines. Clinical decisions should accordingly not rely heavily upon a palpatory estimate of liver size.

Adult↗

PubMedDate not supplied

Surgery for abdominal aortic aneurysms. A survey of 656 patients.

Between 1979 and 1988, 656 patients were operated upon for abdominal aortic aneurysm. Elective operation was performed in 287 patients (44%) and acute operation in 369 patients. A ruptured aneurysm was found in 218 patients (33%). Patients with arteriosclerotic heart disease, hypertension, impaired renal function or chronic pulmonary disease showed an increased perioperative mortality. Development of postoperative cardiac and renal complications could not be related to previous cardiac or renal diseases. The major postoperative complications were renal failure in 81 patients (12%), pulmonary insufficiency in 77 patients (11%) and cardiac complications in 96 patients (13%). Failure of one or more organs occurred in 153 patients (23%) and the mortality rate for patients with multiorgan failure was 68%. Complications leading to reoperation occurred in 93 patients (14%). The perioperative mortality was 18.8%. The mortality for elective cases was 4.8%, for symptomatic cases 17.2% and 37% for ruptured aneurysms. The five-year survival rate was 48% for ruptured aneurysms, 70% for symptomatic cases and 75% for elective cases. After six months the life expectancy in these three groups of patients were identical and comparable to the expected survival for a sex and age matched control population.

Aged↗