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Björck, M. (2020). A Pearl in the Oyster Is Not Common, but Still Precious. European Journal of Vascular and Endovascular Surgery, 59(2), 254-254
Open this publication in new window or tab >>A Pearl in the Oyster Is Not Common, but Still Precious
2020 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 59, no 2, p. 254-254Article in journal, Editorial material (Other academic) Published
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-407267 (URN)10.1016/j.ejvs.2019.08.015 (DOI)000512400000009 ()31543399 (PubMedID)
Note

Invited commentary.

Available from: 2020-03-23 Created: 2020-03-23 Last updated: 2020-03-23Bibliographically approved
Björck, M., Earnshaw, J. J., Acosta, S., Goncalves, F. B., Cochennec, F., Debus, E. S., . . . Rai, K. (2020). Editor's Choice - European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia. European Journal of Vascular and Endovascular Surgery, 59(2), 173-218
Open this publication in new window or tab >>Editor's Choice - European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia
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2020 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 59, no 2, p. 173-218Article in journal (Refereed) Published
Place, publisher, year, edition, pages
W B SAUNDERS CO LTD, 2020
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-407202 (URN)10.1016/j.ejvs.2019.09.006 (DOI)000512400000003 ()31899099 (PubMedID)
Available from: 2020-03-23 Created: 2020-03-23 Last updated: 2020-03-23Bibliographically approved
Cervin, A., Wanhainen, A. & Björck, M. (2020). Popliteal aneurysms are common among men with screening detected abdominal aortic aneurysms, and prevalence correlates with the diameters of the common iliac arteries. European Journal of Vascular and Endovascular Surgery, 59(1), 67-72
Open this publication in new window or tab >>Popliteal aneurysms are common among men with screening detected abdominal aortic aneurysms, and prevalence correlates with the diameters of the common iliac arteries
2020 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 59, no 1, p. 67-72Article in journal (Refereed) Published
Abstract [en]

Background: Data on the prevalence of popliteal artery aneurysm (PA) are scarce and difficult to interpret as the definition differs among papers. The aim was to investigate the prevalence among men with screening detected abdominal aortic aneurysms (>= 30 mm, AAAs) and subaneurysmal aortic dilatation (25-29 mm, SAA), and to explore whether the existence of a PA correlated with the diameters of the aorta, iliac, and femoral arteries.

Methods: In Uppsala, Sweden, a county with 376 000 inhabitants, AAA screening of 65 year old men was initiated in 2006. All men with AAA and SAA also had measurements of the common iliac artery (CIA). The common femoral (CFA), superficial femoral (SFA), and popliteal arteries were evaluated at re-examination, performed after 1-2 years for AAA and five years for SAA. PA was defined as >= 12 mm, or 1.5 times larger than the distal SFA according to the ISCVS/SVS Ad Hoc Committee. The relationships between PA and other vessel diameters were explored.

Results: A total of 19 820 65 year old men (84.6%) accepted the invitation to screening between 2006 and 2017. AAA was found in 173 (0.9%), and SAA in 149 subjects (1.1% of those screened 2006-2013, eligible for this study). In the whole cohort, 14.2% of those examined had at least one PA of any size, 3.0% were >= 15 mm and 2.2% >= 20 mm. There was no difference in PA prevalence between AAA and SAA: 15.9% vs. 12.2% (p = .48). There was no difference in aortic diameter in those with or without PA (p = .46), but there were significant correlations with CIA (p < .001), CFA (p < .001), and SFA (p < .001) diameters.

Conclusions: A high prevalence of PA among subjects with screening detected AAA and SAA was found. PA was not correlated with the aortic diameter in this cohort, where all had dilated aortas, while correlations with peripheral and iliac artery diameters were identified.

Keywords
Abdominal aortic aneurysm; Popliteal artery aneurysm; Iliac artery; Screening, Prevalence.
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:uu:diva-381518 (URN)10.1016/j.ejvs.2019.07.042 (DOI)000506204700013 ()31757587 (PubMedID)
Note

Title in dissertation list of papers: Popliteal aneurysms are common among men with screening detected abdominal aortic aneurysms, and the prevalence is correlated with the diameters of the common iliac arteries

Available from: 2019-04-10 Created: 2019-04-10 Last updated: 2020-01-27Bibliographically approved
Högberg, D. & Björck, M. (2020). Response to "Re. Five Year Outcomes in Men Screened for Carotid Artery Stenosis at 65 Years of Age: A Population Based Cohort Study" [Letter to the editor]. European Journal of Vascular and Endovascular Surgery, 59(1), 152-152
Open this publication in new window or tab >>Response to "Re. Five Year Outcomes in Men Screened for Carotid Artery Stenosis at 65 Years of Age: A Population Based Cohort Study"
2020 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 59, no 1, p. 152-152Article in journal, Letter (Other academic) Published
Place, publisher, year, edition, pages
W B SAUNDERS CO LTD, 2020
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-403534 (URN)10.1016/j.ejvs.2019.07.036 (DOI)000506204700029 ()31473055 (PubMedID)
Available from: 2020-01-31 Created: 2020-01-31 Last updated: 2020-01-31Bibliographically approved
Wanhainen, A., Mani, K., Kullberg, J., Svensjö, S., Bersztel, A., Karlsson, L., . . . Björck, M. (2020). The effect of ticagrelor on growth of small abdominal aortic aneurysms: a randomized controlled trial. Cardiovascular Research, 116(2), 450-456
Open this publication in new window or tab >>The effect of ticagrelor on growth of small abdominal aortic aneurysms: a randomized controlled trial
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2020 (English)In: Cardiovascular Research, ISSN 0008-6363, E-ISSN 1755-3245, Vol. 116, no 2, p. 450-456Article in journal (Refereed) Published
Abstract [en]

AIM: To evaluate if ticagrelor, an effective platelet inhibitor without known non-responders, could inhibit growth of small AAAs.

METHODS AND RESULTS: In this multi-center randomized controlled trial, double-blinded for ticagrelor and placebo, acetylic salicylic acid naïve patients with AAA and with a maximum aortic diameter 35-49 mm were included. The primary outcome was mean reduction in log-transformed AAA volume growth rate (%) measured with magnetic resonance imaging (MRI) at 12 months compared with baseline. Secondary outcomes include AAA-diameter growth rate and ILT volume enlargement rate. 144 patients from eight Swedish centers were randomized (72 in each group). MRI AAA volume increase was 9.1% for the ticagrelor-group and 7.5% for the placebo-group (p = 0.205) based on intention-to-treat analysis, and 8.5% vs 7.4% in a per-protocol-analysis (p = 0.372). MRI diameter change was 2.5 mm vs 1.8 mm (p = 0.113), US diameter change 2.3 mm vs 2.2 mm (p = 0.778), and ILT volume change 12.9% vs 10.4% (p = 0.590).

CONCLUSION: In this RCT platelet inhibition with ticagrelor did not reduce growth of small AAAs. Whether the ILT has an important pathophysiological role for AAA growth cannot be determined based on this study due to the observed lack of thrombus modulating effect of ticagrelor.

Keywords
Abdominal aortic aneurysm, Growth inhibitor, Intraluminal thrombus, Ticagrelor, Anti-platelet treatment, Randomized controlled trial, Aortic volume, Aortic diameter, bleeding
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-392825 (URN)10.1093/cvr/cvz133 (DOI)000515095600028 ()31135888 (PubMedID)
Funder
AstraZeneca
Available from: 2019-09-10 Created: 2019-09-10 Last updated: 2020-03-30Bibliographically approved
Dick, F. & Björck, M. (2020). The EJVES is Taking the Next Step Anew. European Journal of Vascular and Endovascular Surgery, 59(1), 1-2
Open this publication in new window or tab >>The EJVES is Taking the Next Step Anew
2020 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 59, no 1, p. 1-2Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
W B SAUNDERS CO LTD, 2020
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-403536 (URN)10.1016/j.ejvs.2019.12.002 (DOI)000506204700001 ()31924296 (PubMedID)
Available from: 2020-01-30 Created: 2020-01-30 Last updated: 2020-01-30Bibliographically approved
Linder, F., Holmberg, L., Björck, M., Juhlin, C., Thorbjörnsen, K., Wisinger, J., . . . Mani, K. (2019). A prospective stepped wedge cohort evaluation of the new national trauma team activation criteria in Sweden - the TRAUMALERT study.. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 27(1), Article ID 52.
Open this publication in new window or tab >>A prospective stepped wedge cohort evaluation of the new national trauma team activation criteria in Sweden - the TRAUMALERT study.
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2019 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 27, no 1, article id 52Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Trauma triage based on prehospital information facilitates correct allocation of in-hospital resources. The Swedish national two-tier trauma team activation (TTA) criteria were revised in 2016. The current study aimed to evaluate the safety and efficacy of the new criteria.

METHODS: Five centres covering trauma care for 1.2 million inhabitants registered all trauma patients prospectively in the Swedish trauma registry (SweTrau) prior to and after stepwise introduction of new TTA criteria within the cohort (a prospective stepped-wedge cohort study design; period August 2016-November 2017). Evaluation of full- and limited-TTA frequency, under- and overtriage were performed at equal duration before and after this change.

RESULTS: The centres registered 1948 patients, 1882 (96.6%) of which were included in the study. With new criteria, frequency of full-TTA was unchanged, while limited-TTA decreased with 46.3% (from 988 to 531). 30-day trauma mortality was unchanged. The overtriage was 107/150 (71.3%) with former criteria, and 104/144 (72.2%) with new criteria, p = 0.866. Undertriage was 50/1037 (4.8%) versus 39/551 (7.1%), p = 0.063. Undertriage was consistently > 20% in patients with fall injury. Among patients with Injury Severity Score (ISS) > 15, 50/93 (53.8%) did not initiate full-TTA with former, vs 39/79 (49.4%) with new criteria, p = 0.565. Age > 60-years was a risk factor for undertriage (OR 2.89, p < 0.001), while low fall injuries indicated a trend (OR 2.70, p = 0.051).

CONCLUSIONS: The newly implemented Swedish TTA criteria result in a reduction in limited TTA frequency, indicating an increased efficiency in use of resources. The over- and undertriage is unchanged compared to former criteria, thus upholding patient safety.

Keywords
Epidemiology, Patient safety, Prospective stepped wedge cohort design, Trauma, Triage, Wounds and injuries
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-383430 (URN)10.1186/s13049-019-0619-1 (DOI)000466508600002 ()31039800 (PubMedID)
Available from: 2019-05-14 Created: 2019-05-14 Last updated: 2020-03-05Bibliographically approved
Grip, O., Wanhainen, A. & Björck, M. (2019). Acute Aortic Occlusion: Nationwide Cohort Study [Letter to the editor]. Circulation, 139(2), 292-294
Open this publication in new window or tab >>Acute Aortic Occlusion: Nationwide Cohort Study
2019 (English)In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 139, no 2, p. 292-294Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS, 2019
Keywords
arterial occlusive diseases, embolism, graft occlusion, vascular, ischemia, thrombosis
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-379086 (URN)10.1161/CIRCULATIONAHA.118.036420 (DOI)000459428700019 ()30615512 (PubMedID)
Available from: 2019-03-12 Created: 2019-03-12 Last updated: 2019-03-12Bibliographically approved
Mani, K. & Björck, M. (2019). Alternatives to Randomised Controlled Trials for the Poor, the Impatient, and When Evaluating Emerging Technologies. European Journal of Vascular and Endovascular Surgery, 57(4), 598-599
Open this publication in new window or tab >>Alternatives to Randomised Controlled Trials for the Poor, the Impatient, and When Evaluating Emerging Technologies
2019 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 57, no 4, p. 598-599Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
W B SAUNDERS CO LTD, 2019
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-383053 (URN)10.1016/j.ejvs.2018.10.026 (DOI)000464932200028 ()30509892 (PubMedID)
Available from: 2019-05-08 Created: 2019-05-08 Last updated: 2019-05-08Bibliographically approved
Kaluza, J., Stackelberg, O., Harris, H. R., Björck, M. & Wolk, A. (2019). Anti-inflammatory diet and risk of abdominal aortic aneurysm in two Swedish cohorts. Heart, 105(24), 1876-1883
Open this publication in new window or tab >>Anti-inflammatory diet and risk of abdominal aortic aneurysm in two Swedish cohorts
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2019 (English)In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 105, no 24, p. 1876-1883Article in journal (Refereed) Published
Abstract [en]

Objective The relationship between dietary patterns and development of abdominal aortic aneurysm (AAA) is not well understood. Thus, we prospectively evaluated the association between the anti-inflammatory potential of diet and risk of AAA. Methods The study population included the Cohort of Swedish Men (45 072 men) and the Swedish Mammography Cohort (36 633 women), aged 45-83 years at baseline. The anti-inflammatory potential of diet was estimated using Anti-inflammatory Diet Index (AIDI) based on 11 foods with anti-inflammatory potential and 5 with proinflammatory potential (maximum 16 points) that was validated againsthigh sensitivity C reactive protein (hsCRP). Cox proportional hazard regression models were used to estimate HRs and 95% CIs. During the 14.9 years of follow-up (1 217 263 person-years), 1528 AAA cases (277 (18%) ruptured, 1251 non-ruptured) were ascertained via the Swedish Inpatient Register, the National Cause of Death Register and the Register for Vascular Surgery (Swedvasc). Results We observed an inverse association between the AIDI and AAA risk in women and men; HRs between extreme quartiles of the AIDI (>= 8 vs <= 5 points) were 0.55 (95% CI 0.36 to 0.83) in women and 0.81 (95% CI 0.68 to 0.98) in men. The AIDI was inversely associated with both ruptured and non-ruptured AAA incidence; the HR of participants in the highest quartile of AIDI compared with those in the lowest quartile was 0.61 (95% CI 0.41 to 0.90) for ruptured AAA and 0.79 (95% CI 0.65 to 0.95) for non-ruptured AAA. Conclusion Adherence to diet with a high anti-inflammatory potential was associated with a reduced AAA risk, an association that was even more pronounced for AAA rupture.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-402390 (URN)10.1136/heartjnl-2019-315031 (DOI)000503800100008 ()31296589 (PubMedID)
Funder
Swedish Research Council, VR 2015-02302Forte, Swedish Research Council for Health, Working Life and Welfare, FORTE 2015-00778Swedish Research Council Formas, 2016-00308Swedish Research Council, 2017-00644
Available from: 2020-01-24 Created: 2020-01-24 Last updated: 2020-01-24Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6561-9734

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