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  • 1. Abbott, A. L.
    et al.
    Adelman, M. A.
    Alexandrov, A. V.
    Barnett, H. J. M.
    Beard, J.
    Bell, P.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Blacker, D.
    Buckley, C. J.
    Cambria, R. P.
    Comerota, A. J.
    Connolly, E. S., Jr.
    Davies, A. H.
    Eckstein, H. H.
    Faruqi, R.
    Fraedrich, G.
    Gloviczki, P.
    Hankey, G. J.
    Harbaugh, R. E.
    Heldenberg, E.
    Kittner, S. J.
    Kleinig, T. J.
    Mikhailidis, D. P.
    Moore, W. S.
    Naylor, R.
    Nicolaides, A.
    Paraskevas, K. I.
    Pelz, D. M.
    Prichard, J. W.
    Purdie, G.
    Ricco, J. B.
    Riles, T.
    Rothwell, P.
    Sandercock, P.
    Sillesen, H.
    Spence, J. D.
    Spinelli, F.
    Tan, A.
    Thapar, A.
    Veith, F. J.
    Zhou, W.
    Why the United States Center for Medicare and Medicaid Services (CMS) Should not Extend Reimbursement Indications for Carotid Artery Angioplasty/Stenting2012In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 43, no 3, p. 247-251Article in journal (Refereed)
  • 2. Abbott, A. L.
    et al.
    Adelman, M. A.
    Alexandrov, A. V.
    Barnett, H. J. M.
    Beard, J.
    Bell, P.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Blacker, D.
    Buckley, C. J.
    Cambria, R. P.
    Comerota, A. J.
    Connolly, E. Sander
    Davies, A. H.
    Eckstein, H. -H
    Faruqi, R.
    Fraedrich, G.
    Gloviczki, P.
    Hankey, G. J.
    Harbaugh, R. E.
    Heldenberg, E.
    Kittner, S. J.
    Kleinig, T. J.
    Mikhailidis, D. P.
    Moore, W. S.
    Naylor, R.
    Nicolaides, A.
    Paraskevas, K. I.
    Pelz, D. M.
    Prichard, J. W.
    Purdie, G.
    Ricco, J. -B
    Riles, T.
    Rothwell, P.
    Sandercock, P.
    Sillesen, H.
    Spence, J. D.
    Spinelli, F.
    Tan, A.
    Thapar, A.
    Veith, F. J.
    Zhou, Wei
    Why the United States Center for Medicare and Medicaid Services (CMS) should not extend reimbursement indications for carotid artery angioplasty/stenting2012In: International Journal of Angiology, ISSN 0392-9590, E-ISSN 1827-1839, Vol. 31, no 1, p. 85-89Article in journal (Refereed)
  • 3. Abbott, Anne L.
    et al.
    Adelman, Mark A.
    Alexandrov, Andrei V.
    Barber, P. Alan
    Barnett, Henry J. M.
    Beard, Jonathan
    Bell, Peter
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Blacker, David
    Bonati, Leo H.
    Brown, Martin M.
    Buckley, Clifford J.
    Cambria, Richard P.
    Castaldo, John E.
    Comerota, Anthony J.
    Connolly, E. Sander, Jr.
    Dalman, Ronald L.
    Davies, Alun H.
    Eckstein, Hans-Henning
    Faruqi, Rishad
    Feasby, Thomas E.
    Fraedrich, Gustav
    Gloviczki, Peter
    Hankey, Graeme J.
    Harbaugh, Robert E.
    Heldenberg, Eitan
    Hennerici, Michael G.
    Hill, Michael D.
    Kleinig, Timothy J.
    Mikhailidis, Dimitri P.
    Moore, Wesley S.
    Naylor, Ross
    Nicolaides, Andrew
    Paraskevas, Kosmas I.
    Pelz, David M.
    Prichard, James W.
    Purdie, Grant
    Ricco, Jean-Baptiste
    Ringleb, Peter A.
    Riles, Thomas
    Rothwell, Peter M.
    Sandercock, Peter
    Sillesen, Henrik
    Spence, J. David
    Spinelli, Francesco
    Sturm, Jonathon
    Tan, Aaron
    Thapar, Ankur
    Veith, Frank J.
    Wijeratne, Tissa
    Zhou, Wei
    Why Calls for More Routine Carotid Stenting Are Currently Inappropriate An International, Multispecialty, Expert Review and Position Statement2013In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 44, no 4, p. 1186-1190Article in journal (Refereed)
  • 4. Abbott, Anne L
    et al.
    Adelman, Mark A
    Alexandrov, Andrei V
    Barnett C C, Henry J M
    Beard, Jonathan
    Bell, Peter
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Blacker, David
    Buckley, Clifford J
    Cambria, Richard P
    Comerota, Anthony J
    Connolly, E Sander
    Davies, Alun H
    Eckstein, Hans-Henning
    Faruqi, Rishad
    Fraedrich, Gustav
    Gloviczki, Peter
    Hankey, Graeme J
    Harbaugh, Robert E
    Heldenberg, Eitan
    Kittner, Steven J
    Kleinig, Timothy J
    Mikhailidis, Dimitri P
    Moore, Wesley S
    Naylor, Ross
    Nicolaides, Andrew
    Paraskevas, Kosmas I
    Pelz, David M
    Prichard, James W
    Purdie, Grant
    Ricco, Jean-Baptiste
    Riles, Thomas
    Rothwell, Peter
    Sandercock, Peter
    Sillesen, Henrik
    Spence, J David
    Spinelli, Francesco
    Tan, Aaron
    Thapar, Ankur
    Veith, Frank J
    Zhou, Wei
    Why the US Center for Medicare and Medicaid Services Should Not Extend Reimbursement Indications for Carotid Artery Angioplasty/Stenting2012In: Angiology, ISSN 0003-3197, E-ISSN 1940-1574, Vol. 63, no 8, p. 639-644Article in journal (Refereed)
  • 5. Abbott, Anne L.
    et al.
    Adelman, Mark A.
    Alexandrov, Andrei V.
    Barnett, Henry J. M.
    Beard, Jonathan
    Bell, Peter
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Blacker, David
    Buckley, Clifford J.
    Cambria, Richard P.
    Comerota, Anthony J.
    Connolly, E. Sander
    Davies, Alun H.
    Eckstein, Hans-Henning
    Faruqi, Rishad
    Fraedrich, Gustav
    Gloviczki, Peter
    Hankey, Graeme J.
    Harbaugh, Robert E.
    Heldenberg, Eitan
    Kittner, Steven J.
    Kleinig, Timothy J.
    Mikhailidis, Dimitri P.
    Moore, Wesley S.
    Naylor, Ross
    Nicolaides, Andrew
    Paraskevas, Kosmas I.
    Pelz, David M.
    Prichard, James W.
    Purdie, Grant
    Ricco, Jean-Baptiste
    Riles, Thomas
    Rothwell, Peter
    Sandercock, Peter
    Sillesen, Henrik
    Spence, J. David
    Spinelli, Francesco
    Tan, Aaron
    Thapar, Ankur
    Veith, Frank J.
    Zhou, Wei
    Why the United States Center for Medicare and Medicaid Services should not extend reimbursement indications for carotid artery angioplasty/stenting2012In: VASCULAR, ISSN 1708-5381, Vol. 20, no 1, p. 1-7Article in journal (Other academic)
  • 6. Aboyans, Victor
    et al.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Brodmann, Marianne
    Collet, Jean-Philippe
    Czerny, Martin
    De Carlo, Marco
    Naylor, A Ross
    Roffi, Marco
    Tendera, Michal
    Vlachopoulos, Charalambos
    Ricco, Jean-Baptiste
    Questions and answers on diagnosis and management of patients with Peripheral Arterial Diseases: a companion document of the 2017 ESC Guidelines for the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)2017In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645Article in journal (Refereed)
  • 7. Aboyans, Victor
    et al.
    Ricco, Jean-Baptiste
    Bartelink, Marie-Louise E L
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Brodmann, Marianne
    Cohnert, Tina
    Collet, Jean-Philippe
    Czerny, Martin
    De Carlo, Marco
    Debus, Sebastian
    Espinola-Klein, Christine
    Kahan, Thomas
    Kownator, Serge
    Mazzolai, Lucia
    Naylor, A Ross
    Roffi, Marco
    Röther, Joachim
    Sprynger, Muriel
    Tendera, Michal
    Tepe, Gunnar
    Venermo, Maarit
    Vlachopoulos, Charalambos
    Desormais, Ileana
    2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by2017In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645Article in journal (Refereed)
  • 8. Acosta, S.
    et al.
    Alhadad, A.
    Verbaan, H.
    Ögren, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    The clinical importance in differentiating portal from mesenteric venous thrombosis2011In: International Journal of Angiology, ISSN 0392-9590, E-ISSN 1827-1839, Vol. 30, no 1, p. 71-78Article in journal (Refereed)
    Abstract [en]

    Aim. To relate the extent of portomesenteric thrombosis to the risk of intestinal infarction, concomitant venous thromboembolism and underlying diseases. Methods. Identification of patients with mesenteric (MVT) and portal vein thrombosis (PVT) at Malmo University Hospital from a clinical series from 2000 - 2006 as well as an autopsy cohort of 24000 consecutive autopsies from 1970 - 1982. Results. In the clinical comparative study, MVT (n=51) was associated with more thrombophilic disorders (P=0.040) and intestinal infarctions (P=0.046), whereas patients with PVT without extension to the superior mesenteric vein (n=20) more often had liver disease (P < 0.001). At autopsy, 270 patients with portomesenteric venous thrombosis were found; twenty-nine out of the 31 cases with MVT had intestinal infarction. None (0%) of the 239 patients with PVT without extension into the superior mesenteric vein had intestinal infarction. Portomesenteric venous thrombosis and intestinal infarction was associated with concomitant venous thromboembolism (O. R. 6.1 [95% CI 1.8-21]). Conclusions. MVT carries a high risk of developing intestinal infarction and is associated with concomitant venous thromboembolism, whereas PVT is associated with liver disease.

  • 9. Acosta, S.
    et al.
    Bjarnason, T.
    Petersson, U.
    Pålsson, B.
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Svensson, M.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Djavani, Khatereh
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Multicentre prospective study of fascial closure rate after open abdomen with vacuum and mesh-mediated fascial traction2011In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 98, no 5, p. 735-743Article in journal (Refereed)
    Abstract [en]

    Background: Damage control surgery and temporary open abdomen (OA) have been adopted widely, in both trauma and non-trauma situations. Several techniques for temporary abdominal closure have been developed. The main objective of this study was to evaluate the fascial closure rate in patients after vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) for long-term OA treatment, and to describe complications. Methods: This prospective study included all patients who received VAWCM treatment between 2006 and 2009 at four hospitals. Patients with anticipated OA treatment for fewer than 5 days and those with non-midline incisions were excluded. Results: Among 151 patients treated with an OA, 111 received VAWCM treatment. Median age was 68 years. Median OA treatment time was 14 days. Main disease aetiologies were vascular (45 patients), visceral surgical disease (57) and trauma (9). The fascial closure rate was 76.6 per cent in intention-to-treat analysis and 89 per cent in per-protocol analysis. Eight patients developed an intestinal fistula, of whom seven had intestinal ischaemia. Intestinal fistula was an independent factor associated with failure of fascial closure (odds ratio (OR) 8.55, 95 per cent confidence interval 1.47 to 49.72; P = 0.017). The in-hospital mortality rate was 29.7 per cent. Age (OR 1.21, 1.02 to 1.43; P = 0.027) and failure of fascial closure (OR 44.50, 1.13 to 1748.52; P = 0.043) were independently associated with in-hospital mortality. Conclusion: The VAWCM method provided a high fascial closure rate after long-term treatment of OA. Technique-related complications were few. No patient was left with a large planned ventral hernia.

  • 10. Acosta, S.
    et al.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Modern treatment of acute mesenteric ischaemia2014In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 101, no 1, p. E100-E108Article, review/survey (Refereed)
    Abstract [en]

    Background: Diagnosis of acute mesenteric ischaemia in the early stages is now possible with modern computed tomography (CT), using intravenous contrast enhancement and imaging in the arterial and/or portal venous phase. The availability of CT around the clock means that more patients with acute mesenteric ischaemia may be treated with urgent intestinal revascularization.

    Methods: This was a review of modern treatment strategies for acute mesenteric ischaemia.

    Results: Endovascular therapy has become an important alternative, especially in patients with acute thrombotic superior mesenteric artery (SMA) occlusion, where the occlusive lesion can be recanalized either antegradely from the femoral or brachial artery, or retrogradely from an exposed SMA after laparotomy, and stented. Aspiration embolectomy, thrombolysis and open surgical embolectomy, followed by on-table angiography, are the treatment options for embolic SMA occlusion. Endovascular therapy may be an option in the few patients with mesenteric venous thrombosis who do not respond to anticoagulation therapy. Laparotomy is needed to evaluate the extent and severity of visceral organ ischaemia, which is treated according to the principles of damage control surgery.

    Conclusion: Modern treatment of acute mesenteric ischaemia involves a specialized approach that considers surgical and, increasingly, endovascular options for best outcomes. Endovascular increasingly important

  • 11.
    Acosta, S.
    et al.
    Lund Univ, Dept Clin Sci, Vasc Ctr, Malmo, Sweden..
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Negative-pressure wound therapy for prevention and treatment of surgical-site infections after vascular surgery2017In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 104, no 2, p. E75-E84Article, review/survey (Refereed)
    Abstract [en]

    BackgroundIndications for negative-pressure wound therapy (NPWT) in vascular surgical patients are expanding. The aim of this review was to outline the evidence for NPWT on open and closed wounds. MethodsA PubMed, EMBASE and Cochrane Library search from 2007 to June 2016 was performed combining the medical subject headings terms wound infection', abdominal aortic aneurysm (AAA)', fasciotomy', vascular surgery' and NPWT' or VAC'. ResultsNPWT of open infected groin wounds was associated with shorter duration of wound healing by 47 days, and was more cost-effective than alginate dressings in one RCT. In one RCT and six observational studies, NPWT-related major bleeding and graft preservation rates were 0-10 and 83-100 per cent respectively. One retrospective comparative study showed greater wound size reduction per day, fewer dressing changes, quicker wound closure and shorter hospital stay with NPWT compared with gauze dressings for lower leg fasciotomy. NPWT and mesh-mediated fascial traction after AAA repair and open abdomen was associated with high primary fascial closure rates (96-100 per cent) and low risk of graft infection (0-7 per cent). One retrospective comparative study showed a significant reduction in surgical-site infection, from 30 per cent with standard wound care to 6 per cent with closed incisional NPWT. ConclusionNPWT has a central role in open and infected wounds after vascular surgery; the results of prophylactic care of closed incisions are promising.

  • 12.
    Acosta, S.
    et al.
    Lund Univ, Vasc Ctr, Dept Clin Sci, Malmo, Sweden..
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Temporary Abdominal Closure After Abdominal Aortic Aneurysm Repair: A Systematic Review of Contemporary Observational Studies2016In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 51, no 3, p. 371-378Article, review/survey (Refereed)
    Abstract [en]

    Objectives: The aim of this paper was to review the literature on temporary abdominal closure (TAC) after abdominal aortic aneurysm (AAA) repair. Methods: This was a systematic review of observational studies. A PubMed, EM BASE and Cochrane search from 2007 to July 2015 was performed combining the Medical Subject Headings "aortic aneurysm" and "temporary abdominal closure", "delayed abdominal closure", "open abdomen", "abdominal compartment syndrome", "negative pressure wound therapy", or "vacuum assisted wound closure". Results: Seven original studies were found. The methods used for TAC were the vacuum pack system with (n = 1) or without (n = 2) mesh bridge, vacuum assisted wound closure (VAWC; n = 1) and the VAWC with mesh mediated fascial traction (VACM; n = 3). The number of patients included varied from four to 30. Three studies were exclusively after open repair, one after endovascular aneurysm repair, and three were mixed series. The frequency of ruptured AAA varied from 60% to 100%. The primary fascia] closure rate varied from 79% to 100%. The median time to closure of the open abdomen was 10.5 and 17 days in two prospective studies with a fascia] closure rate of 100% and 96%, respectively; the inclusion criterion was an anticipated open abdomen therapy time >= 5 days using the VACM method. The graft infection rate was 0% in three studies. No patient with longterm open abdomen therapy with the VACM in the three studies was left with a planned ventral hernia. The in hospital survival rate varied from 46% to 80%. Conclusions: A high fascial closure rate without planned ventral hernia is possible to achieve with VACM, even after long-term open abdomen therapy. There are, however, few publications reporting specific results of open abdomen treatment after AAA repair, and there is a need for randomized controlled trials to determine the most efficient and safe TAC method during open abdomen treatment after AAA repair.

  • 13.
    Acosta, Stefan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Mesenteric vascular disease: Venous thrombosis2010In: Rutherford's Vascular Surgery: volume two / [ed] Jack L. Cronenwett and K. Wayne Johnston, Philadelphia: Saunders Elsevier, 2010, 7, p. 2304-2310Chapter in book (Refereed)
  • 14. Acosta, Stefan
    et al.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Petersson, Ulf
    Vacuum-assisted wound closure and mesh-mediated fascial traction for open abdomen therapy: a systematic review2017In: Anaesthesiology intensive therapy, ISSN 1731-2515, Vol. 49, no 2, p. 139-145Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: The aim of this paper was to review the literature on vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) in open abdomen therapy. It was designed as systematic review of observational studies.

    METHODS: A Pub Med, EMBASE and Cochrane search from 2007/01-2016/07 was performed combining the Medical Subject Headings "vacuum", "mesh-mediated fascial traction", "temporary abdominal closure", "delayed abdominal closure", "open abdomen", "abdominal compartment syndrome", "negative pressure wound therapy" or "vacuum assisted wound closure".

    RESULTS: Eleven original studies were found including patients numbering from 7 to 111. Six studies were prospective and five were retrospective. Nine studies were on mixed surgical (n = 9), vascular (n = 6) and trauma (n = 6) patients, while two were exclusively on vascular patients. The primary fascial closure rate per protocol varied from 80-100%. The time to closure of the open abdomen varied between 9-32 days. The entero-atmospheric fistula rate varied from 0-10.0%. The in-hospital survival rate varied from 57-100%. In the largest prospective study, the incisional hernia rate among survivors at 63 months of median follow-up was 54% (27/50), and 16 (33%) repairs out of 48 incisional hernias were performed throughout the study period. The study patients reported lower short form health survey (SF-36) scores than the mean reference population, mainly dependent on the prevalence of major co-morbidities. There was no difference in SF-36 scores or a modified ventral hernia pain questionnaire (VHPQ) at 5 years of follow up between those with versus those without incisional hernias.

    CONCLUSIONS: A high primary fascial closure rate can be achieved with the vacuum-assisted wound closure and meshmediated fascial traction technique in elderly, mainly non-trauma patients, in need of prolonged open abdomen therapy.

  • 15.
    Acosta, Stefan
    et al.
    Kärlcentrum, Malmö Universitetssjukhus.
    Block, Tomas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Björnsson, Steinarr
    Kärlcentrum, Malmö Universitetssjukhus.
    Resch, Timothy
    Kärlcentrum, Malmö Universitetssjukhus.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Nilsson, Torbjörn
    Sektionen för Klinisk kemi, Örebro universitetssjukhus.
    Diagnostic pitfalls at admission in patients with acute superior mesenteric artery occlusion2012In: Journal of Emergency Medicine, ISSN 0736-4679, E-ISSN 1090-1280, Vol. 42, no 6, p. 635-641Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Acute superior mesenteric artery (SMA) occlusion leads to acute intestinal ischemia and is associated with high mortality. Early diagnosis is often missed, and confounding factors leading to diagnostic delays need to be highlighted.

    OBJECTIVES:

    To identify potential diagnostic laboratory pitfalls at admission in patients with acute SMA occlusion.

    METHODS:

    Fifty-five patients with acute SMA occlusion were identified from the in-hospital register during a 4-year period, 2005-2009.

    RESULTS:

    The median age was 76 years; 78% were women. The occlusion was embolic in 53% and thrombotic in 47% of patients. At admission, troponin I was above the clinical decision level (> 0.06 μg/L) for acute ischemic myocardial injury in 9/19 (47%) patients with embolic occlusion. Elevated pancreas amylase and normal plasma lactate were found in 12/45 and 13/27, respectively. A troponin I (TnI) above the clinical decision level was associated with a high frequency of referrals from the general surgeon to a specialist in internal medicine (p = 0.011) or a cardiologist (p = 0.024). The diagnosis was established after computed tomography angiography in 98% of the patients. The overall in-hospital mortality rate was 33%. Attempting intestinal revascularization (n = 43; p < 0.001), with a 95% frequency rate of completion control of the vascular procedure, was associated with a higher survival rate, whereas referral to the cardiologist was associated with a higher mortality rate (p = 0.018).

    CONCLUSION:

    Elevated TnI was common in acute SMA occlusion, and referral to the cardiologist was found to be associated with adverse outcome. Elevated pancreas amylase and normal plasma lactate values are also potential pitfalls at admission in patients with acute SMA occlusion.

  • 16.
    Acosta, Stefan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Nilsson, Torbjörn
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    D-dimer testing in patients with suspected acute thromboembolic occlusion of the superior mesenteric artery2004In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 91, no 8, p. 991-994Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    There is no accurate non-invasive method available for the diagnosis of acute thromboembolic occlusion of the superior mesenteric artery (SMA). The aim of this study was to assess the diagnostic properties of the fibrinolytic marker D-dimer.

    METHODS:

    From September 2000 to April 2003 consecutive patients aged over 50 years admitted to hospital with acute abdominal pain were studied. Patients with possible acute SMA occlusion at presentation had blood samples taken within 24 h of the onset of the pain for analysis of D-dimer, plasma fibrinogen, activated partial thromboplastin time, prothrombin time and antithrombin. The value of D-dimer testing to diagnose SMA occlusion was assessed by means of likelihood ratios.

    RESULTS:

    Nine of 101 patients included had acute SMA occlusion. The median D-dimer concentration was 1.6 (range 0.4-5.6) mg/l, which was higher than that in 25 patients with inflammatory disease (P = 0.007) or in 14 patients with intestinal obstruction (P = 0.005). The combination of a D-dimer level greater than 1.5 mg/l, atrial fibrillation and female sex resulted in a likelihood ratio for acute SMA occlusion of 17.5, whereas no patient with a D-dimer concentration of 0.3 mg/l or less had acute SMA occlusion.

    CONCLUSION:

    D-dimer testing may be useful for the exclusion of patients with suspected acute SMA occlusion.

  • 17. Acosta, Stefan
    et al.
    Seternes, Arne
    Venermo, Maarit
    Vikatmaa, Leena
    Sörelius, Karl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Svensson, Mats
    Djavani, Khatereh
    Department of Surgery, Gävle Hospital, Gävle, Sweden.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Open Abdomen Therapy with Vacuum and Mesh Mediated Fascial Traction After Aortic Repair: an International Multicentre Study2017In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 54, no 6, p. 697-705Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    Open abdomen therapy may be necessary to prevent or treat abdominal compartment syndrome (ACS). The aim of the study was to analyse the primary delayed fascial closure (PDFC) rate and complications after open abdomen therapy with vacuum and mesh mediated fascial traction (VACM) after aortic repair and to compare outcomes between those treated with open abdomen after primary versus secondary operation.

    METHODS:

    This was a retrospective cohort, multicentre study in Sweden, Finland, and Norway, including consecutive patients treated with open abdomen and VACM after aortic repair at six vascular centres in 2006-2015. The primary endpoint was PDFC rate.

    RESULTS:

    Among 191 patients, 155 were men. The median age was 71 years (IQR 66-76). Ruptured abdominal aortic aneurysm (RAAA) occurred in 69.1%. Endovascular/hybrid and open repairs were performed in 49 and 142 patients, respectively. The indications for open abdomen were inability to close the abdomen (62%) at primary operation and ACS (80%) at secondary operation. Duration of open abdomen was 11 days (IQR 7-16) in 157 patients alive at open abdomen termination. The PDFC rate was 91.8%. Open abdomen initiated at primary (N=103), compared with secondary operation (N=88), was associated with less severe initial open abdomen status (p=.006), less intestinal ischaemia (p=.002), shorter duration of open abdomen (p=.007), and less renal replacement therapy (RRT, p<.001). In hospital mortality was 39.3%, and after entero-atmospheric fistula (N=9) was 88.9%. Seven developed graft infection within 6 months, 1 year mortality was 28.6%. Intestinal ischaemia (OR 3.71, 95% CI 1.55-8.91), RRT (OR 3.62, 95% CI 1.72-7.65), and age (OR 1.12, 95% CI 1.06-1.12), were independent factors associated with in hospital mortality, but not open abdomen initiated at primary versus secondary operation.

    CONCLUSIONS:

    VACM was associated with a high PDFC rate after prolonged open abdomen therapy following aortic repair. Patient outcomes seemed better when open abdomen was initiated at primary, compared with secondary operation but a selection effect is possible.

  • 18. Acosta, Stefan
    et al.
    Ögren, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Bengtsson, Henrik
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Lindblad, Bengt
    Zdanowski, Zbigniew
    Increasing incidence of ruptured abdominal aortic aneurysm: a population-based study2006In: Journal of Vascular Surgery, ISSN 0741-5214, Vol. 44, no 2, p. 237-243Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of the present population-based study was to assess the trends of age- and gender-specific incidence of ruptured abdominal aortic aneurysm (rAAA).

    Methods. Patients with rAAA from the city of Malmo, Sweden, were studied between 2000 and 2004. An analysis of trends of incidence and mortality of rAAA in Malmo was possible because of a previous population-based study on patients with rAAA between 1971 and 1986 (autopsy rate 85% compared with 25% for the time period 2000 to 2004). The in-hospital registry of Malmo University Hospital and the databases at the Department of Pathology, Malmo, and the Institution of Forensic Medicine, Lund, identified patients with rAAA, and the in-hospital registry identified all elective repairs for AAA.

    Results. Compared with the time period 1971 to 1986, the overall incidence of rAAA significantly increased from 5.6 (95 % confidence interval [CI], 4.9 to 6.3) to 10.6 (95% CI, 8.9 to 12.4) per 100,000 person-years (standardized mortality ratio, 1.6; 95% CI, 1.0 to 2.1). In men aged 60 to 69 and 70 to 79 years, the incidence increased significantly from 16 (95% CI, 11 to 21) and 56 (95% Cl, 43 to 69) to 46 (95% Cl, 28 to 63) and 117 (95% CI, 84 to 149) per 100,000 person-years, respectively, whereas no increase in the age-specific incidence in women could be demonstrated. The overall incidence of elective repair of AAA increased significantly from 3.4 (95% CI, 2.8 to 4.0) to 7.0 (95% CI, 5.6 to 8.4) per 100,000 person-years and increased most significantly from 12 (95% CI, 3.4 to 32) to 68 (95% CI, 34 to 102) per 100,000 person-years in men aged 80 to 89 years and from 5.1 (95% CI, 2.4 to 9.3) to 28 (95% CI, 15 to 41) per 100,000 person-years in women aged 70 to 79 years. The elective-acute repair ratio in women increased from 2.4 to 5.6 and decreased in men from 2.1 to 1.0.

    Conclusions: Between 1971 to 1986 and 2000 to 2004, the incidence of rAAA increased significantly, despite a 100% increase in elective repairs and notwithstanding a potential for bias towards underestimation due to lower autopsy rates in recent years. The reason behind this increase is unclear, and further studies are needed to identify risk groups for direction of effective prevention and screening.

  • 19.
    Acosta, Stefan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Ögren, Mats
    Sternby, Nils-Herman
    Bergqvist, David
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Autopsy findings in 213 patients with fatal acute thrombo-embolic occlusion of the superior mesenteric arteryArticle in journal (Refereed)
  • 20. Acosta, Stefan
    et al.
    Ögren, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Sternby, Nils-Herman
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Fatal colonic ischaemia: A population-based study2006In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 41, no 11, p. 1312-1319Article in journal (Refereed)
    Abstract [en]

    Objectives. To estimate the incidence of fatal colonic ischaemia (CI) and the cause-specific mortality of CI, and to describe the localization and extension of colonic infarction and quantify the risk factors associated with CI. Material and methods. Between 1970 and 1982 the autopsy rate in Malmo, Sweden, was 87%, creating the possibilities for a population-based study. Out of 23,446 clinical autopsies, 997 cases were coded for intestinal ischaemia in a database. In addition, 7569 forensic autopsy protocols were analysed. In a case-control study nested in the clinical autopsy cohort, four CI-free controls, matched for gender, age at death and year of death, were identified for each fatal CI case in order to evaluate the risk factors. Results. The cause-specific mortality ratio was 1.7/1000 autopsies. The overall incidence of autopsy-verified fatal CI was 1.7/100,000 person years, increasing with age up to 23/100,000 person years in octogenarians. Fatal cardiac failure (odds ratio (OR) 5.2), fatal valvular disease (OR 4.3), previous stroke (OR 2.5) and recent surgery (OR 3.4) were risk factors for fatal CI. Narrowing/occlusion of the inferior mesenteric artery (IMA) at the aortic origin was present in 68% of the patients. The most common segments affected by transmural infarctions were the sigmoid (83%) and the descending (77%) colon. Conclusions. Heart failure, atherosclerotic occlusion/stenoses of the IMA and recent surgery were the main risk factors causing colonic hypoperfusion and infarction. Segments of transmural infarctions were observed within the left colon in 94% of the patients. Awareness of the diagnosis and its associated cardiac comorbidities might help to improve survival.

  • 21. Agnelli, G
    et al.
    Eriksson, B I
    Cohen, A T
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Dahl, O E
    Lassen, M R
    Mouret, P
    Rosencher, N
    Andersson, M
    Bylock, A
    Jensen, E
    Boberg, B
    Safety assessment of new antithrombotic agents: Lessons from the EXTEND study on ximelagatran.2009In: Thrombosis Research, ISSN 0049-3848, E-ISSN 1879-2472, Vol. 123, no 3, p. 488-497Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Ximelagatran, the first oral direct thrombin inhibitor, was shown to be an effective antithrombotic agent but was associated with potential liver toxicity after prolonged administration. OBJECTIVES AND METHODS: The aim of the EXTEND study was to assess safety and efficacy of extended administration (35 days) of ximelagatran or enoxaparin for the prevention of venous thromboembolism after elective hip replacement and hip fracture surgery. A follow-up period, including assessment of liver enzymes (in particular alanine aminotransferase; ALAT), until post-operative day 180 was planned, with visits at days 56 and 180. RESULTS: Randomization and administration of study drugs were stopped following a report of serious liver injury occurring 3 weeks after completion of ximelagatran treatment. At the time of study termination, 1158 patients had been randomized and 641 had completed the 35-day treatment; with 303 ximelagatran and 265 enoxaparin patients remaining in the study through to the day 56 follow-up visit. Overall, 58 patients showed an ALAT increase to >2x upper limit of normal: 31 treated with enoxaparin, 27 with ximelagatran. Three ximelagatran patients also showed symptoms potentially related to liver toxicity. Eleven ximelagatran patients showed an ALAT increase after study treatment ended. The clinical development of ximelagatran was terminated and the drug withdrawn from the market. Evaluation of the relative efficacy of the two treatments as specified in the protocol was impossible due to the premature termination of the study. CONCLUSIONS: Prolonged administration of ximelagatran was associated with an increased risk of liver toxicity. In a substantial proportion of patients, ALAT increase occurred after treatment withdrawal. The findings seen with ximelagatran should be considered when designing studies with new antithrombotic agents.

  • 22.
    Ahlström, Håkan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    MRA eller DSA?: Välgjord multicenterstudie ett skolexempel på hur ny medicinsk teknik bör utvärderas1996In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 93, no 41, p. 3555-3556Article in journal (Refereed)
  • 23. Apelqvist, Jan
    et al.
    Bergqvist, Dvid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Diabetesfoten2010In: Diabetes / [ed] Carl-David Agardh & Christian Berne, Stockholm: Liber, 2010, 4:e uppl., p. 411-426Chapter in book (Refereed)
  • 24. Arnelöv, Conny
    et al.
    Furebring, Mia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Aortagraftinfektion – ett komplicerat kärlkirurgiskt tillstånd2013In: Svensk Kirurgi, ISSN 0346-847X, Vol. 71, no 2, p. 84-88Article in journal (Refereed)
    Abstract [sv]

    Infektion runt ett aortagraft är en fruktad komplikation och utgör både en kirurgisk och antibakteriell utmaning där erfarenhet och multidisciplinär kompetens krävs. Åtgärder kan behövas akut vid graftenterisk blödning, men i andra fall med enbart infektion finns det tid för en noggrann utredning och diskussion angående kirurgisk strategi. 

  • 25. Authors/Task Force Members,
    et al.
    Aboyans, Victor
    Ricco, Jean-Baptiste
    Bartelink, Marie-Louise E L
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Brodmann, Marianne
    Cohnert, Tina
    Collet, Jean-Philippe
    Czerny, Martin
    De Carlo, Marco
    Debus, Sebastian
    Espinola-Klein, Christine
    Kahan, Thomas
    Kownator, Serge
    Mazzolai, Lucia
    Naylor, A Ross
    Roffi, Marco
    Röther, Joachim
    Sprynger, Muriel
    Tendera, Michal
    Tepe, Gunnar
    Venermo, Maarit
    Vlachopoulos, Charalambos
    Desormais, Ileana
    Document Reviewers,
    Widimsky, Petr
    Kolh, Philippe
    Agewall, Stefan
    Bueno, Héctor
    Coca, Antonio
    De Borst, Gert J
    Delgado, Victoria
    Dick, Florian
    Erol, Cetin
    Ferrini, Marc
    Kakkos, Stavros
    Katus, Hugo A
    Knuuti, Juhani
    Lindholt, Jes
    Mattle, Heinrich
    Pieniazek, Piotr
    Piepoli, Massimo Francesco
    Scheinert, Dierk
    Sievert, Horst
    Simpson, Iain
    Sulzenko, Jakub
    Tamargo, Juan
    Tokgozoglu, Lale
    Torbicki, Adam
    Tsakountakis, Nikolaos
    Tuñón, José
    de Ceniga, Melina Vega
    Windecker, Stephan
    Zamorano, Jose Luis
    2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS).2017In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, article id S1078-5884(17)30454-9Article in journal (Refereed)
  • 26.
    Baderkhan, Hassan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Gonçalves, Frederico M. Bastos
    Erasmus Univ, Dept Vasc Surg, Med Ctr, Rotterdam, Netherlands; Hosp Santa Marta, Dept Angiol & Vasc Surg, Ctr Hosp Lisboa Cent, Lisbon, Portugal.
    Oliveira, Nelson Gomes
    Erasmus Univ, Dept Vasc Surg, Med Ctr, Rotterdam, Netherlands; Hosp Divino Espirito Santo Ponta Delgada, Dept Angiol & Vasc Surg, Azores, Portugal.
    Verhagen, Hence J. M.
    Erasmus Univ, Dept Vasc Surg, Med Ctr, Rotterdam, Netherlands.
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Mani, Kevin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Challenging Anatomy Predicts Mortality and Complications After Endovascular Treatment of Ruptured Abdominal Aortic Aneurysm2016In: Journal of Endovascular Therapy, ISSN 1526-6028, E-ISSN 1545-1550, Vol. 23, no 6, p. 919-927Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To analyze the effects of aortic anatomy and endovascular aneurysm repair (EVAR) inside and outside the instructions for use (IFU) on outcomes in patients treated for ruptured abdominal aortic aneurysms (rAAA).

    METHODS: All 112 patients (mean age 73 years; 102 men) treated with standard EVAR for rAAA between 2000 and 2012 in 3 European centers were included in the retrospective analysis. Patients were grouped based on aortic anatomy and whether EVAR was performed inside or outside the IFU. Data on complications, secondary interventions, and mortality were extracted from the patient records. Cox regression analysis was performed to assess predictors of mortality and complications; results are presented as the hazard ratio (HR) with 95% confidence interval (CI). Survival was analyzed using the Kaplan-Meier method.

    RESULTS: Of the 112 patients examined, 61 (54%) were treated inside the IFU, 43 (38%) outside the IFU, and 8 patients lacked adequate preoperative computed tomography scans for determination. Median follow-up of those surviving 30 days was 2.5 years. Mortality at 30 days was 15% (95% CI 6% to 24%) inside the IFU vs 30% (95% CI 16% to 45%) outside (p=0.087). Three-year mortality estimates were 33.8% (95% CI 20.0% to 47.5%) inside the IFU vs 56% (95% CI 39.7% to 72.2%) outside (p=0.016). At 5 years, mortality was 48% (95% CI 30% to 66%) inside the IFU vs 74% (95% CI 54% to 93%) outside (p=0.015). Graft-related complications occurred in 6% (95% CI 0% to 13%) inside the IFU and 30% (95% CI 14% to 42%) outside (p=0.015). The rate of graft-related secondary interventions was 14% (95% CI 4% to 22%) inside the IFU vs 35% (95% CI 14% to 42%) outside (p=0.072). In the multivariate analysis, neck length <15 mm (HR 8.1, 95% CI 3.0 to 21.9, p<0.001) and angulation >60° (HR 3.1, 95% CI 1.0 to 9.3, p=0.045) were independent predictors of late graft-related complications. Aneurysm neck diameter >29 mm (HR 2.5, 95% CI 1.1 to 5.9, p=0.035) was an independent predictor of overall mortality.

    CONCLUSION: Long-term mortality and complications after rEVAR are associated with aneurysm anatomy. The role of adjunct endovascular techniques and the outcome of open repair in cases with challenging anatomy warrant further study.

  • 27.
    Baderkhan, Hassan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Haller, O.
    Department of Radiology, Gävle Hospital, Gävle, Sweden.
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Mani, Kevin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Follow-up after endovascular aortic aneurysm repair can be stratified based on first postoperative imaging2018In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 05, no 6, p. 709-718Article in journal (Refereed)
    Abstract [en]

    Background

    Lifelong postoperative surveillance is recommended following endovascular aneurysm repair (EVAR). Although the purpose is to prevent and/or identify complications early, it also results in increased cost and workload. This study was designed to examine whether it may be possible to identify patients at low risk of complications based on their first postoperative CT angiogram (CTA).

    Methods

    All patients undergoing EVAR in two Swedish centres between 2001 and 2012 were identified retrospectively and categorized based on the first postoperative CTA as at low risk (proximal and distal sealing zone at least 10 mm and no endoleak) or high risk (sealing zone less than 10 mm and/or presence of any endoleak) of complications.

    Results

    Some 326 patients (273 men) with a CTA performed less than 1 year after EVAR were included (low risk 212, 65·0 per cent; high risk 114, 35·0 per cent). There was no difference between the groups in terms of sex, age, co‐morbidities, abdominal aortic aneurysm (AAA) diameter, preoperative AAA neck anatomy, stent‐graft type or duration of follow‐up (mean(s.d.) 4·8(3·2) years). Five‐year freedom from AAA‐related adverse events was 97·1 and 47·7 per cent in the low‐ and high‐risk groups respectively (P < 0·001). The corresponding freedom from AAA‐related reintervention was 96·2 and 54·1 per cent (P < 0·001). The method had a sensitivity of 88·3 per cent, specificity of 77·0 per cent and negative predictive value of 96·6 per cent to detect AAA‐related adverse events. The number of surveillance imaging per AAA‐related adverse event was 168 versus 11 for the low‐risk versus high‐risk group.

    Conclusion

    Two‐thirds of patients undergoing EVAR have an adequate seal and no endoleak on the first postoperative CTA, and a very low risk of AAA‐related events up to 5 years. Less vigilant follow‐up after EVAR may be considered for these patients.

  • 28. Baird, D L H
    et al.
    Mani, Kevin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Sabharwal, T
    Taylor, P R
    Zayed, H A
    Endovascular treatment of isolated iliac artery aneurysms using a custom-made stent graft with proximal barb fixation: early outcome2013In: Vascular, ISSN 1708-5381, Vol. 21, no 2, p. 92-96Article in journal (Refereed)
    Abstract [en]

    Current endovascular treatments for isolated iliac artery aneurysms (IIAAs) include the use of aortoiliac stent grafts with coverage of the distal aorta or stent grafts confined to the iliac artery without active proximal fixation. We report our experience in the use of custom-made Cook ZenithTM iliac limb stent grafts with proximal barb fixation. Patients treated from July 2009 to February 2011 were included. All imaging and patient records were assessed for perioperative and early outcomes. Nine IIAAs (seven patients) were treated. The mean patient age was 80 years (range 58–91 years). The mean aneurysm size was 48 mm (35–80 mm), and the mean length of the proximal landing zone (PLZ) was 29 mm (10–50 mm). The distal landing zone was in the external iliac artery after coil embolization of the internal iliac artery. The Mean diameter of the PLZ was 21 mm (20–24 mm). Technical success was achieved in eight cases. Perioperative complications included reoperation in one patient for groin bleeding and ischemia. On follow-up (mean 12 months, range 1–26), all aneurysms were successfully excluded from the circulation and there was no stent graft migration or thrombosis. Use of custom-made stent grafts with proximal barb fixation in treatment of IIAAs is a feasible option which may reduce the risk of migration when compared with stent grafts with lack of proximal fixation.

  • 29. Balaz, P
    et al.
    Rokosny, S
    Bafrnec, J
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    The role of hybrid procedures in the management of peripheral vascular disease2012In: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 101, no 4, p. 232-237Article, review/survey (Refereed)
    Abstract [en]

    This paper provides a summary of up-to-date information and experience with the combined treatment of patients suffering from peripheral arterial disease (PAD) with endovascular and open surgery, performed simultaneously and in a single operating room. Hybrid intervention is reported to have good results in well-indicated groups of patients with acute and chronic limb ischemia, even with older, high-risk patients. The indications for the use of this technique remain unclear with inconsistent opinions among vascular surgeons. The indications for treat-ment were divided into three main groups: 1) Patients with chronic limb ischemia, 2) acute limb ischemia, and 3) occlusion of a previous vascular reconstruction. The operating techniques for the most commonly used combinations are described. In conclusion, hybrid operating techniques are often useful when treating complex problems and multilevel disease in patients with chronic or acute lower limb ischemia. Modern vascular surgeons need to master both open and endovascular techniques, and to combine them in a creative fashion to the benefit of our patients.

  • 30.
    Balaz, P.
    et al.
    Inst Clin & Expt Med, Vasc & Transplant Surg Dept, Prague, Czech Republic.;Charles Univ Prague, Fac Med 3, Fac Hosp Kralovske Vinohrady, Vasc Surg Unit,Dept Surg, Prague, Czech Republic..
    Wohlfahrt, P.
    St Annes Univ Hosp, Int Clin Res Ctr, Brno, Czech Republic.;Inst Clin & Expt Med, Dept Prevent Cardiol, Prague, Czech Republic.;Charles Univ Prague, Fac Med 1, Ctr Cardiovasc Prevent, Prague, Czech Republic.;Thomayer Hosp, Prague, Czech Republic..
    Rokosny, S.
    Inst Clin & Expt Med, Vasc & Transplant Surg Dept, Prague, Czech Republic..
    Maly, S.
    Inst Clin & Expt Med, Vasc & Transplant Surg Dept, Prague, Czech Republic..
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Is It Worthwhile Treating Occluded Cold Stored Venous Allografts by Thrombolysis?2016In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 52, no 3, p. 370-376Article in journal (Refereed)
    Abstract [en]

    Objectives: Thrombolysis has been reported to be suboptimal in occluded vein grafts and cryopreserved allografts, and there are no data on the efficacy of thrombolysis in occluded cold stored venous allografts. The aim was to evaluate early outcomes, secondary patency and limb salvage rates of thrombolysed cold stored venous allograft bypasses and to compare the outcomes with thrombolysis of autologous bypasses. Methods: This was a single center study of consecutive patients with acute and non-acute limb ischemia between September 1, 2000, and January 1, 2014, with occlusion of cold stored venous allografts, and between January 1, 2012, and January 1, 2014, with occlusion of autologous bypass who received intra-arterial thrombolytic therapy. Results: Sixty-one patients with occlusion of an infrainguinal bypass using a cold stored venous allograft (n = 35) or an autologous bypass (n = 26) underwent percutaneous intra-arterial thrombolytic therapy. The median duration of thrombolysis was 20 h (IQR 18-24) with no difference between the groups (p = .14). The median follow up was 18.5 months (IQR 11.0-52.0). Secondary patency rates of thrombolysed bypass at 6 and 12 months were 44 +/- 9% and 32 +/- 9% in patients with a venous allograft bypass and 46 +/- 10% and 22 +/- 8% with an autologous bypass, with no difference between groups (p = .40). Limb salvage rates at 1, 6, and 12 months after thrombolysis in the venous allograft group were 83 +/- 7%, 72 8% and 63 +/- 9%, and in the autologous group 91 +/- 6%, 76 +/- 9%, and 65 +/- 13%, with no difference between groups (p = .69). Conclusions: Long-term results of thrombolysis of venous allograft bypasses are similar to those of autologous bypasses. Occluded cold stored venous allograft can be successfully re-opened in most cases with a favorable effect on limb salvage.

  • 31. Balaz, Peter
    et al.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    True aneurysm in autologous hemodialysis fistulae: definitions, classification and indications for treatment2015In: Journal of Vascular Access, ISSN 1129-7298, E-ISSN 1724-6032, Vol. 16, no 6, p. 446-453Article, review/survey (Refereed)
    Abstract [en]

    INTRODUCTION: Definition, etiology, classification and indication for treatment of the arteriovenous access (AVA) aneurysm are poorly described in medical literature. The objectives of the paper are to complete this information gap according to the extensive review of the literature.

    METHODS: A literature search was performed of the articles published between April 1, 1967, and March 1, 2014. The databases searched included Medline and the Cochrane Database of Systematic Reviews. The eligibility criteria in this review studies the need to assess the association of aneurysms and pseudoaneurysms with autologous AVA. Aneurysms and pseudoaneurysms involving prosthetic AVA were not included in this literature review. From a total of 327 papers, 54 non-English papers, 40 case reports and 167 papers which did not meet the eligibility criteria were removed. The remaining 66 papers were reviewed.

    RESULTS: Based on the literature the indication for the treatment of an AVA aneurysm is its clinical presentation related to the patient's discomfort, bleeding prevention and inadequate access flow. A new classification system of AVA aneurysm, which divides it into the four types, was also suggested.

    CONCLUSIONS: AVA aneurysm is characterized by an enlargement of all three vessel layers with a diameter of more than 18 mm and can be presented in four types according to the presence of stenosis and/or thrombosis. The management of an AVA aneurysm depends on several factors including skin condition, clinical symptoms, ease of cannulation and access flow. The diameter of the AVA aneurysm as a solo parameter is not an indication for the treatment.

  • 32. Balaz, Peter
    et al.
    Rokosny, Slavomir
    Wohlfahrt, Peter
    Adamec, Milos
    Janousek, Libor
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Early and late outcomes of hybrid endovascular and open repair procedures in patients with peripheral arterial disease2013In: VASA, ISSN 0301-1526, E-ISSN 1664-2872, Vol. 42, no 4, p. 292-300Article in journal (Refereed)
    Abstract [en]

    Background: Hybrid endovascular and open reconstructions are used increasingly often for multilevel revascularization for lower limb ischaemia. The aim was to evaluate outcomes after such procedures in a single-center non-randomized retrospective study. Patients and methods: Consecutive patients with multilevel arterial disease who underwent single session hybrid procedures were analyzed depending on the type of ischaemia and the type of revascularization. Results: 164 patients were included with a median follow up time of 14 months (range: 0 - 70). Indication was claudication (group 1, 47 %), critical limb ischaemia (group 2, 33 %) and acute limb ischaemia (group 3, 20 %). Technical success rate was 99.3%, perioperative mortality 2%. Primary, assisted-primary and secondary patency rates at one year were 60%, 61% and 64%, respectively. Primary, primary assisted and secondary patency were lower in group 2 and 3 compared to group 1 (all p < 0.05). Results were better when endovascular repairs were performed above compared to below the open repair site (all p < 0.05). Limb salvage at 1 year in groups 1 - 3 were 98%, 92% and 90%, respectively. The risk of major amputation was highest in group 3 compared to group 1 (p = 0.001) or group 2 (p < 0.04). Conclusions: The results depend on the type of ischaemia and the localization of endovascular procedures.

  • 33. Beck, AW
    et al.
    Sedrakyan, A
    Mao, J
    Venermo, M
    Faizer, R
    Debus, S
    Behrendt, CA
    Scali, S
    Altreuther, M
    Schermerhorn, M
    Beiles, B
    Szeberin, Z
    Eldrup, N
    Danielsson, G
    Thomson, I
    Wigger, P
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Cronenwett, JL
    Mani, Kevin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    International Consortium of Vascular Registries,
    Variations in abdominal aortic aneurysm care: a report from the International consortium of vascular registries2016In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539Article in journal (Refereed)
    Abstract [en]

    Background: This project by the ICVR (International Consortium of Vascular Registries), a collaboration of 11 vascular surgical quality registries, was designed to evaluate international variation in the contemporary management of abdominal aortic aneurysm (AAA) with relation to recommended treatment guidelines from the Society for Vascular Surgery and the European Society for Vascular Surgery.

    Methods: Registry data for open and endovascular AAA repair (EVAR) during 2010 to 2013 were collected from 11 countries. Variations in patient selection and treatment were compared across countries and across centers within countries.

    Results: Among 51 153 patients, 86% were treated for intact AAA (iAAA) and 14% for ruptured AAA. Women constituted 18% of the entire cohort (range, 12% in Switzerland–21% in the United States; P<0.01). Intact AAAs were repaired at diameters smaller than recommended by guidelines in 31% of men (<5.5 cm; range, 6% in Iceland–41% in Germany; P<0.01) and 12% of women with iAAA (<5 cm; range, 0% in Iceland–16% in the United States; P<0.01). Overall, use of EVAR for iAAA varied from 28% in Hungary to 79% in the United States (P<0.01) and for ruptured AAA from 5% in Denmark to 52% in the United States (P<0.01). In addition to the between-country variations, significant variations were present between centers in each country in terms of EVAR use and rate of small AAA repair. Countries that more frequently treated small AAAs tended to use EVAR more frequently (trend: correlation coefficient, 0.51; P=0.14). Octogenarians made up 23% of all patients, ranging from 12% in Hungary to 29% in Australia (P<0.01). In countries with a fee-for-service reimbursement system (Australia, Germany, Switzerland, and the United States), the proportions of small AAA (33%) and octogenarians undergoing iAAA repair (25%) were higher compared with countries with a population-based reimbursement model (small AAA repair, 16%; octogenarians, 18%; P<0.01). In general, center-level variation within countries in the management of AAA was as important as variation between countries.

    Conclusions: Despite homogeneous guidelines from professional societies, significant variation exists in the management of AAA, most notably for iAAA diameter at repair, use of EVAR, and the treatment of elderly patients. ICVR provides an opportunity to study treatment variation across countries and to encourage optimal practice by sharing these results.

  • 34. Belch, Jill J. F.
    et al.
    Dormandy, John
    Biasi, B. M.
    Cairols, M.
    Diehm, C.
    Eikelboom, B.
    Golledge, J.
    Jawien, A.
    Lepäntalo, M.
    Norgren, L.
    Hiatt, W. R.
    Becquemin, J. P.
    Bergqvist, D.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Clement, D.
    Baumgartner, I.
    Minar, E.
    Stonebridge, P.
    Vermassen, F.
    Matyas, L.
    Leizorovicz, A.
    Results of the randomized, placebo-controlled clopidogrel and acetylsalicylic acid in bypass surgery for peripheral arterial disease (CASPAR) trial2010In: Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter, ISSN 0741-5214, Vol. 52, no 4, p. 825-833, 833.e1-2Article in journal (Refereed)
    Abstract [en]

    The combination of clopidogrel plus ASA did not improve limb or systemic outcomes in the overall population of PAD patients requiring below-knee bypass grafting. Subgroup analysis suggests that clopidogrel plus ASA confers benefit in patients receiving prosthetic grafts without significantly increasing major bleeding risk.

  • 35. Berger, P.
    et al.
    Willems, M. C.
    Van Der Vliet, J. A.
    Schultze Kool, L. J.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Blankensteijn, J. D.
    Validation of the Simulator for Testing and Rating Endovascular SkillS (STRESS)-machine in a setting of competence testing2010In: Journal of Cardiovascular Surgery, ISSN 0021-9509, E-ISSN 1827-191X, Vol. 51, no 2, p. 253-256Article in journal (Refereed)
    Abstract [en]

    AIM: Endovascular skills are an integral part of modern-day vascular surgery. The STRESS machine has been developed to test these skills in vascular surgeons. This study aims to define an optimal pass/fail cutoff value for the STRESS test score. METHODS: The STRESS machine consists of a dry glass model of the abdominal aorta and its tributaries with various stenotic lesions, elongations, and tortuosities. A camera and computer software are used to simulate plain fluoroscopy-mode. The test subjects are given two assignments after which two reviewers use a combination of the ICEPS and MRS to produce the final total score; 43 subjects were tested. According to previous endovascular experience, subjects were classified into four groups: novice-low (no experience, less than 11 performed procedures, less than 50 assisted procedures), novice-high (11-25 performed procedures, more than 50 assisted procedures), intermediate (1-10 performed and >11-25 assisted procedures, 11-25 performed and >1-10 assisted procedures or 25-50 performed procedures) and advanced (more than 50 performed procedures). RESULTS: Test-score and noted experience showed a correlation of 0.794. All intermediate and advanced test subjects scored more than 50 points compared to 4 out of 15 novices. CONCLUSION: We demonstrated that it is possible to determine an optimal cut-off value for competence testing with the STRESS machine.

  • 36.
    Berglund, David
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Lundqvist, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology.
    Magnusson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology.
    Sedigh, Amir
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Bäckman, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Biglarnia, Ali-Reza
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Vascular reconstruction using allogeneic homografts in a renal transplant patient with pseudoaneurysm and infected vascular prosthesis2012In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 93, no 4, p. e15-e16Article in journal (Refereed)
  • 37.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Akut extremitetsischemi2009In: Kärlsjukdom: Vaskulär medicin / [ed] Folke Lindgärde, Tomas Thulin och Jan Östergren, Lund: Studentlitteratur , 2009, 3, p. 319-326Chapter in book (Other (popular science, discussion, etc.))
  • 38.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Aneurysm: dramatik och patologisk estetik2012In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 109, no 16, p. 829-830Article in journal (Refereed)
  • 39.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Aneurysms: from traumatology to screening2010In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 115, no 2, p. 81-87Article in journal (Refereed)
    Abstract [en]

    This paper deals with aneurysmal disease, primarily when localized in the abdominal aorta. It is based on the Olof Rudbeck lecture 2009. Aneurysm is a localized widening of an artery, and its definition has become an important issue today when the disease is in focus for screening programmes. Aetiology and pathogenesis are still poorly understood, but a genetic component determining the strength of the aortic wall is important, and there is a strong male dominance. Historically, several attempts have been made to treat the disease, but reconstructive treatment has been possible only since 1951, in an increasing number of cases performed endovascularly. By early detection through screening, and thereby the possibility to treat before rupture, it has now become possible to decrease the total mortality from the disease in the population.

  • 40.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Antiswelling effect of StepIt: an active foot pump system2009In: Journal of the American Podiatric Medical Association (Print), ISSN 8750-7315, E-ISSN 1930-8264, Vol. 99, no 1, p. 20-22Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: StepIt is a device for active movement of the foot that simulates normal walking with calf muscle contractions. METHODS: In 40 healthy volunteers with predominantly office work and sitting conditions, StepIt was used regularly for 1 day, and the volume of the calf, approximated to a truncated cone, was measured before and after using StepIt. One leg was used as a control, and after 5 days, the exercise was repeated, with the other leg as the control. RESULTS: The volume of the leg increased during the day and the increase was significantly smaller in the leg that used StepIt. CONCLUSIONS: By using a device for active foot movement in healthy people, it is possible, in some individuals, to reduce the swelling that occurs during sitting conditions.

  • 41.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Artärsjukdomar: Utredning, klinisk bedömning och behandling2013 (ed. 2)Book (Refereed)
    Abstract [sv]

    Arterioskleros med dess olika kliniska manifestationer är en av våra stora folksjukdomar och den vanligaste orsaken till för tidig död i höginkomstländer. Artärsjukdomar ger dig en orientering om den kärlsjuke patienten sedd från kärlkirurgens perspektiv.Boken är praktiskt och kliniskt inriktad och den är rikligt försedd med illustrationer. Den första delen avhandlar anamnes och status, därefter beskrivs sjukdomstillstånd avseende symtom, kliniska fynd och behandlingsprinciper i del två. Den tredje delen beskriver handläggningen schematiskt utifrån specifika symtom och fynd. I bokens avslutande del diskuteras övergripande organisatoriska frågor.Artärsjukdomar riktar sig till studenter vid utbildningen till läkare, sjuksköterska och biomedicinsk analytiker samt yrkesverksamma som kommer i kontakt med kärlpatienter.

  • 42.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Betraktelser från ett vetenskapligt råd i kärlkirurgi2009In: Svensk kirurgi, ISSN 0346-847X, Vol. 67, no 5, p. 172-174Article in journal (Refereed)
  • 43.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Dags att pröva ut kirurgin med vassare metodik2011In: Information från SBU Medicinsk vetenskap & praxis, ISSN 1104-1250, no 3-4, p. 8-10Article in journal (Other academic)
    Abstract [sv]

    Äntligen har kirurger föreslagit en modell för hur nya metoder kan föras in på ett ordnat sätt, och samtidigt studeras vetenskapligt, skriver professor emeritus David Bergqvist.

    Att utvärdera läkemedel är enkelt - åtminstone i princip. I en randomiserad, dubbelblindad studie jämförs det nya preparatet med placebo eller annan aktiv substans och sedan utvärderas resultaten.Lika viktigt, men ofta svårare, är det att studera effekterna av icke-farmakologiska metoder, till exempel kirurgiska behandlingar.[1]En särskild svårighet är att utfallet ofta är beroende av kirurgens tekniska kompetens, erfarenhet och förmåga att hantera oväntade situationer i samband med ingreppet - till exempel överraskande anatomiska eller patologiska fynd under operationen. Förtrogenhet och improvisationsförmåga kan spela stor roll och kan svårligen standardiseras. Behandlarnas varierande "hantverksskicklighet" kan också ha betydelse.

  • 44.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Group prophylaxis is the best strategy2010In: Disease-a-month, ISSN 0011-5029, E-ISSN 1557-8194, Vol. 56, no 10, p. 560-562Article in journal (Refereed)
  • 45.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Hemostas, blödning, trombos2009In: Kirurgi / [ed] Bertil Hamberger, Ulf Haglund, Stockholm: Liber , 2009, 7, p. 61-68Chapter in book (Other (popular science, discussion, etc.))
  • 46.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Historical aspects on aneurysmal disease2008In: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 97, no 2, p. 90-99Article, review/survey (Refereed)
  • 47.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Introduction of new technology in vascular surgery2008In: Acta Chirurgica Belgica, ISSN 0001-5458, Vol. 108, no 2, p. 167-170Article in journal (Refereed)
    Abstract [en]

    In this review paper introduction of new technologies in vascular surgery is discussed. The difficulties compared to introduction of pharmacological treatment are analyzed. Pros and cons with randomized controlled trials and observational studies are listed.

  • 48.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Introduction of new technology: the surgical point of view2009In: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 98, no 1, p. 3-7Article, review/survey (Refereed)
    Abstract [en]

    Introduction of new non-pharmacological technology is challenging and the methodology for evaluating such technologies is much less standardized than when dealing with new pharmacological substances. It is, however, as important to use randomized design with blinded assessment and combine that with prospective population based registries to be able to analyze generalizability.

  • 49.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Kultur på tentamen: i kärlkirurgi2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, no 6, p. 226-227, article id DAXMArticle in journal (Other academic)
  • 50.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Kärlkirurgi: ny som specialitet2011In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, no 8, p. 391-391Article in journal (Refereed)
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