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Biomedical subjects

J G Rasmussen

Publications and source records attributed to J G Rasmussen.

12 recordsLinked to original sources
PubMed2000

The clinical importance and prediction of steal following femoro-femoral cross-over bypass: study of the donor iliac artery by intravascular ultrasound, arteriography, duplex scanning and pressure measurements.

OBJECTIVES: to evaluate the clinical significance of the steal phenomenon following femoro-femoral bypass, and whether the addition of intravascular ultrasound (IVUS) to the established examinations of the donor iliac artery can improve the prediction of patients who will develop steal. DESIGN: prospective study. MATERIAL AND METHODS: twenty-eight patients, aged 73 (50-81) years, scheduled for femoro-femoral bypass surgery in the period from 1994 to 1997, had the donor iliac artery examined by single-plane arteriography, duplex scanning, IVUS and femoral-artery blood pressure measurements (FABP)+/-papaverine. Three patients were excluded due to simultaneous thromboendarterectomy (TEA) of the donor iliac artery. The clinical stage and the ankle-brachial index (ABPI) were measured pre-, postoperatively and prospectively 1, 6, 12 and 24 months after discharge. RESULTS: two patients developed clinical steal, while an additional five had a measurable (>0.1) decline in the donor ABPI postoperatively, but no symptoms (subclinical steal). The clinical stage of the donor limb did not deteriorate further during the follow-up period (median 8 months) in these seven patients. The decline in donor ABPI correlated with the FABP and the IVUS measurements, but not to duplex scanning or arteriography. FABP after papaverine injection and IVUS examination showed equal sensitivities and and specificities. CONCLUSION: a clinical steal phenomenon following femoro-femoral bypass surgery seems relatively uncommon, although a subclinical steal is more frequent. Both can be predicted by FABP or IVUS. Further follow-up is required to evaluate whether subclinical steal has any consequences in the long term.

Aged↗
PubMed1999

Effect and outcome of balloon angioplasty and stenting of the iliac arteries evaluated by intravascular ultrasound.

OBJECTIVES: To document the mechanism of percutaneous transluminal angioplasty (PTA) and stenting of the iliac arteries, and to relate the effect to patency. MATERIALS AND METHODS: Thirty-seven stenotic iliac arteries were examined by intravascular ultrasound (IVUS) and arteriography before and after PTA, and after stent deployment (n = 16). The patients were followed prospectively by duplex scanning at 3, 6, 12, 18 and 24 months after the intervention. RESULTS: The effect of PTA was established by both compression and stretching with the major contribution arising from stretching. There were differences in the effect of PTA dependent on plaque morphology: in homogeneous eccentric lesions, stretching contributed significantly more than compression to the luminal gain, while stretching and compression contributed equally in concentric or heterogeneous plaques. Stenting of the arteries had no effect on the free luminal area as measured by IVUS. The primary 1-year patency rate was 72%. The patency was related to the free luminal area and diameter and the heterogenicity of the plaque as evaluated by IVUS. The arteriographic measurements did not have any predictive value. CONCLUSION: IVUS was able to document the effect of PTA and stenting in the iliac arteries, and predict the outcome. The luminal gain and reduction in degree of stenosis seemed to be accomplished primarily by stretching of the arteries and to a lesser extent by plaque compression. Stenting did not change the IVUS measurements. Patency was related to the size of the free lumen and the heterogenicity of the plaque.

Aged↗
PubMed1998

Quantification of iliac artery stenoses: a methodological comparative study between intravascular ultrasound, arteriography and duplex scanning.

Two morphological methods for quantifying the degree of stenoses in the iliac arteries, intravascular ultrasound (IVUS) and arteriography, were compared with duplex scanning, a method of evaluating the haemodynamic importance of the stenosis. A total of 38 patients, 20 women and 18 men, median age 66 y, admitted for either PTA (n=18) or femoro-femoral crossover bypass surgery (n=20), were examined by IVUS, single plane arteriography and duplex scanning. The predictive value, sensitivity, specificity and kappa value of IVUS were higher than the corresponding values for arteriography. Logistic regression analysis found that IVUS had a predictive value (p=0.0003) for diagnosing significant stenosis as defined by duplex scanning, but arteriography did not (p=0.1). However, this difference in usefulness as predictors did not reach significance. The agreement between arteriography and IVUS was relatively good. The conclusion is that IVUS seems to be superior to single-plane arteriography in predicting hemodynamically significant stenoses as defined by duplex scanning.

Adult↗
PubMed1997

Prediction of outcome after femoropopliteal balloon angioplasty by intravascular ultrasound.

OBJECTIVE: To evaluate intravascular ultrasound (IVUS) as a control procedure after femoropopliteal percutaneous transluminal angioplasty (PTA), and compare it with arteriography. DESIGN: Descriptive study. MATERIAL: Arteriographic and intravascular ultrasound data obtained from 18 patients (20 limbs) undergoing PTA of the superficial femoral or popliteal artery. The degree of stenosis, the diameter and area of the lumen and the morphological changes in the plaque were related to the short-term patency of the intervention, as evaluated by duplex scan and ankle branchial index. RESULTS: Fifteen arteries remained patent. Two occlusions and two stenoses developed during the first 3 months after the intervention and one occlusion occurred after 1 year. The following IVUS parameters were related to a favourable patency: presence of calcification; dissection or plaque rupture and residual stenosis of less than 70%. The arteriographically determined diameter reduction did not show predictive value. CONCLUSION: This study shows that in contrast to arteriography, IVUS revealed parameters predictive for patency following PTA.

Aged↗
PubMed1993

A 24-week study of 20 mg citalopram, 40 mg citalopram, and placebo in the prevention of relapse of major depression.

A total of 147 patients who had responded in a placebo-controlled study to 6 weeks treatment of an episode of DSM-III-R major depression with either 20 mg or 40 mg citalopram were randomized double-blind to continue on the same dose of citalopram or to receive placebo during a 24-week study of the efficacy of citalopram in the prevention of relapse. The citalopram 20 and 40 mg groups showed a significant advantage compared with placebo both in relapses (p < 0.05) and in the survival analysis of time to relapse (p = 0.01 and p = 0.02, respectively). Both 20 and 40 mg citalopram appeared similarly safe and well tolerated with little difference in side effects from placebo. The results demonstrate that citalopram, at a dose of both 20 and 40 mg is effective and well tolerated in continuation treatment to consolidate response. The relapse rate in patients who had responded to placebo during the 6-week acute treatment study, who were continued double-blind with placebo but not included in the efficacy analysis, was similar to the rate in the formal placebo control group, suggesting that patients who respond to placebo in a short treatment course may nonetheless require long-term active treatment to prevent relapse.

Citalopram↗
PubMed1982

Closure of terminal and loop colostomy.

The clinical course after closing of a temporary colostomy was studied in 56 patients, 26 with loop colostomy and 30 with terminal colostomy. No significant difference was found in the complication rate or hospital stay between the two groups. It is concluded that terminal colostomy is preferable, as a standard procedure, because it is more acceptable to the patient and gives a complete diversion of the fecal stream.

Adolescent↗