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Biomedical subjects

J K Christoffersen

Publications and source records attributed to J K Christoffersen.

At least 19 recordsLinked to original sources
PubMed2006

Long-term computed tomography follow-up after open surgical repair of abdominal aortic aneurysms.

PURPOSE: To describe the findings on computed tomography (CT) of the aortic sac (AS) in patients operated on for abdominal aortic aneurysm (AAA) with insertion of a coated Dacron prosthesis. MATERIAL AND METHODS: A prospective study of 36 consecutive patients operated on for AAA over 2 years and followed longitudinally with CT for up to 10 years. RESULTS: All patients had a fluid-filled AS on CT 7-10 days postoperatively. At 6 months, the AS had decreased in most patients, mainly in the antero-posterior diameter, and in two had disappeared completely. In five patients with complications, the AS increased in size. The AS disappeared completely at 10 years' follow-up in 13 patients. When present, a retroperitoneal hematoma always disappeared after 6 months. CONCLUSION: These data indicate that the AS after graft implantation will diminish gradually but will persist for at least 6 months. Usually the transverse diameter is bigger than the antero-posterior diameter. If the AS enlarges and becomes rounded and distended with an inhomogeneous interior, it might be a sign of graft infection. In these cases an ultrasound-guided or CT-guided puncture is recommended.

Adult↗
PubMed2006

Patient injuries in response to anaesthetic procedures: cases evaluated by the Danish Patient Insurance Association.

BACKGROUND: In response to medical treatment, side-effects may occur and the patient may be injured. In Denmark, a patient is entitled to raise a claim for financial compensation and the validity of the claim which, based on defined criteria, is decided by the independent Patient Insurance Association (PIA). In this study, we investigated the files of the patients who were given financial compensation because of an injury caused by an anaesthetic procedure. We wanted to find the sort of injuries and the anaesthetic procedures involved and the size of financial compensation. METHODS: A retrospective study of the PIA database from 1996 to 2002 concerning the speciality anaesthesiology. RESULTS: From 1996 to 2002, 18,917 patients made a claim and out of these 916 files were related to anaesthetic procedures, of which 374 cases resulted in financial compensation. In the same period, it is estimated that the total number of anaesthetic procedures was approximately 400,000 per year in Denmark. The primary causes for financial compensation were nerve lesions in response to regional anaesthesia (epidural, spinal, peripheral nerve blockade; n = 132), body positional-related injuries (n = 100), complications due to intravascular catheters or needles (n = 39) and teeth damage during airway handling (n = 31). After anaesthesia, 12 patients' brain functions were impaired probably as a result of prolonged peri-operative hypotension and hypoxaemia. Death occurred in 21 cases. The average financial compensation was 21,500 euros (0.3% of the total amount from all cases) and in 13 cases the injury induced severe patient disability and therefore the compensation was above 1 million DKr. equal to 150,000 euros. CONCLUSION: In the 6-year period 1996-2002, 374 patients were given in total 8.0 million euros in financial compensation for an injury caused by an anaesthetic procedure. Some anaesthetic complications may result in severe disability whereby the financial compensation to the suffering patients is high. In this study, we estimate that approximately approximately 0.2 per thousand of all patients receiving anaesthesia may develop complications that entitle them to financial compensation.

Adult↗
PubMed2000

Intraluminal calcification of the abdominal aorta.

A patient who had no evidence of atherosclerotic disease and had never been hypertensive, presented with symptoms usually associated with gallstone disease. A large intraluminal calcification in the juxtarenal aorta was found to be the probable cause of these symptoms. The aorta was otherwise free of atherosclerotic changes. Although it could not be identified with certainty, this calcification could have developed secondary to a single ulcerated atheroma.

Aorta, Abdominal↗
PubMed1999

[The Bird's Nest vena cava filter: preliminary experiences].

We report our preliminary experience with the Bird's Nest inferior vena cava filter. Six patients, three men and three women, mean age 71 years (range 25-86), were considered for a Bird's Nest Filter during a 28-month period. Indications were contraindications to anticoagulation in two patients and insufficient effect of anticoagulant therapy in four patients. Three patients succumbed before filter placement. Two filters were placed percutaneously via the right common femoral vein and one via the left common femoral vein. All three filters were inserted successfully without complications. One patient died of multi-organ-failure 25 days after the filter insertion. Two patients are without any complaints and have normal ultrasound examinations 90 and 350 days after filter placement. It is uncommon to insert IVC filters in Denmark, we recommend that it be done by interventional radiologists.

Adult↗
PubMed1998

Below-knee popliteal and distal bypass with PTFE and vein cuff.

OBJECTIVES: To determine the value of PTFE grafts with a distal vein cuff as a conduit for below-knee (BK) popliteal and distal bypass in the absence of autologous vein. DESIGN: Retrospective study. MATERIALS AND METHODS: Forty below BK popliteal and distal bypass procedures in 39 patients with PTFE and distal vein cuff (Miller cuff n = 31, Wolfe cuff and adjuvant arteriovenous fistula n = 9). Nineteen primary and 21 secondary reconstruction procedures. RESULTS: The primary patency rate was 62.5% at 1 year falling to 50% at 2 years. The secondary patency rates were very similar owing to poor outcome of thrombectomy. Ten cases (25%) resulted in major amputation postoperatively. There was a tendency towards better outcome for primary procedures compared to secondary/redo procedures. CONCLUSIONS: BK popliteal and distal bypass with PTFE and distal vein cuff is a worthwhile procedure in the absence of autologous vein. The value of thrombectomy following thrombosis of a secondary bypass procedure with PTFE and distal vein cuff is questionable.

Aged↗
PubMed1997

[Occurrence of renal artery stenosis in patients with peripheral arteriosclerosis and hypertension].

The aim of this study was to evaluate the prevalence of renal artery stenosis in patients with clinical signs of peripheral vascular disease and hypertension. One hundred patients, mean age 69 years (range 45-88) with symptoms and clinical signs of severe peripheral ischaemia, underwent aortography to determine the degree of peripheral vascular disease and possible renal artery stenosis. History of claudication and measurement of systolic distal blood pressure and calculation of the Ankle Brachial Index was used to define the severity of peripheral vascular disease. Thirty-one percent had renal artery stenosis (14% greater than 50% reduction in luminal diameter). In a subgroup of patients with hypertension and peripheral vascular disease (n = 74), 34% had renal artery stenosis. In the subgroup of patients with renal artery stenosis, 81% had hypertension. Among patients with renal artery stenosis and lumen reduction of more than 50%, 93% had hypertension (p < 0.001). In conclusion this study shows that the combination of peripheral vascular disease and hypertension is an important clinical clue for renovascular disease. Examination for renovascular disease in this population should be considered, since the prevalence of the condition is high. Furthermore, examination for renal vascular disease in this population is mandatory, before treatment with angiotensin converting enzyme inhibitors is initiated, since treatment might lead to serious renal function impairment.

Aged↗
PubMed1996

Prevalence of renal artery stenosis in patients with peripheral vascular disease and hypertension.

The aim of this study was to evaluate the prevalence of renal artery stenosis in patients with clinical signs of peripheral vascular disease and hypertension. One hundred patients, mean age 69 years (range 45-88) with symptoms and clinical signs of severe peripheral ischemia, underwent aortography to determine the degree of peripheral vascular disease and possible renal artery stenosis. History of claudication, and measurement of systolic distal blood pressure (BP) and calculation of the Ankle Brachial Index was used to define the severity of peripheral vascular disease. A total of 31% had renal artery stenosis (14% greater than 50% reduction in luminal diameter). In a subgroup of patients with hypertension and peripheral vascular disease (n = 74), 34% had renal artery stenosis. In the subgroup of patients with renal artery stenosis, 81% have hypertension. Patients with renal artery stenosis and lumen reduction of more than 50%, 93% have hypertension (P < or = 0.001). In conclusion this study shows that the combination of peripheral vascular disease and hypertension is an important clinical clue for renovascular disease. Examination for reno-vascular disease in this population should be considered, since the prevalence of the condition is high. Furthermore examination for renal vascular disease in this population is mandatory, before treatment with angiotensin converting enzyme (ACE) inhibitors is initiated, since treatment might lead to serious renal function impairment.

Aged↗
PubMed1991

Popliteal venous aneurysms with or without pulmonary embolism.

Popliteal venous aneurysms are rare and are most often found in patients with pulmonary embolism suggesting that such aneurysms are thrombogenic. Only 16 cases have been found in the past and only a few of these patients were without thrombus or pulmonary embolism. In this paper three patients are presented of whom two showed signs of thrombus. Surgical resection was performed to prevent thrombosis with a successful result. The literature is reviewed and according to this and our own experience surgical resection under cover of anti-coagulation is recommended. Our surgical technique is presented.

Aged↗
PubMed1988

Microvascular circulatory changes in the lower extremities after reconstructive vascular surgery for intermittent claudication.

We have studied the circulatory changes in the lower extremities after reconstructive vascular surgery in ten patients with intermittent claudication. The following examinations were carried out 3 days before, 3 days, and 28 days after the operation: measurement of ankle systolic blood pressure, calf plethysmography, resting calf muscle blood flow and resting subcutaneous foot blood flow. The vasoconstrictor response (veno-arteriolar reflex) was also assessed. On the night before the operation and on the 28th night after aorto-bifemoral bypass surgery, subcutaneous adipose tissue blood flow in the forefoot was measured during sleep. The ankle systolic blood pressure and the ankle index rose significantly. The former increased from 57 +/- 16.4 mmHg to 93 +/- 24.0 mmHg (mean +/- S.E.M.) and was still elevated on the 28th postoperative day. The total limb blood flow, the muscle blood flow and the blood flow in the subcutaneous tissue of the forefoot during daytime were unchanged. In contrast, the blood flow in the forefoot during sleep increased significantly from 3.5 +/- 1.63 ml x (min x 100 g)-1 to 5.2 +/- 2.14 ml x (min x 100 g)-1 (mean +/- S.E.M.) on the 28th night. The vasoconstrictor response was potentiated, and increased from 27% before the operation to 45% on the third postoperative day. This change was maintained 28 days postoperatively. In conclusion the increase in arterial blood pressure was only reflected in the vasoconstrictor response which had returned to normal by the third postoperative day and nocturnal blood flow in the subcutaneous adipose tissue which did likewise.

Aged↗
PubMed1985

Ischemic colitis complicating reconstruction of the abdominal aorta.

A review of 23 patients with ischemic colitis after surgical treatment of the abdominal aorta disclosed a pathogenetic heterogeneous finding. Ligation of the inferior mesenteric artery, abolished collateral blood supply or nonocclusive low flow state, or both, was a common feature. An incidence of 0.5 per cent was revealed for full-thickness necrosis. The mortality was 70 per cent since diagnosis was made first since perforation and peritonitis had occurred. On the basis of these findings vital prophylactic measures and diagnostic possibilities are discussed herein.

Aged↗
PubMed1983

Regional scintimetry in scaphoid fractures.

A quantitative scintigraphic method was introduced to examine the proximal, middle and distal third of the carpal scaphoid bone. 99mTc-Sn-pyrophosphate scintimetry was obtained by the use of a gamma camera equipped with a pinhole collimator. Of six patients in whom a unilateral fresh fracture of the scaphoid was clinically suspected, radiology showed a fracture of the scaphoid in four and no fractures in two. The method may be suitable in early diagnosis and further localization of clinically suspected fractures with initially non-diagnostic radiographs.

Adolescent↗