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Biomedical subjects

L Norgren

Publications and source records attributed to L Norgren.

At least 181 records · Page 10Linked to original sources
PubMed1975

Pressure-volume characteristics of foot veins in normal cases and patients with venous insufficiency.

In order to evaluate pressure-volume characteristics of foot veins in patients with venous insufficiency compared with a control group, the foot-volumetric method was utilized, combined with intravenous pressure measurements. Calculations of compliance and elastance were preformed within a fixed pressure interval, where the veins were filled or almost filled. The investigation demonstrates a lower compliance and a higher elastance in the varicose veins compared with the control cases. This is contrary to most previous investigations, in which the veins have not been fully distended, as the measurements were preformed in the lying position with rather low venous pressure. Changes of compliance and elastance were most marked in cases with advanced venous disease and skin changes of the ankle region. The observed changes of a 'greater stiffness' of the foot-vascular system can be explained by fibrotic or phlebosclerotic changes. In addition to the observations of slightly altered elasticity factors, we observed volume changes after exercise which seem to be related to capillary filtration.

Adult↗
PubMed1975

Foot-volumetry before and after surgical treatment of patients with varicose veins.

The present study reports the changes of foot volume and venous reflux in a material of 20 cases with varicose veins after radical surgery as assessed by a new method (foot-volumetry). Parameters characterizing venous reflux (incompetent valves) were reduced by a factor of 0.3-0.7 following surgery. These changes were statistically significant. Some remaining abnormality can be explained by concomitant residual deep venous insufficiency. The result of the examination supports the opinion that foot-volumetry is a valuable method for examination of patients with venous insufficiency.

Adult↗
PubMedDate not supplied

Pharmacotherapy for critical limb ischaemia.

Critical limb ischaemia involves a severe disturbance of both macrocirculation and microcirculation. Provided revascularisation can be performed (balloon angioplasty, bypass procedures or other reopenings), the major pharmacological problem is to reduce the risk of early thrombosis and midterm hyperplastic growth. Adjuvant treatment for the former is useful, while the latter has not yet found any specific solution. When no technical prerequisites exist for revascularisation, which means extremely deranged vascular morphology, pharmacotherapy can be tried to reduce the specific micro-circulatory events. Results are far from good, though significant reduction of amputations and deaths may be achieved with certain drugs.

Anticoagulants↗
PubMedDate not supplied

Deposition of platelets and neutrophils in porcine iliac arteries after angioplasty and Wallstent placement compared with angioplasty alone.

PURPOSE: This study was designed to compare deposition of 111In-labeled platelets and neutrophils after balloon angioplasty (PTA) alone and PTA plus Wallstents. METHODS: Histological investigation was performed with scanning electron microscopy (SEM). Fifty percent stenoses of both iliac arteries was created by resorbable ligature in 13 pigs. After 30 days, PTA was performed bilaterally with an additional stenting procedure done on one side. Autologous platelets were labeled and reinfused before the interventional procedure in six pigs, and labeled neutrophils were used in seven pigs. The deposition of the labeled cells was recorded in vivo over 270 min using a scintillation camera. The results were correlated with in vitro measurements. RESULTS: Scanning revealed significant increase in platelet and neutrophil deposition at the site of the stent compared with the site where PTA alone was undertaken. In vitro measurements confirmed these differences. SEM demonstrated a fibrin lining on the stent surface and numerous adherent platelets. The adjacent arterial lumen was almost completely covered by fibrinous material. The PTA-alone site demonstrated denudation of endothelial cells and less fibrinous material, as well as platelets and leukocytes. CONCLUSION: The complex interaction in the response of the vessel wall and flowing blood involves both platelet and neutrophil adhesion. The self-expandable vascular endoprosthesis contributes to increased deposition of platelets and neutrophils as seen in this experimental model of nonatheromatous stenosis.

Angioplasty, Balloon↗
PubMedDate not supplied

Acceleration ratio measurements with ultrasound Doppler in patients with occlusive arterial disease. A prospective investigation.

A prospective investigation was performed concerning the clinical value of Doppler examination with a flow velocity profile analysis using the quotient (AR) between the acceleration of velocity in a supposed diseased artery as compared with the acceleration of flow velocity in a healthy artery. Seventy-nine patients with peripheral arterial disease were followed at least one year after angiography which was performed as a preoperative examination. Comparing AR with angiography and blood pressure measurements it was found that AR values were affected favourably by development of good collaterals. AR less than or equal to 0.25 (Doppler frequency 5 MHz) in the best artery of the foot was found in all patients where amputation had to be performed, and in 36 of 44 legs treated with vascular reconstruction.

Adult↗
PubMedDate not supplied

Nephrotoxicity of ionic and non-ionic contrast media in aorto-femoral angiography.

Nineteen patients examined with aorto-femoral angiography were randomized into two contrast medium groups (meglumine metrizoate and iohexol). Urine activity of beta-hexosaminidase, a specific renal enzyme, was determined before and on three occasions after angiography. No change of beta-hexosaminidase activity was found after angiography with iohexol, while there was a significant increase after examination with meglumine metrizoate. This indicates that meglumine metrizoate even following injection into the abdominal aorta damages renal cells which could not be shown with iohexol as contrast medium. We therefore recommend that at least patients with impaired renal function should be examined with the non-ionic contrast medium iohexol to minimize the danger of further damage to the kidneys and a possible renal failure.

Aged↗
PubMedDate not supplied

[Various aspects of phlebology in Sweden].

The incidence of symptomatic varicose veins seems to be about the same in most industrialized countries. After decades of radical surgical treatment of most cases with this condition a much more restrictive attitude seems to be present. Patients with limited varicose veins are often told that since there is no medical danger suffering from simple varicose veins, surgery is not necessary. A simple compression stocking is frequently advised. For those patients suffering from symptoms or a finding that their varicose veins are cosmetically disturbing, surgery is performed, however, restricted to be as minor as possible. The long saphenous vein is saved in those parts being competent. The surgical procedures are performed on an outpatient basis in almost all cases which means that the cost has been very much decreased. The incidence of venous leg ulcers has also decreased in Sweden. We seem to have an incidence of 0.3 p. cent ulcers of which 54 p. cent are of venous etiology. The cost for treatment of these patients is here as everywhere else very high as is also the cost for sick-leave. A conservative attitude using compressing stockings and screening to find out in which cases reconstructive venous surgery might be a possibility seems advisable especially in recurrent ulcer cases.

Adult↗
PubMedDate not supplied

Renal artery stenosis in patients with peripheral vascular disease and its correlation to hypertension. A retrospective study.

To estimate the frequency of renal artery stenosis, and to detect the correlation between renal artery stenosis and hypertension, 450 consecutive patients with peripheral vascular disease (PVD) were selected. All subjects had undergone aorto-femoral conventional angiography. For a possible association with renal artery stenosis, risk factors, clinical and angiographical variables were evaluated e.g.: age, sex, diabetes mellitus, smoking habits, use of antihypertensive drugs, serum creatinine, serum cholesterol, ECG pathology, side of the renal artery lesion, bilateral stenoses, post-stenotic dilatation, number of renal arteries, aortic atherosclerosis, size of the kidneys and angiography induced renal dysfunction. Renal artery stenosis (RAS) was found in 49.1%, 117 patients had a moderate and 104 had a severe stenosis. Of the 221 patients with a renal artery lesion, 44 were normotensive, 177 hypertensive. Hypertension was significantly correlated to RAS. An association was also found for age over 70 years, smoking and pathologic ECG. It is concluded that renal artery stenosis is very common in a population with peripheral vascular disease, and the results achieved from this study makes it worthwhile to identify possible functional markers in a prospective study.

Adult↗
PubMedDate not supplied

The late results after axillo-femoral bypass grafts in patients with leg ischaemia.

The late results--up to six years--after axillo-femoral bypass reconstruction are reported for 85 patients with leg ischaemia who were regarded as poor-risk patients for aortic bypass surgery, or who had aortic graft infection. Velour-Dacron grafts and expanded polytetrafluoroethylene (PTFE, Gore-Tex)--grafts have been used. The cumulative patency rate (life table) six years after graft implantation was 64% (PTFE-grafts) and 58% (Velour-Dacron grafts). The corresponding cumulative limb salvage rate six years after graft implantation was 88% when PTFE grafts were used and 77% when Velour-Dacron grafts were used. Our results demonstrate that axillo-femoral reconstruction is a useful procedure with a good patency rate 6 years after implantation. This procedure should be considered when dealing with poor risk patients with severe leg ischaemia.

Aged↗
PubMedDate not supplied

Experimental evaluation of small diameter synthetic arterial grafts.

Platelets labelled with Indium-111 were used to examine the in vivo thrombogenicity of different vascular grafts. The deposition of platelets in two partly different kinds of umbilical vein grafts, double velour Dacron grafts and double velour Dacron grafts with internal collagen was studied as a function of time. The grafts were inserted end to side in the femoral artery of pigs and then imaged for 120 minutes. Platelet distribution was also studied by in vitro static imaging. No difference was seen between the different umbilical vein grafts. The double velour grafts accumulated more platelets, the platelets mainly located in the midportion of the graft. The collagen-impregnated grafts occluded within 45 minutes.

Animals↗