[Follow-up after infraligamental PTA treatment]. / Followup efter infraligamentaer PTA-behandling.

A total of 48 percutaneous transluminal angioplasties (PTAs) of the superficial femoral and popliteal artery performed between 1993 and 1998 were evaluated with ultrasound duplex scanning and ankle-arm pressure. Twenty-seven (60%) patients presented with claudication and 18 (40%) had limb-threatening ischaemia. Three patients had bilateral PTA. The PTAs were initially successful, corresponding to an early patency rate of 87.5% within the first four weeks. The 12 month patency rate, calculated by life table method, was 68% and 72%, respectively (non-significant). The mortality was 4% and 33% respectively during the first year (p < 0.05). In spite of the size of the material, PTA of the femoropopliteal arterial segment is considered as a valid alternative treatment to vascular surgery in patients presenting with claudication and in patients presenting limb-threatening ischemia.

[The Bird's Nest vena cava filter: preliminary experiences]. / Bird's nest vena cava-filter: praeliminaere erfaringer.

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.

[Intravascular ultrasound and percutaneous transluminal angioplasty. Preliminary results]. / Intravaskulaer ultralyd og perkutan transluminal angioplastik. Praeliminaere resultater.

Intravascular ultrasound is a new imaging modality which enables cross-sectional images of blood vessels. These preliminary results of intravascular ultrasound used before and after percutaneous transluminal angioplasty (PTA) in 19 patients, confirm earlier reports of the ability to distinguish between the three different layers of the vessel wall. Atherosclerotic plaques may also be assessed as well as a quantification of the stenosis. After PTA changes in the plaques such as intimal fractures, flaps and dissections could be recognized, and the effect of the intervention could be quantified by measuring the reduction of stenosis and increment of the luminal area. The increased luminal area following PTA was partly due to stretching of the artery and partly due to compression of the atheroma. We found a correlation between the amount of calcium in the plaque and the size of the dissection after PTA. Comparing IVUS with angiography revealed an acceptable agreement in quantifying stenoses before the intervention but not after. We conclude that IVUS is a feasible method to evaluate stenosis in blood vessels before and after PTA. By supplying additional information to angiography, it may improve the selection and outcome after PTA.

[Percutaneous transluminal angioplasty of iliac occlusions]. / Perkutan transluminal angioplastik af iliacaokklusioner.

Percutaneous transluminal angioplasty (PTA) has become an established treatment modality for iliac artery stenosis. PTA of iliac artery occlusions, however, remains a topic of controversy due to difficulties with mechanical recanalization, a lower patency rate and a higher complication rate than obtained after PTA of iliac artery stenosis. During a three year period, we performed 31 PTA's of iliac artery occlusions. The primary recanalization rate was 71% (22 occlusions). Stents were applied in 16 patients. The cumulated patency rates were 95% and 85% after one and six months respectively. There was one late reocclusion after two years. We found a tendency towards inferior patency in the longer occlusions (> or = 5cm). The complication rate was 10% due to three episodes of distal embolisation, all of which were successfully treated immediately with additional PTA and stenting. These results are in accordance with the results of international studies, and suggest that PTA is a useful alternative to surgical treatment of iliac artery occlusions, albeit long occlusions involving both the common and the external iliac artery should be excluded.

[Color Doppler ultrasound examination of carotid arteries]. / Ultralyd farve-Doppler-undersøgelse af arteria carotis. Prospektiv sammenligning med arteriografi.

Eleven hundred and thirty-eight patients suspected of carotid artery disease were examined prospectively by ultrasound-Doppler. In 39 cases, intra-arterial digital subtraction arteriography was performed as well as well and compared to ultrasound Doppler examination. The overall accuracy was 80% (kappa: 0.65). Discrimination between normal and diseased vessels could be made with an accuracy of 93% (kappa: 0.70) and the accuracy when separating vessels into greater or less than 50% stenosis was 88% (kappa: 0.74). Sources of error are discussed and the paper concludes that colour-Doppler examination is an accurate method for assessment of the carotid artery.

[Diagnosis of carotid artery sclerosis with Doppler ultrasound. Description of the method and a prospective comparison with arteriography]. / Diagnostik af arteriosklerose i arteria carotis ved hjaelp af ultralyd-Doppler. Metodebeskrivelse og prospektiv sammenligning med arteriografi.

The ultrasound Doppler method for examination of the carotid artery is described. Out of a total of 370 patients examined with ultrasound Doppler for suspected arteriosclerosis in the carotid artery in 1988, 27 were also submitted to digital subtraction arteriography (DSA). The accuracy of the ultrasound examination was compared with DSA 90% (43/48) when differentiating between normal and affected carotid arteries, and 85% (41/48) when differentiating between stenoses of more than or less than 50%. All of the occlusions were correctly identified. It is concluded that ultrasound Doppler examination is an accurate method for diagnoses of stenosis in the carotid artery.

[A perforating foreign body in a duodenal blind loop]. / Perforerende fremmedlegeme i duodenal blind loop.

A case of perforating foreign body which ran a fatal course is described. The foreign body was situated in a blind loop after a Billroth II operation.