O E Teebken

Hannover Medical School, Hannover, Lower Saxony, Germany

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Publications (110)179.62 Total impact

  • VASA.: Zeitschrift für Gefässkrankheiten. Journal for vascular diseases 01/2014; 43(1):78-80. · 1.01 Impact Factor
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    ABSTRACT: Introduction: At present the generation of a small-calibre (≤ 5 mm) vascular replacement for artificial bypasses remains a challenge for tissue engineering. The biocompatibility of bioartificial vessel replacements is of decisive significance for function and depends on the materials used. A completely autologous vessel substitute must exhibit high biocompatibility and functionality. For this purpose we developed and optimised a technique for the engineering of an autologous bypass material from a fibrin scaffold and vascular cells isolated from the same sample of peripheral blood in a porcine model.Materials and Methods: Fibrinogen, late outgrowth endothelial and smooth muscle cells were isolated from peripheral blood samples (n = 14, 100 mL each). Fibroblasts were isolated from porcine aortic adventitial tissue (n = 4). Tubular seeded fibrin segments were obtained using an injection moulding technique with the simultaneous incorporation of the in vitro expanded cells into the fibrin matrix. The segments were cultivated under dynamic conditions with pulsatile perfusion in a bioreactor. Morphological and functional characterization was done.Results: Artificial vascular segments with a length of 150 mm were reproducibly obtained with a hierarchical arrangement of incorporated cells similar to the structure of the vascular wall. By additional seeding of fibroblasts, suturable segments with biomechanical properties suitable for implantation into the arterial system were obtained.Conclusions: Implantable bioartificial vascular grafts can be generated from blood. After cultivation under dynamic conditions the vascular segments possess a structure similar to that of the vascular wall and exhibit biomechanical properties sufficient for implantation as arterial substitutes.
    Zentralblatt für Chirurgie 01/2013; · 0.69 Impact Factor
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    ABSTRACT: BACKGROUND: We report on a 62-year-old gentleman presenting at our urological department with an advanced renal cell cancer of the right kidney (10 cm in diameter), with an extensive caval vein thrombus (level IV) and bilateral pulmonary metastases. Another suspicious lesion at the left hemithorax was radiologically described. METHOD: A presurgical, neoadjuvant systemic therapy with sunitinib, a tyrosine kinase inhibitor, was initiated for 4 cycles in total (50 mg/day; 4 weeks on/2 weeks off). The cytoreductive nephrectomy was performed following the fourth cycle of sunitinib and after a 14-day break. Transesophageal echocardiography was used for intraoperative monitoring of the caval vein thrombus. Systemic treatment with sunitinib was continued 4 weeks after surgery. RESULTS: A significant reduction in tumor size, metastatic sites and down-staging of IVC from level IV to level III according to Novick classification was achieved. CONCLUSION: Significant down-staging of the tumor caval vein thrombus which initially reached the right atrium enabled us to perform surgery limited to the abdominal cavity without extracorporeal circulation nor hypothermia.
    World Journal of Urology 09/2012; · 2.89 Impact Factor
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    ABSTRACT: SUMMARY Surgical site infection (SSI) after vascular surgery is a serious complication increasing morbidity, mortality, and costs for healthcare systems. A 4-year retrospective cohort study was performed in a university hospital with patients who had undergone arterial vascular surgery below the aortic arch. Investigated variables included demographics and clinical data. Forty-four of 756 patients experienced SSI, 29 of which were superficial, five were deep, and 10 had organ/space infections. Coagulase-negative staphylococci (22%), enterococci (20%), and Staphylococcus aureus (18%) were the most common pathogens. Independent risk factors for SSIs were femoral grafting [odds ratio (OR) 6·7], peripheral atherosclerotic disease, Fontaine stages III-IV (OR 4·1), postoperative drainage >5 days (OR 3·6), immunosuppression (OR 2·8), duration of operation >214 min (OR 2·8), and body mass index >29 (OR 2·6). The application of perioperative antibiotic prophylaxis was an independent protective factor (OR 0·2). Patients with certain risk factors for SSIs warrant special attention for infection prevention.
    Epidemiology and Infection 08/2012; · 2.87 Impact Factor
  • Omke E Teebken, Theodosios Bisdas
    VASA.: Zeitschrift für Gefässkrankheiten. Journal for vascular diseases 05/2012; 41(3):161-2. · 1.01 Impact Factor
  • Journal of Bioengineering and Biomedical Science. 04/2012; J Bioengineer & Biomedical Sci(2; 3):115.
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    ABSTRACT: To compare the in vitro efficacy of graft impregnation with nebacetin versus rifampin versus daptomycin against vascular graft infections caused by Staphylococcus epidermidis and Staphylococcus aureus and nebacetin versus rifampin against Pseudomonas aeruginosa and Escherichia coli. Twenty-three Dacron-grafts (1 cm2) for each micro-organism were microbiologically tested and eight grafts per antibiotic underwent viability tests against human umbilical vein endothelial cells (ECs). Fifteen grafts (5/antibiotic agent) underwent 15 min impregnation and contamination with 4 ml bacterial solution (optical density (OD (600 nm)): 0.20 ± 0.02). After 24-h-incubation, all grafts were washed with phosphate-buffered saline and underwent sonification to release viable adherent bacteria. OD (600 nm) of the solution was measured. Afterwards, six 1:10 dilution steps took place and colony-forming units (CFUs) were counted. Nebacetin showed comparable efficacy to daptomycin against Gram-positive bacteria. Both eradicated more efficiently S. epidermidis than rifampin (daptomycin:0, rifampin:5 ± 7.3, nebacetin:0 CFU ml(-1), P = 0.0003). All antibiotics showed comparable antibacterial activity against S. aureus. Nebacetin was more efficient than rifampin to eradicate Gram-negative organisms (P. aeruginosa: rifampin:1308 ± 252, nebacetin:8 ± 8 CFU ml(-1), P = 0.01, E. coli: rifampin:294 ± 159, nebacetin:0.2 ± 0.5 CFU ml(-1), P = 0.001), while only rifampin was toxic against ECs (daptomycin:30.88 ± 5.44, rifampin:5.13 ± 5.08, nebacetin:28.50 ± 3.82 ECs/field, P = 0.0003). Nebacetin showed excellent in vitro antibacterial activity against both Gram-positive and -negative pathogens representing an effective candidate for vascular graft impregnation.
    European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 01/2012; 43(4):448-56. · 2.92 Impact Factor
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    ABSTRACT: Ovine animal models are widely used to conduct preclinical studies, e.g., to evaluate cardiovascular prostheses intended to be applied in man. However, although analyzed in many of those studies, information about ovine blood reference values is scanty. The aim of this study is to establish a reference list of ovine blood parameters relevant for blood coagulation. A cohort of 47 mature ewes was evaluated. Parameters comprised the following: cells and cellular components-platelet, red, and white cell counts (including subsets), hemoglobin (Hb), hematocrit (HCT), mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV), and MCH concentration (MCHC); global tests of coagulation-prothrombin time (Quick's time) and activated partial thromboplastin time (aPTT); and parameters relevant for blood coagulation-fibrinogen, antithrombin (AT), and von Willebrand Factor. After explorative data analysis, a list of ovine reference values was established. Interestingly, a comparison with human reference values revealed some interspecies differences between sheep and man, i.e., much higher ovine ranges for some cell counts (neutrophils, lymphocytes, basophils, eosinophils, and platelets) but lower values for some other parameters (Hb, HCT, MCV, MCH, AT, and Quick's test). We established a reference list of ovine blood count and blood coagulation parameters. Because of some peculiarities of the ovine blood, this list may have implications for the interpretation of experimental data.
    ASAIO journal (American Society for Artificial Internal Organs: 1992) 01/2012; 58(1):79-82. · 1.39 Impact Factor
  • O E Teebken, T Bisdas, O Assadian, J-B Ricco
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    ABSTRACT: The purpose of these recommendations is to provide a standard format for reporting treatment results and standardised epidemiologic data after aortic vascular graft infection to improve the comparison of clinical outcomes between different therapeutic approaches and different study populations. Analytical reporting standards for patients' characteristics, type and extent of the disease, type of treatment and study design are described. Adherence to these recommendations will improve clinical relevance, quality and comparability of future studies dealing with aortic vascular graft infections.
    European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 12/2011; 43(2):174-81. · 2.92 Impact Factor
  • T Bisdas, O E Teebken
    VASA.: Zeitschrift für Gefässkrankheiten. Journal for vascular diseases 11/2011; 40(6):427-8. · 1.01 Impact Factor
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    ABSTRACT: Injuries of internal carotid arteries caused by high energy trauma are rare but often combined with poor outcome. Blunt trauma to the head and neck as well as the use of newer motorcycle helmets together with crash circumstances should promptly lead to a differentiated polytrauma management with expansion of radiologic diagnostics. This could lead to a reduction of overlooked dissections and an increase in promptly and correctly treated injuries.
    Der Unfallchirurg 09/2011; 115(10):930-5. · 0.64 Impact Factor
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    Theodosios Bisdas, Axel Haverich, Omke E Teebken
    Journal of the American College of Cardiology 08/2011; 58(10):1085; author reply 1085-6. · 14.09 Impact Factor
  • Theodosios Bisdas, Axel Haverich, Omke E Teebken
    Circulation 08/2011; 124(6):e194; author reply e195-6. · 15.20 Impact Factor
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    ABSTRACT: Cryopreserved arterial homograft (CAH) is a well-established substitute material for in situ reconstruction of vascular infections. However, their degeneration remains serious complication. Although several studies propose ABO-mismatching between CAH-donor and -recipient as the main reason, the results are controversial. We compared the outcome between ABO-compatible and ABO-incompatible CAH recipients to evaluate the contribution of ABO-mismatching. Between January 2004 and December 2007, a retrospective review in 32 patients who underwent CAH-implantation was performed. The patients were divided in ABO-incompatible (group A: 17/32 patients; 53%) and ABO-compatible (group B: 15/32 patients; 47%) to CAH donor. Leucocytes, platelets and C-reactive protein (CRP) levels were recorded during the in-hospital stay. These were correlated with the surface of implanted homograft (SIH). Mid-term survival- and freedom-from-reoperation (FFR) rates were also calculated. In both groups, peak of leucocytes and CRP was recorded on third postoperative day (POD3) and regarding platelets lowest values on POD1. Interestingly, a second CRP-peak was reported on POD8 in group A (A: 172±104mg/L vs. B: 75±55mg/L, P=0.01). No relationship between second CRP-peak and SIH was found. After 27 months median follow-up (range, 5-49 months), survival- (65% vs. 84%, P=0.28) and FFR-rates (94% vs. 93%, P=0.98) remained comparable. We consider that the second CRP-peak expresses an early cytoimmunologic response of ABO-incompatible recipients against CAH. However, we did not find any relationship between ABO-incompatibility and poor mid-term outcome in terms of reoperation or mortality. Longer surveillance of our patients is mandatory.
    International angiology: a journal of the International Union of Angiology 06/2011; 30(3):247-55. · 1.46 Impact Factor
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    ABSTRACT: Extracorporeal membrane oxygenation (ECMO) is a well-established treatment for severe cardiopulmonary failure. Patients undergoing ECMO support through femoral vessels are prone to vascular complications. The aim of this study was to evaluate such complications to outline basic technical principles for their prevention. From January 2005 to December 2009, 174 patients underwent ECMO support through cannulation of the femoral vessels. The primary outcome was any vascular complication. Secondary outcomes were 30-day mortality and 1-year survival. A logistic regression analysis including ECMO duration, peripheral arterial disease, ECMO access (percutaneous versus open), and diabetes mellitus identified predictors for vascular complications. The venoarterial mode was used in 143 patients (82%), and venovenous in 31 patients (18%). Of the 17 (10%) observed vascular complications, 15 (88%) occurred in patients with venoarterial access, whereas 2 (12%) occurred after venovenous access (p=0.50) Two patients who had extremity ischemia required limb amputation. Thirty-day mortality and 1-year survival rates were 63% and 26%, respectively. Peripheral arterial disease was the only strong predictor of vascular complications (odds ratio, 6.95; 95% confidence interval, 1.89 to 25.59; p=0.003). Vascular complications were not associated with early or late mortality. The incidence of vascular complications in venovenous cannulation was low, whereas in arterial cannulation, it is still considerable. Peripheral arterial disease remains a risk factor, and early involvement of vascular surgeons for open vascular exposure or alternative vascular access sites can be recommended. Vascular complications after ECMO support are not associated with higher mortality rates.
    The Annals of thoracic surgery 05/2011; 92(2):626-31. · 3.74 Impact Factor
  • O E Teebken, T Bisdas
    European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 03/2011; 41(6):859; author reply 859-60. · 2.92 Impact Factor
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    ABSTRACT: The gold standard for the treatment of abdominal aortic infections remains controversial. Cryopreserved arterial homografts and silver-coated Dacron grafts have both been advocated as reasonable grafts. Direct clinical or experimental comparisons between these two treatment options have not been published before. This study compared cryopreserved arterial homografts and silver-coated Dacron grafts for the treatment of abdominal aortic infections in a contaminated intraoperative field. From January 2004 to December 2009, 56 patients underwent in situ arterial reconstruction for an abdominal aortic infection. Patients with negative intraoperative microbiologic specimens were excluded. We compared 22 of 36 patients (61%) receiving cryopreserved arterial homografts (group A) vs 11 of 20 (55%) receiving a silver-coated Dacron graft (group B). Primary outcomes were survival and limb salvage; secondary outcomes were graft patency and reinfection. Direct costs of therapy were also calculated. Thirty-day mortality was 14% in group A and 18% in group B (P >.99), and 2-year survival rates were 82% and 73%, respectively (P = .79). After 2 years, limb salvage was 96% and 100%, respectively (P = .50), whereas graft patency was 100% for both groups. Major complications were an aneurysmal degeneration in group A and graft reinfection in group B (n = 2). Median direct costs of therapy (in US $) were $41,697 (range, $28,347-$53,362) in group A and $15,531 (range, $11,310-$22,209) in group B (P = .02). Our results show comparable effectiveness between cryopreserved arterial homograft and silver-coated Dacron graft in the contaminated operative field with respect to early mortality and midterm survival. Graft-inherent complications, aneurysmal degeneration for homografts, and reinfection for silver graft, were also observed. The in situ arterial reconstruction with homografts is nearly three times more expensive than with silver graft.
    Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 02/2011; 53(5):1274-1281.e4. · 3.52 Impact Factor
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    ABSTRACT: The coexistence of infected abdominal aortic aneurysms and spondylitis is rare but challenging. The etiology of the infection is frequently unknown. The aim of this study was to review the outcome of surgical repair of this complex disease. From 2004 to 2006, six patients were identified who underwent surgical repair of concomitant infected abdominal aortic aneurysm and spondylitis. Diagnosis, treatment and intermediate-term results are presented. The clinical manifestation included the signs of ongoing systemic infection, neurological deficit and abdominal or back pain. Computed tomography revealed abdominal aortic aneurysms associated with polysegmental spondylitis. Patients underwent radical debridement and aortic replacement with cryopreserved aortic allografts or silver-coated prostheses followed by antibiotic treatment. Only one patient received a simultaneous anterior vertebral stabilization. Greater omentum was placed in the abscess cavity. Intensive care unit and hospital stay averaged 3.0 and 28.0 days, respectively. Organisms were identified in all but one patient. Over a follow-up period of 4.4 years, four patients are alive and showing freedom from infection, and two patients had died unrelated at seven and eight months. In conclusion, surgical repair of infected aortic aneurysms with resection of infected tissues and implantation of a homograft or a silver-coated prosthesis achieved favorable results in this sick patient group. Simultaneous vertebral stabilization is rarely necessary.
    Vascular 02/2011; 19(1):34-41. · 0.86 Impact Factor
  • T Bisdas, O E Teebken
    European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 01/2011; 41(4):570; author reply 570-1. · 2.92 Impact Factor
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    ABSTRACT: HintergrundDie In-vitro-Effektivität von Bakteriophagen (BPH) hinsichtlich der Prävention vaskulärer Graftinfektionen wurde getestet. MethodeWir setzten keimspezifische BPH gegen S. epidermidis, S. aureus, P. aeruginosa und E. coli ein. Jeweils 7 Prothesengewebe pro Gruppe wurden imprägniert (1cm2, 15min); weitere 7 dienten als Positiv- und 4 als Negativkontrolle. 5 Segmente wurden mittels Rasterelektronmikroskop (REM) analysiert. Nach einer Inkubation von 24h wurden die Segmente 3-mal in PBS gespült. Nach Ablösung lebensfähiger Bakterien mithilfe von Ultraschall wurde die optische Dichte (OD) der Bakterienlösung ermittelt. Dann erfolgten sechs 1:10 Verdünnungsreihen und eine Inkubation von 24h (37°C) auf Agarplatten. Die koloniebildenden Einheiten (KBE) der 4. und 6.Verdünnung wurden errechnet. ErgebnisseDie Imprägnierung mit BPH gegen S. epidermidis und E. coli führte zu einer statistisch signifikanten Reduktion der OD, der KBE-4 und -6. Bei S. aureus und P. aeruginosa waren alle Parameter vergleichbar mit der Kontrollgruppe. Die REM-Aufnahmen des Biofilms bestätigten die mikrobiologischen Ergebnisse. SchlussfolgerungenDie getesteten BPH waren effektiv gegen In-vitro-Graftinfektionen, die durch S. epidermidis und E. coli verursacht wurden, aber nicht durch S. aureus und P. aeruginosa. BackgroundThe in vitro antibacterial effect of bacteriophages (BPH) as impregnation agents was tested for prevention of vascular graft infections. MethodsPathogen-specific BPHs for S. epidermidis, S. aureus, P. aeruginosa and E. coli were tested. In each case 7 segments of prosthesis tissue sized 1cm2 were impregnated for each group (15min), a further 7 segments were used as a positive control and 4 as a negative control and 5 segments were observed under scanning electron microscopy (SEM). After 24h incubation (37°C) segments were washed 3 times in 20ml PBS. Viable adherent bacteria were released by sonification and the optical density (OD) of the bacterial solutions was measured. A total of 6 dilution steps of 1:10 of the solution was made and incubated for 24h (37°C) on agar plates. Colony formed units (CFU) after the 4th and 6th dilution were counted. ResultsImpregnation with BPHs against S. epidermidis and E. coli showed a statistically significant reduction of OD, CFU-4 and CFU-6. For S. aureus and P. aeruginosa, all parameters were comparable to the positive control group. The microbiological findings were confirmed by SEM bio-films. ConclusionsThe pathogen-specific BPHs tested were effective in prevention of in vitro graft infections caused by S. epidermidis and E. coli but not by S. aureus and P. aeruginosa. SchlüsselwörterGraftinfektion–Imprägnierung–Antibiotika–Bakteriophage–Protheseninfektion KeywordsVascular graft infection–Impregnation–Antibiotics–Bacteriophages–Prosthesis infection
    Gefässchirurgie 01/2011; 16(6):387-394. · 0.24 Impact Factor

Publication Stats

691 Citations
146 Downloads
179.62 Total Impact Points

Institutions

  • 1998–2013
    • Hannover Medical School
      • • Department of Cardiothoracic, Transplantation and Vascular Surgery (HTTG)
      • • Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO)
      • • Department of Gastroenterology, Hepatology and Endocrinology
      Hannover, Lower Saxony, Germany
  • 1996–1998
    • Christian-Albrechts-Universität zu Kiel
      • UKSH Klinik für Herz- und Gefäßchirurgie
      Kiel, Schleswig-Holstein, Germany