O E Teebken

Hannover Medical School, Hanover, Lower Saxony, Germany

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Publications (119)205.36 Total impact

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    ABSTRACT: Background: Pericytes surround endothelial cells at the perivascular interface. Signaling between endothelial cells and pericytes is crucial for capillary homeostasis, as pericytes stabilize vessels and regulate many microvascular functions. Recently it has been shown that pericytes are able to detach from the vascular wall and contribute to fibrosis by becoming scar-forming myofibroblasts in many organs including the kidney. At the same time, the loss of pericytes within the perivascular compartment results in vulnerable capillaries which are prone to instability, pathological angiogenesis, and, ultimately, rarefaction. Aims: This review will give an overview of pericyte-endothelial cell interactions, summarize the signaling pathways that have been identified to be involved in pericyte detachment from the vascular wall, and present pathological endothelial responses in the context of disease of the kidney. © 2014 S. Karger AG, Basel.
    Journal of Vascular Research 09/2014; 51(4):247-258. · 2.43 Impact Factor
  • Critical care medicine. 09/2014; 42(9):e632-3.
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  • European Journal of Vascular and Endovascular Surgery 06/2014; 47(6):696–697. · 2.82 Impact Factor
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    ABSTRACT: Myocardial infarction after major surgery is frequent, drives outcome, and consumes health resources. Specific prediction and detection of perioperative myocardial infarction is an unmet clinical need. With the widespread use of high-sensitive cardiac troponin T assays, positive tests become frequent, but their diagnostic or prognostic impact is arguable. We, therefore, studied the association of routinely determined pre- and postoperative high-sensitive cardiac troponin T with the occurrence of major adverse cardiac events. This study was a prospective noninterventional trial. This study was conducted at Hannover Medical School in Germany. A total of 455 patients undergoing open vascular surgery were followed for 30 days for the occurrence of major adverse cardiac events. None. Preoperative and 24-hour postoperative high-sensitive cardiac troponin T measurements and the respective changes were correlated to medical history and the occurrence of major adverse cardiac events (cardiovascular death, myocardial infarction, and ischemia). Pre- and postoperative high-sensitive cardiac troponin T measurements demonstrated a majority of patients with detectable troponin levels preoperatively and an increase over the 24 hours after surgery. The level of high-sensitive cardiac troponin T was significantly associated with preexisting diseases that constitute the Lee's Revised Cardiac Risk Index. A preoperative high-sensitive cardiac troponin T greater than or equal to 17.8 ng/L and a perioperative high-sensitive cardiac troponin T change greater than or equal to 6.3 ng/L are independently associated with the occurrence of major adverse cardiac events. Adding high-sensitive cardiac troponin T absolute change to the Revised Cardiac Risk Index improves the risk predictive accuracy of the score as evidenced by increased area under receiver operating characteristic and significant reclassification effects. The risk predictive power of high-sensitive cardiac troponin T change in addition to the Revised Cardiac Risk Index could facilitate 1) detection of patients at highest risk for perioperative myocardial ischemia, 2) evaluation and development of cardioprotective therapeutic strategies, and 3) decisions for admission to and discharge from high-density care units.
    Critical care medicine 02/2014; · 6.37 Impact Factor
  • 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. · 3.45 Impact Factor

Publication Stats

848 Citations
205.36 Total Impact Points


  • 1998–2014
    • 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
      Hanover, Lower Saxony, Germany
  • 1996–1998
    • Christian-Albrechts-Universität zu Kiel
      • UKSH Klinik für Herz- und Gefäßchirurgie
      Kiel, Schleswig-Holstein, Germany