O Forsberg

Uppsala University Hospital, Uppsala, Uppsala, Sweden

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Publications (7)4.98 Total impact

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    ABSTRACT: Background: Patency and limb salvage after synthetic bypass to the arteries below-knee are inferior to that which can be achieved with autologous vein. Use of a vein collar at the distal anastomosis has been suggested to improve patency and limb salvage, a problem that is analysed in this randomised clinical study. Methods: Patients with critical limb ischaennia undergoing polytetrafluoroethylene (PTFE) bypass to below-knee arteries were randomly either assigned a vein collar or not in two groups bypass to the popliteal artery below-knee (femoro-popliteal below-knee (FemPopBK)) and more distal bypass (femoro-distal bypass (FemDist)). Follow-up was scheduled until amputation, death or at most 5 years, whichever event occurred first. Results: In the FemPopBK and in the FemDist groups, 115/202 and 72/150 were randomised to have a vein collar, respectively. Information was available for 345 of 352 randomised patients (98%). At 3 years, primary patency was 26% (95% confidence interval (CI) 18-38) with a vein collar and 43 (33-58) without a vein collar for femoro-popliteal bypass and 20 (11-38), and 17 (9-33) for femoro-distal bypass, respectively. The corresponding figures for limb salvage were 64 (54-75) and 61(50-74) for femoro-popliteal bypass, and 59 (46-76) and 44 (32-61) for femoro-distal bypass with and without a vein collar, respectively. Log-rank-test for the whole Kaplan-Meier life table curve showed no statistically significant differences with or without vein collar primary patency: p = 0.0853, p = 0.228; secondary patency: p = 0.317, p = 0.280; limb salvage: p = 0.757, p = 0.187 for FemPopBK and FemDist, respectively. The use of a vein collar did not influence patency or limb salvage. Conclusion: This study failed to show any benefit for vein collar with PTFE bypass to a below-knee artery.
    No preview · Article · Jun 2010 · European Journal of Vascular and Endovascular Surgery
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    ABSTRACT: To investigate a series of patients with secondary aortoenteric fistulas and compare it with a previous series (1985-93 vs. 1973-84). Retrospective study of medical records. Sixteen vascular surgical centers in Sweden. Twenty-seven patients were identified making an overall incidence of 0.5% of all aortoiliac operations. Among aneurysm patients the incidence was significantly lower than in the previous series. One patient record could not be identified. Fourteen primary operations were for aortic aneurysm, 12 for occlusive disease and one was an aortorenal vein bypass. Symptoms of the fistula occurred after a median interval of 90 months which is significantly later than the previous series (32 months; p<0.05). The commonest presentation was bleeding followed by septis. The median diagnostic delay was 10.5 days, which was significantly shorter than in the previous series. Most fistulas involved the duodenum (88%). One patient died before surgery. The postoperative mortality was 28%, significantly lower than in the previous series (58%) (p<0.05). At the end of follow up (median 43 months) significantly more patients were alive than in the previous series (42% vs 18%) (p<0.05). Over a 21 year period there seems to have been a decrease in the frequency of secondary aortoenteric fistulas after aneurysm surgery, a longer interval before they occur, a shorter diagnostic delay, and a better survival.
    Full-text · Article · May 1996 · European Journal of Vascular and Endovascular Surgery
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    ABSTRACT: Secondary aortoenteric fistulas are seen with an increasing frequency which parallels the expansion of reconstructive vascular surgery. During a 12-year period 42 cases have been collected from the hospitals, which perform most of the vascular surgery in Sweden (0.7% of vascular operations). Twenty-five were seen after operation for aortic aneurysm, 15 for aortoiliac occlusive disease, one after renal artery ligation (as a part of reconstruction for renovascular hypertension) and one after operation for an iliac pseudoaneurysm. The frequency of complications during and after the primary operation was high. The interval between operation and onset of fistula symptoms was significantly shorter if there had been infectious complications, the median interval was 32 months, the longest being 10 years. The most important symptom was gastrointestinal haemorrhage, consisting of several small bleeds often combined with septic complications. A large number of negative investigations usually preceded the final diagnosis which was made at exploratory laparotomy. After surgery for the fistula the frequency of complications and mortality, were very high. Mortality was 58%, the most common cause of death being a blow out of the aortic stump. Of those leaving hospital, several further operations were performed with a high mortality. Recurrence of the fistula occurred in 16 out of 34 patients who survived surgery. At follow-up (12-74 months after fistula closure) seven patients were still alive.
    No preview · Article · Mar 1987 · European Journal of Vascular Surgery
  • I Eriksson · O Forsberg · B Lundqvist · A Schwan
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    ABSTRACT: Samples for bacteriological examination were obtained from the aneurysm wall of 85 patients subjected to abdominal aortic aneurysmectomy. Twelve patients (14%) had positive cultures. A total of 13 bacterial strains were isolated, the majority of which were present in only small numbers and were regarded as contaminants. One patient developed a graft infection due to ischemic necrosis of the sigmoid colon. During the follow-up period no further graft infection was noted in patients with positive or negative aortic cultures. It is concluded that the aneurysm wall itself does not represent an important source of early or late graft infection.
    No preview · Article · Feb 1983 · Acta chirurgica Scandinavica
  • I Eriksson · B Almgren · S Bowald · O Forsberg

    No preview · Article · Mar 1982 · Lakartidningen
  • B Almgren · S Bowald · I Eriksson · O Forsberg
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    ABSTRACT: A posterior midline incision was used for subfascial ligation of incompetent medial and lateral perforating veins in 57 limbs. The indications for surgery were recurrent ulceration in 41 limbs and severe skin changes in 16 limbs. At follow-up two years or more after surgery 48 limbs remained free from ulceration. Wound infection (7%) and necrosis (12%) healed with conservative treatment. In our experience the posterior approach is a good alternative to other methods for ligation of incompetent perforating veins in patients with advanced skin changes, including active ulceration.
    No preview · Article · Feb 1982 · Acta chirurgica Scandinavica

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