Effects of three months of low molecular weight heparin (dalteparin) treatment after bypass surgery for lower limb ischemia--a randomised placebo-controlled double blind multicentre trial.

Objectives: To test the hypothesis that long-term postoperative dalteparin (Fragmin), Pharmacia Corp) treatment improves primary patency of peripheral arterial bypass grafts (PABG) in lower limb ischemia patients on acetylsalicylic acid (ASA) treatment.

Design: Prospective randomised double blind multicenter study.

Materials And Methods: Using a computer algorithm 284 patients with lower limb ischemia, most with pre-operative ischemic ulceration or partial gangrene, from 12 hospitals were randomised, after PABG, to 5000 IU dalteparin or placebo injections once daily for 3 months.

Long-term prognosis for patients with chronic leg ulcers: a prospective cohort study.

Objectives: To assess the long-term prognosis of leg ulcers.

Design: A 5 year prospective cohort study.

Materials: A random sample of 382 patients with open leg ulcers (foot ulcers included) treated in the community.

The prevalence of chronic lower-limb ulceration has been underestimated: results of a validated population questionnaire.

A validated population questionnaire was used to survey 12,000 randomly selected inhabitants, aged 50-89 years, in two defined regions of Sweden. The sample included 7 per cent of the total population in the age interval. Overall response rate was 91 per cent.

Low molecular weight heparin started before surgery as prophylaxis against deep vein thrombosis: 2500 versus 5000 XaI units in 2070 patients.

The optimal administration regimens of low molecular weight heparins (LMWHs) have not yet been established. The aim of this study was to compare the efficacy and safety of 2500 and 5000 XaI units of the LMWH dalteparin in patients undergoing elective general surgery for malignant and benign abdominal disease. Prophylaxis was started in the evening before surgery and given once-daily every evening thereafter.

Venous and non-venous leg ulcers: clinical history and appearance in a population study.

In a defined Swedish population of 270,800, all patients with current chronic leg ulcers (827) were identified and a random sample of 382 studied in detail. Ulcers of primarily venous cause comprised 54 per cent of the total, giving a point prevalence of 0.16 per cent (95 per cent confidence interval 0.

High prevalence of diabetes in chronic leg ulcer patients: a cross-sectional population study.

In a cross-sectional survey, designed to detect all patients with current chronic leg ulcers, 27% of the patients had diabetes mellitus. The outcome for the 104 examined diabetic patients has been evaluated and compared with the 278 nondiabetic patients. The purpose was to establish the prevalence of leg ulcers among diabetic patients and to assess potential causes.

Leg ulcer etiology--a cross sectional population study.

Three hundred eighty-two patients with active leg ulcers were clinically examined after random selection out of a population of 827 patients identified within a previous cross-sectional population survey. Bidirectional Doppler ultrasonography was used for objective assessment of arterial and venous circulation. The purpose was to register causative factors and the etiologic spectrum.

Chronic leg ulcers: an underestimated problem in primary health care among elderly patients.

Study Objective: The aim was to establish leg ulcer point prevalence, basal patient characteristics, and level of caretaking.

Design: The study was a postal cross sectional survey. The validity was ensured by examining a randomly selected sample of reported patients.

Thromboprophylactic effect of low molecular weight heparin started in the evening before elective general abdominal surgery: a comparison with low-dose heparin.

A prospective randomized double-blind trial was performed comparing conventional low-dose heparin with a LMWH fragment (Kabi 2165, Fragmin) for thromboprophylaxis in elective general abdominal surgical patients. The first dose of the fragment was given in the evening before surgery, and thereafter every evening. There were 1002 analyzable patients, 826 having received correct prophylaxis.

Late symptoms after pregnancy-related deep vein thrombosis.

Thromboembolism during pregnancy is a rare complication with a potential fatal outcome. Very little is known about long-term effects and therefore 104 women with thrombosis during pregnancy or puerperium were identified and their subjective complaints were assessed in a questionnaire. All had their thrombosis diagnosed by objective methods and the median follow-up time was 11 years.

Low molecular weight heparin given the evening before surgery compared with conventional low-dose heparin in prevention of thrombosis.

A prospective randomized double-blind trial was performed comparing conventional low-dose heparin with a low molecular weight heparin fragment for thromboprophylaxis in elective general abdominal surgical patients. The first dose of the heparin fragment was given the evening before surgery, and further doses were given thereafter every evening. There were 1002 analysable patients, 826 having received correct prophylaxis.

Secondary aortoenteric fistulas--an analysis of 42 cases.

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).

Late venous function in the leg after deep venous thrombosis occurring in relation to pregnancy.

The frequency of deep venous insufficiency was investigated in 23 patients 3-10 years (mean 7 years) after they had developed an objectively diagnosed deep venous thrombosis (DVT) during pregnancy or the first week after delivery. Investigations included clinical examination, listing of symptoms and plethysmography, venous pressure and Doppler ultrasound. At follow-up there were clinical signs or symptoms of venous insufficiency in 35% of the legs with earlier DVT but in none of the non-thrombosed contralateral legs.

Venous function after fracture of the lower extremity. A 9-year follow-up of 150 cases.

One hundred and fifty patients were examined 8-10 years after a fracture of the lower limb to evaluate whether the frequency of deep venous insufficiency (DVI) was influenced by the type of fracture. The evaluation included clinical examination, subjective complaints, venous pressure, plethysmography and doppler sonography. Symptoms and signs of DVI were more common in the fractured than in the uninjured limbs, while objectively diagnosed DVI did not differ between the groups.

Venous function five to eight years after clinically suspected deep venous thrombosis.

One hundred and fifty-four patients, who had been subjected to phlebography 5-8 years previously because of clinical suspicion of deep venous thrombosis (DVT), were investigated to evaluate the frequency of deep venous insufficiency (DVI). The evaluation included clinical examination, registration of subjective complaints and objective measurements with plethysmography, venous pressure and Doppler ultrasound. DVT had been present in 75 legs.

Deep venous insufficiency after postoperative thrombosis diagnosed with 125I-labelled fibrinogen uptake test.

Postoperative thrombosis detected with the 125I-labelled fibrinogen uptake test (FUT) is frequent. FUT correlates well with phlebography and a positive FUT is associated with high incidence of pulmonary embolism. This study has been performed to evaluate venous function 3-5 years after FUT-detected thrombosis.

Postoperative haemostatic changes in patients given thromboembolic prophylaxis with dextran 70--alone, or in combination with dihydroergotamine.

Haemostatic changes were studied in 107 patients undergoing elective general and urologic surgery or hip replacement. All patients received dextran 70 and half of them, randomly chosen, were also given dihydroergotamine. Blood samples were taken before operation and on the fourth postoperative day.

After-exercise thermography compared to strain-gauge plethysmography and venous pressure measurements to detect deep venous insufficiency.

After-exercise thermography (AET) has been claimed to be a means of detecting deep venous insufficiency. The question was studied in 167 patients four to five years after major surgery. The tests af follow-up included AET, strain-gauge plethysmography and venous pressure measurements in addition to clinical examination and a questionnaire concerning history, symptoms etc.

Venous function in the leg after postoperative thrombosis diagnosed with 125I-fibrinogen uptake test.

The 125I-fibrinogen uptake test (FUT) has been widely used in the past decade to detect postoperative thrombosis. FUT has been shown to correlate well with phlebography, and positive FUT is associated with a high frequency of pulmonary embolism. The long-term venous function of the leg after FUT-detected postoperative thrombosis, however, is inadequately documented.

Lung complications after elective hip surgery.

A total of 350 patients undergoing elective hip surgery were retrospectively studied as regards pulmonary complications. The study is based on the findings of pre- and postoperative chest X-rays and of pulmonary perfusion scintigrams. Twenty-seven per cent of the patients had pulmonary complications of some kind.

After-exercise thermography and prediction of deep vein thrombosis.

A total of 112 patients participated in a prospective study of after-exercise thermography as a screening method for predicting risk of postoperative deep venous thrombosis. The fibrinogen-uptake test was used to detect thrombosis after elective surgery. The incidence of the complication showed no significant difference between patients who had had positive and those who had had negative thermograms.

Abdominal trauma in persons older than 60 years.

Abdominal trauma occurring in persons older than 60 years over a 30-year period (1950-79) in a well defined region of Sweden was reviewed. The 177 patients comprised 12.5% of the total with abdominal trauma during that period.

Venous function in the leg 20 years after ligation and partial resection of the popliteal vein.

Thirty-eight patients who had undergone resection of the popliteal vein for deep venous insufficiency 20 years previously were investigated with strain gauge plethysmography and venous pressure measurements. They also replied to a questionnaire. Venous symptoms of some kind were reported by 95% of the patients.

Complications of phlebography: a randomised comparison between an ionic and a non-ionic contrast medium.

A high frequency of thrombotic complications of phlebography with conventional ionic contrast media has recently been reported by several writers. A switch to expensive non-ionic media has been recommended. Such a switch would undoubtedly place great restrictions on the use of this valuable procedure.