Publications by authors named "Joakim Nordanstig"

Background: Drug-coated devices are frequently used in coronary and peripheral interventions, but their effect on amputation risk in peripheral artery disease is unclear. We assessed whether drug-coated devices affect the rate of above-ankle amputation in patients with chronic limb-threatening ischaemia undergoing infrainguinal endovascular revascularisation.

Methods: The Swedish Drug-Elution Trial in Peripheral Arterial Disease 1 (SWEDEPAD 1) was a pragmatic, nationwide, multicentre, participant-masked, registry-based, randomised controlled trial at 22 Swedish centres.

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Background: Drug-coated devices are widely used to reduce restenosis after lower limb revascularisation in patients with peripheral artery disease, but their effect on patient-centred outcomes remains unclear. We assessed the effect of paclitaxel-coated devices on clinically important outcomes in patients with intermittent claudication undergoing infrainguinal endovascular revascularisation.

Methods: The Swedish Drug-Elution Trial in Peripheral Arterial Disease 2 (SWEDEPAD 2) was a pragmatic, nationwide, multicentre, participant-masked, registry-based, randomised controlled trial conducted at 22 Swedish vascular centres.

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Background: Peripheral artery disease (PAD) is prevalent in women and men with type 2 diabetes (T2D). Sex-based differences exist in its epidemiology, clinical presentation, functional impact, outcomes, and potentially in responses to treatments. Recently, semaglutide 1.

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Objective: The Semaglutide and Walking Capacity in People with Symptomatic Peripheral Artery Disease and Type 2 Diabetes (STRIDE) trial (NCT04560998) showed that once-weekly subcutaneous semaglutide 1.0 mg significantly improved functional outcomes, symptoms, and quality of life in individuals with symptomatic peripheral artery disease (PAD) and type 2 diabetes. Whether these benefits are consistent across diabetes-related characteristics remains unclear.

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Background: Endovascular technologies continue to evolve to meet the large and growing burden of peripheral arterial disease. The overall quality of published RCTs in endovascular treatments for peripheral arterial disease is low, resulting in uncertainty over treatment effectiveness. The aim of this study was to develop a framework to improve the design, conduct, and reporting of future clinical trials for infrainguinal endovascular treatments of peripheral arterial disease.

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Background: Peripheral artery disease is a highly morbid type of atherosclerotic vascular disease involving the legs and is estimated to affect over 230 million individuals globally. Few therapies improve functional capacity and health-related quality of life in people with lower limb peripheral artery disease. We aimed to evaluate whether semaglutide improves function as measured by walking ability as well as symptoms, quality of life, and outcomes in people with peripheral artery disease and type 2 diabetes.

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Objective: Ischaemia and reperfusion can result in permanent tissue damage. During complex open abdominal aortic surgery, transient clamping of the renovisceral arteries may be required to successfully complete the vascular repair. Endovascular shunting (endoshunting) presents an alternative technique for managing such temporary renovisceral ischaemia.

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Article Synopsis
  • The STRIDE trial is testing the effects of semaglutide, a GLP-1 receptor agonist, on improving walking distance and functional ability in people with peripheral artery disease (PAD) and type 2 diabetes (T2D).
  • The study includes 792 participants across 20 countries, primarily older adults with significant health risks and functional impairments related to their conditions.
  • Results from this trial aim to clarify whether semaglutide can enhance quality of life and physical performance in this patient population.
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Peripheral arterial disease is the third leading cause of cardiovascular morbidity after coronary artery disease and stroke. Lower limb peripheral arterial disease commonly involves infrainguinal arteries, may impair walking ability (intermittent claudication) and may confer a significant risk of limb loss (chronic limb-threatening ischaemia), depending on the severity of ischaemia. Endovascular treatment has become the mainstay revascularisation option in both the femoropopliteal and the below-the-knee arterial segments.

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Objective: The aim of this study was to determine how many pre-operative ischaemic events occurring within a specific timeframe before carotid endarterectomy (CEA) are needed to increase the peri-operative 30 day risk of stroke or death.

Methods: This was a secondary exploratory analysis based on pooled data from three observational studies sourced from a single centre. Patients with recently symptomatic conventional ≥ 50% carotid stenosis were included.

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Objective: Major adverse limb events (MALEs) are frequent in patients with lower extremity peripheral arterial disease (PAD). However, routine care MALE rate estimations after revascularisation are scarce. This study aimed to determine post-procedural MALE rates in revascularised patients with PAD and identify predictors of post-procedural MALEs.

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Article Synopsis
  • The study investigates long-term trends and risk factors for peripheral arterial complications in individuals with type 2 diabetes compared to the general population, using data from the Swedish National Diabetes Register from 2001 to 2019.
  • It includes a large sample size of 655,250 people with diabetes, analyzing the incidence rates of various complications over the years, such as lower extremity artery disease and diabetic foot disease.
  • Key findings reveal that risk factors like hemoglobin A1c levels, systolic blood pressure, smoking, and lipid levels significantly influence these complications, with higher risk for those not meeting target levels.
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Article Synopsis
  • This study analyzed long-term trends and risk factors for non-coronary complications in individuals with type 1 diabetes compared to matched controls using a large dataset from the Swedish National Diabetes Register.
  • Between 2001 and 2019, the incidence rates of complications like large artery disease and diabetic foot syndrome decreased significantly in those with type 1 diabetes, while certain risk factors like education and blood sugar levels had a substantial impact on these outcomes.
  • Interestingly, people with type 1 diabetes who maintained cardiometabolic risk factors at target levels showed lower risks for some complications, but had a significantly higher risk for diabetic foot disease if all risk factors were present.
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Objective: Temporary arterial shunting is an established method to prevent tissue ischaemia. Although less well established, shunting might also be achieved through endovascular and hybrid techniques, known as endoshunting. Endoshunting offers advantages, for example, enabling minimally invasive access and avoiding complete occlusion of the donor artery.

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