K H Tønnesen's research while affiliated with Bispebjerg Hospital, Copenhagen University and other places

Publications (64)

Article
An audit of treating femoro-crural bypass stenosis in the first instance by PTA. Prospective clinical pilot study in consecutive patients. Prior to vascular bypass grafting all patients had critical ischaemia. Sixty-four PTA procedures in 50 grafts in 49 patients were carried out. Thirteen were in situ saphenous grafts, 16 were combined venous segm...
Article
Compare the recanalization rate of femoropopliteal occlusions between movable core wire guide (MG) and hydrophilic guidewire (HG). Conventional PTA technique was used, followed by enclosed thrombolysis. The MG was used for all patients in the first 2 years, the HG in the following 2 years. Baseline characteristics were similar for the two groups of...
Article
The authors measured the binding of indium-111-labeled recombinant tissue-type plasminogen activator (rt-PA) within the recanalized femoropopliteal segment after percutaneous transluminal angioplasty (PTA) and enclosed thrombolysis. In patients with long occlusions (n = 3), 91 micrograms of rt-PA was bound 1 hour after the procedure, and the half-t...
Article
Removal of fibrin from the site of a newly dilated femoro-popliteal occlusion may be an attractive way of preventing rethrombosis. A double balloon catheter with a dilating tip balloon and an occlusive balloon 10, 15 or 20 cm approximately were introduced percutaneously. Following successful dilatation of femoro-popliteal occlusions, the balloons w...
Article
Segmentally enclosed thrombolysis (SET) was performed immediately following 34 percutaneous transluminal angioplasties (PTAs) for femoropopliteal occlusions. The dilated segment was sealed off with a double balloon catheter, and recombinant tissue plasminogen activator (rt-PA) 1 mg/ml and heparin 200 IU/ml were injected between the balloons. The ca...
Article
The outcome of percutaneous transluminal angioplasty (PTA) was evaluated for treatment of 87 limbs with femoropopliteal stenoses, including 55 short stenoses (2.4 +/- 1.6 cm, mean +/- SD), seven single long stenoses (10.4 +/- 2.0 cm), and 25 multifocal stenoses (2.1 +/- 1.6 cm), where two to four separate segments were dilated. Following 98% initia...
Article
Possible sources of error during long-term measurements of subcutaneous blood flow rate with the portable CdTe(Cl) detector system were ruled out in the present study. Local blood flow rates were recorded in the lower legs of normal human subjects by means of the 133Xe wash-out technique. A good correlation was found between the portable CdTe(Cl) a...
Article
One hundred and thirty-seven consecutive percutaneous transluminal angioplasties (PTA) were performed for femoropopliteal vascular disease including 58 stenoses and 79 total occlusions. Nine occlusions could not be crossed with the guidewire, but in the remaining 128 the haemodynamic and clinical success as well as vascular patency were evaluated....
Article
A total of 107 patients suffering from intermittent claudication (CI) was studied after a mean observation time of 5.9 years. Thirty-one (29%) had died during the observation period. A questionnaire was sent to 76 patients and 78% replied. All patients were under 50 years of age at the first consultation. No patients had been operated upon. The rat...
Article
To establish whether re-occlusion of the femoral artery could be prevented, in 6 consecutive patients undergoing percutaneous transluminal angioplasty (PTA) for superficial femoral artery occlusion the recanalised segment was isolated, with a 7-French double-balloon catheter. 5 mg recombined human tissue-type plasminogen activator (rt-PA) and 1000...
Article
Percutaneous transluminal angioplasty was performed 92 times in 86 patients with severe lower-limb ischaemia (40% occlusion), giving rise to rest pain and/or gangrene. The patients were thereafter observed for periods up to 5 years. Criteria for success were appearance of normal groin pulse (iliac angioplasty) or persistent greater than or equal to...
Article
Percutaneous transluminal angioplasty was performed on 55 iliac and 31 femoropopliteal arteries in 71 patients with intermittent claudication (23 women, 48 men). The two-year patency rate was 80% after iliac and 41% after femoropopliteal angioplasty. In 17 femoropopliteal cases with lesions greater than or equal to 5 cm the 2-year patency rate was...
Article
We report the results of 50 angioplasty procedures via the popliteal artery. A 3-year follow-up including control of blood pressures at ankle and toe levels show results comparable to reports in the literature. This new approach for angioplasty of the superficial femoral artery and eventually of coexisting iliac lesions enables treatment of previou...
Article
Adipose tissue blood flow in the forefoot was measured simultaneously with mean systemic arterial blood pressure over 24 hours in 8 patients (15 feet) with different degrees of arterial insufficiency. Mean systemic arterial pressure decreased by 19 +/- 9% during sleep, irrespective of symptomatology. In two limbs, with a normal peripheral circulati...
Article
Ninety-four consecutive patients with lower leg stasis ulcers (LSU) were examined for coexistence of arterial occlusive disease. The average age of the patients was 77 years. Two-thirds of the patients were women. Eleven of the patients had diabetes mellitus. Systolic arm, ankle and toe blood pressures were measured. Indices of ankle/arm (AI) and t...
Article
Simultaneous measurement during 24 h of mean arterial blood pressure (MABP) and forefoot subcutaneous adipose tissue blood flow (SBF) was undertaken in eight patients (15 feet) with different degrees of arterial insufficiency. The recordings were undertaken with the patients in the supine position only. The MABP decreased by 19 +/- 9% from awake to...
Article
In a double-blind cross-over trial an oral thromboxane synthetase inhibitor (TSI) or placebo was given to 15 patients with severe foot ischaemia. After TSI therapy, rest pain remitted in nine out of 14 legs, while remission during placebo was seen in three out of 11 legs (NS). The ankle and toe systolic blood pressures remained constant during both...
Article
Wash-out of 133xenon from a local depot in the subcutaneous adipose tissue in the forefoot was measured continuously during 24 hours on subsequent recordings in 51 feet (normal circulation: 10, intermittent claudication: 22 and ischaemic nocturnal rest pain: 19) with a mean time interval of 26 days (range: 3-90 days). The patients were studied unde...
Article
Full-text available
The fate of 257 consecutive patients (100 women) aged 36-85 years (mean 65) first seen with intermittent claudication in 1977 was analysed after a mean of 6.5 (SD 0.5) years. When first seen none of the patients complained of rest pain or had ulcers or gangrenous lesions on the feet. At follow up 113 of the patients (44%) had died. Causes of death...
Article
The effects of acebutolol (with intrinsic sympathomimetic activity (ISA] and metoprolol (without ISA) on arm blood pressure, ankle systolic blood pressure, claudication distances (CD) and maximal walking distances (MWD) were compared in patients with essential hypertension and intermittent claudication. Fourteen patients participated in a long-term...
Article
1. Twenty-four hour continuous recording of xenon (133Xe) wash-out from the forefoot was performed on patients with normal circulations (n = 10) and on patients with different degrees of arterial insufficiency (n = 36). 2. During day hours the calculated subcutaneous blood flow in the forefoot was on average the same in patients with normal circula...
Article
Full-text available
Two-plane angiography and direct segmental pressure measurements in the femoral and popliteal arteries and indirectly on the arm and ankle were performed in 101 limbs seeking to establish a relationship between angiographic assessment of the patency of the popliteal artery and the trifurcation vessels and the popliteal ankle pressure difference. Wh...
Article
The function of sympathetic vasoconstrictor fibres was studied in 18 patients with occlusive arterial disease of the legs and somatic neuropathy, as evidenced as an increased vibration perception threshold. Nine patients suffered from long-term diabetes mellitus. Sympathetic vasoconstrictor function was studied by the capability of the local sympat...
Article
Thirty-six legs in thirty-three diabetic patients with ischemia at rest and multiple level arterial disease were studied preoperatively. Direct intraarterial femoral and popliteal artery blood pressures were measured together with indirect arm and foot blood pressures. Based on the systolic segmental pressure gradients it was predicted preoperative...
Article
Knowledge of the tissue to blood partition coefficient (λ) is essential for calculation of the perfusion coefficient in a single tissue based on measurements of the washout of locally injected isotopes. No measurements of λ for Xenon in subcutaneous tissue in the leg have been done in patients with occlusive arterial disease. In 12 patients with oc...
Article
Direct measurement of the femoral artery pressure before operation has been used to predict the postoperative change in ankle and toe pressure in 102 limbs (83 patients) that underwent aortoiliac surgery for the treatment of atherosclerotic occlusion or stenosis affecting both the aortoiliac and femoral artery segments. Rest pain or gangrene was pr...
Article
The vascular response in the lower extremities to 40 degrees head-up tilt was studied in 5 patients with occlusion of the superficial femoral artery and maturity onset diabetes mellitus with symptoms suggesting autonomic neuropathy. The pressure measurements were performed via catheters placed in the brachial artery, femoral artery and vein and pop...
Article
The effect of head-up tilt on leg blood flow and segmental arterial blood pressures was studied in 21 patients with occlusion or severe stenosis of the common or superficial femoral artery. Arterial pressure was measured directly in the brachial artery, common femoral artery and popliteal artery. Relative change in blood flow in the leg during tilt...
Article
Patients with severe ischemia due to multilevel obstructions in the leg arteries both above and below the groin were assessed preoperatively by intraarterial brachial and femoral artery pressure measurements. The systolic pressure drop along aortoiliac obstructions was compared to the angiographic findings. A consistent pressure gradient was found...
Article
The peripheral run-off arteries were insufficiently visualized due to occlusions in the aorto-iliac segments in studies of 10 patients (15 legs) in 183 consecutive aorto-femoral angiograms. Guided by a combination of the Doppler technique and fluoroscopy, the non-opacified and pulseless common femoral artery was catheterized. Angiography through th...
Article
19 patients with obstructive arterial disease both proximal and distal to the inguinal ligament were studied with segmental blood pressure recordings because reconstruction of the proximal lesion was considered. The common femoral pressure was measured intraarterially as well as with a 12 cm cuff placed as proximally as possible on the thigh. The p...
Article
Plasma angiotensin II concentration gradients across the pulmonary vascular bed were measured during diagnostic renal venous/right heart catheterization in twenty-seven hypertensive patients with renal or renovascular disease. There was a linear correlation between the plasma angiotensin II concentration in mixed venous blood and in systemic arteri...
Article
The clinical course was followed and the ankle and toe blood pressures were measured with the strain gauge technique on 5 occasions during 2 years in 43 patients with pain at rest and/or ischaemic ulceration due to severe ischaemia of the legs on the basis of occlusive arterial disease. Although arteriosclerosis of the legs in non-diabetic patients...
Article
Forty-one reconstructive procedures were carried out in thirty-five consecutive patients. Average age was 63 years (range 46-75). Thrombendarterectomy or by-pass procedures were carried out in twenty-nine proximal and twelve femoropopliteal reconstructions. Twenty-three patients had rest pain fifteen had ischemic ulcers. The preoperative median pre...
Article
Regional venous plasma aldosterone concentrations were determined and assessed against concurrent arterial levels in 16 patients with primary aldosteronism. The results obtained by sampling from the left adrenal vein or the left renal vein allowed correct side prediction of the presupposed adenoma in each patient. The problems caused by intermitten...
Article
Systolic blood pressures at toe and ankle were measured in 459 consecutive patients with occlusive arterial disease. Fifty-eight per cent had intermittent claudication with arterial disease of all degrees of severity. Seventeen per cent complained of rest pain having toe systolic pressures below 30 mmHg, half had arterial lesions proximal to the gr...
Article
A study of 44 hypertensive patients with unilateral renovascular or renal parenchymal disease is presented. All patients underwent corrective surgery. Out of the 44 operated patients, five did not participate in the follow-up examination. The remaining 39 patients constitute the study population. The effects of surgery on the hypertensive state cou...
Article
A study of 44 hypertensive patients with unilateral renovascular or renal parenchymal disease is presented. All patients underwent corrective surgery. Out of the 44 operated patients, five did not participate in the follow-up examination. The remaining 39 patients constitute the study population. The effects of surgery on the hypertensive state cou...
Article
Preoperative measurements of direct femoral artery systolic pressure, indirect ankle systolic pressure and direct brachial artery systolic pressure were carried out in nine patients with severe ischemia and arterial occlusions both proximal and distal to the ingvinal ligament. The pressure-rise at the ankle was estimated preoperatively by assuming...
Article
Forty-two patients, mean age 68 years, with severe leg ischaemia were randomly treated with placebo or by controlled defibrination with ancrod for 3 weeks. Plasma fibrinogen concentration was kept at about 20% of normal in the ancrod treated group. The two groups proved to be well matched regarding factors which could affect the degree of ischaemia...
Article
Transcutaneous oxygen tension at 44d̀C and maximal isotope clearance (99mTcpertechnetate + histramine) just proximal to the 1st toe and systolic toe blood pressure (strain gauge) were studied on a tilt table in patients with various degrees of obstructive arteriosclerotic disease. In legs with moderate obstruction, the oxygen tension reached zero a...
Article
Regional 133Xe ventilation/perfusion studies were used to predict residual lung function after pulmonary resections. The accuracy of the method was good as checked by postoperative spirometry in 11 patients. In 25 patients with impaired lung function and pulmonary cancer, who were consecutively selected for surgery, the predicted postoperative maxi...
Article
The systolic blood-pressure at the ankle and the first toe was measured in 30 patients, mean age 42, who had taken ergotamine regularly for more than a year. With one exception, the patients had no symptoms or signs of arterial insufficiency in the limbs, but all had low-normal or abnormal foot systolic blood-pressures. In a group of 13 patients wh...
Article
Estimations of the residual glomerular filtration rate (GFR) were made from renography and GFR measurements before unilateral nephrectomy in 28 patients aged 42-77 years. The GFR was measured one week and three months after the operation and comparisons were made between the function of the remaining kidney and the preoperative estimate. In 23 pati...
Article
The residual kidney function was predicted from preoperative renography and determination of the glomerular filtration rate (GFR) in 57 patients undergoing unilateral nephrectomy for cancer, postrenal obstruction or renovascular hypertension. Postoperative GFR measurements were carried out 6-36 months after the operation. In eleven patients where t...
Article
The authors' experience with a Nuclear Enterprises Ltd. renography system is described. In two and a half years over 300 renograms were performed. The apparatus fulfilled many of the functions for which it was designed. It was easy to operate, with a clear “write-out” and was well accepted by patients. Although moderately reliable, it was less mobi...
Article
15 patients with Buerger's disease were treated for inschemic toe ulcers and rest pain by moderate hypertension induced with a mineralocorticoid. Systolic distal blood pressure was significantly increased during therapy. In 14 patients disappearance of rest pain was obtained after 1 to 2 weeks and healing of the ischemic ulcers after on the average...
Article
Five cases of sudden massive hemorrhage after renal transplantation are reported. It is supposed that an infective arteritis with damage of the artery wall caused the observed disruption of the arteries. Prompt ligation far from the infected site is recommended as necessary to prevent recurrence of the bleeding and to afford the best possibility fo...

Citations

... Coefficient of Tc-99m (0.153) is calculated using Tonnesen's formula. [11] GFR is calculated, in ml/min, as: 9.75621 × FU − 6.19843. Tc-99m DTPA is prepared in-house at our center, regular chromatography for labeling efficiency is performed, and radiochemical purity has consistently been shown to be over 95%. ...
... Conversely, when the perfusion pressure is low, a small decrease in perfusion pressure causes a much greater decrease in TcPO2 which may even reach 0 mmHg despite blood flow evidenced using other techniques [11]. Furthermore, it was pointed out that a null TcPO2 value did not indicate that no oxygen is reaching the tissue but rather that the oxygen delivery equals or exceeds the metabolic consumption of the skin [12]. ...
... Decades ago, attempts were made to directly reduce the procoagulant potential of blood plasma by defibrination. For this purpose, it was proposed to use ancrod, an enzyme from the venom of Calloselasma rhodostoma [63,64]. Created on the basis of this enzyme, the drug "Arvin" has been widely used in clinical trials [65]. ...
... In the early 1970s, KRISTERSSON et al. [44] were able to accurately predict the functional loss after pneumonectomy and lobecto- my [113]. TØNNESEN et al. [114] and subsequently ALI et al. [115] have confirmed these findings, the latter as long as the resection involved more than three segments. Since then, radiospirometry has been replaced by split perfusion scans using intravenous technetium-99 macroaggregate . ...
... This finding suggests that the proportional theory is correct and actual measurement or better estimation of femoral artery pressure would allow accurate predictions; in fact, this has been reported by one group in Scandinavia that used a proportional transmission formula. 10 The use of regularly sized cuffs is best in this regard but gives only slightly better than 80% accuracy. Although some of the predictive errors could be due to unexpectedly poor ABIs caused by unrecognized technical errors, most were probably due to poor TBI estimates caused by variable thigh girth. ...
... The Gates' method has been widely used because it is simple, convenient, noninvasive, repeatable and less time-consuming. The accuracy of this method is affected by many factors, such as ROI (6,7), renal depth (8)(9)(10)(11)(12), and net injection dose (13). From the Gates' formula we can find the accuracy of GFR also affected by the net counts of the kidneys. ...
... However, increasing the blood pressure in aged atherosclerotic patients is not devoid of risk in terms of cerebral bleeding, and an increase in sodium chloride in the diet may precipitate heart failure. This therapy has been restricted to ischaemic ulcers in young patients with Buerger's disease [49]. ...
... Successful recanalization of subacute (Ͼ2 weeks and Ͻ3 months) and chronic occlusions with thrombolytic therapy-usually in combination with angioplasty and stenting-in various arterial beds has increased awareness of the presence of varying degrees of organized clot components in these nonacute occlusions. 1,2 This clot component was implicated as a source of embolization after plain angioplasties 3 or postoperative occlusions, 4 and a number of interventions other than the time-consuming thrombolysis, including enclosed thrombolysis, 4,5 and mechanical thrombectomy using various devices 6 were used to address this issue. Although effective in removing acutely formed clots, the mechanical thrombectomy devices such as aspira-tion catheters 6 and mechanical thrombectomy catheters are considered to be unsuitable for removing subacute occlusions of more than 14 days' duration, because of the rapid organization and adherence of the clot to the arterial wall. ...
... Another important finding is that a lesion length ≥ 30 cm and a TASC II D lesion are predictors of primary patency loss. This finding is in contrast with one of the few previously published reports on the endovascular recanalization of the native SFA CTOs in patients with CLI after failed femoropopliteal bypass (Li et al. 2018), whose regression analysis had not shown significant influence of a lesion length > 20 cm and a TASC II D lesion on the primary patency loss, but it's in agreement with the historical and contemporary vascular literature on primary endovascular therapy for lower limb lesions (Jørgensen et al. 1991;Iida et al. 2014). In particular, 2017 ESC guidelines on the diagnosis and treatment of PAD (Aboyans et al. 2018) clearly state that if the occlusion/stenosis is > 25 cm, endovascular recanalization is still possible, but better long-term patency is achieved with surgical bypass, especially when using the great saphenous vein, although it does not distinguish between primary patency and secondary patency rates. ...
... A relationship between temperature and sleep stage is not entirely surprising, as body temperature is circadian and therefore linked with sleep-wake cycles. It is well established that heat is redistributed upon sleep onset, resulting in a decrease in core body temperature and a concomitant increase in peripheral temperature (Kräuchi, 2007;Sindrup, Kastrup & Jørgensen, 1991). Thermoregulation has been shown to be suppressed during REM sleep but not during NREM sleep (Adam, Tomeny, & Oswald, 1986). ...