Vascular Surgery

The research group uses several different methods including prospective clinical studies, registry-based research, data-simulation (Markov-analysis), animal experiments, biochemical analyses and complex imaging techniques. The PhD projects normally include several different scientific methods. The research group coordinates large multicentre randomized trials evaluating the effect of a mastcell-inhibitor (AORTA-trial) and platelet inhibition (TicAAA-trial) on AAA growth rate.

Disease, in particular Abdominal Aortic Aneurysm (AAA)

1) Etiology/pathogenesis with multiple translational research projects that are implemented in collaboration with other research groups. They are focused on inflammation (studied with PET/CT and MRI imaging), relative telomere length, SNP analyses, infectious agents and possible auto-immune reactions. A population-based blood- and tissue-bank has been created, as well as one blood-bank from patients with multiple aneurysms. A multicentre genome-wide-analysis (GWA) project has been initiated. The research group coordinates a large multicentre randomized trial evaluating the effect of a mastcell-inhibitor on AAA growth rate.

Autoradiograms showing the uptake of [18]fluciclatide in sections of AAA from 2 patients (A and B). Controls of normal aortic tissue (C and D). B and D have an excess of unmarked fluciclatide as blocking agent.
Autoradiograms showing the uptake of [18]fluciclatide in sections of AAA from 2 patients (A and B). Controls of normal aortic tissue (C and D). B and D have an excess of unmarked fluciclatide as blocking agent.


2) Prevention by screening, where the role of Uppsala as pioneer in Sweden is exploited in various projects. Three of our PhD students at neighbouring hospitals are engaged in evaluating different aspects of the screening program. The prevalence of, and risk factors for, the disease in different risk groups are being studied in a multicentre collaboration. The cost-effectiveness of different screening strategies is evaluated, in particular population-based screening of men and women as well as selective high-risk screening. Methodological aspects of ultrasound measurement are studied as well as the importance of various suggested definitions of AAA.

3) Improvement of treatment results including methods for prevention and treatment of abdominal compartment syndrome and intestinal ischaemia, optimisation of follow-up after endovascular aortic repair and evaluation of modern endovascular aortic repair techniques. The group is involved in several projects related to the dynamic endovascular development within vascular surgery, including treatment of diseases of aneurysmal disease and dissections in the thoracic and thoracoabdominal aorta.

This research-line was scrutinized by the Swedish Research Council in 2012, the grants were prolonged and increased almost three-fold. In 2011 an extra grant from the Swedish Research Council was given as a result of a separate application for clinical research (“Kunskapsluckor i Sjukvården”), explaining why we have two grants. The Heart and Lung Foundation, and the Regional Research Fund also support this research-line. There are multiple international collaborators: Zürich, London, Paris and Rotterdam being the most important centres, as well as the VASCUNET, a collaboration of eleven national and regional vascular registries.

Example of attenuation CT, PET image, and fused images PET/CT. This examination revealed a vascular graft infection.
Example of attenuation CT, PET image, and fused images PET/CT. This examination revealed a vascular graft infection.

Peripheral Arterial Occlusive Disease

4) Several projects focusing on carotid artery stenosis, and surgery to prevent stroke, are under evolution. One project studies population based screening of carotid artery stenosis in 65-year old men, profiting from the screening organisation for AAA, another focuses on the importance of contra-lateral occlusion when operating on patients with carotid artery stenosis, and a third one analyses symptoms occurring between a qualifying symptoms and surgery.

5) Intestinal ischaemia is studied with both epidemiological and translational methodology, including micro-array analysis of tissue from porcine experiments.

6) Iatrogenic vascular injuries are studied in different registries with the aim of defining preventive strategies, and in collaboration with the orthopaedic department popliteal artery injuries after both elective orthopaedic surgery and knee trauma are studied.

7) In a basic research project levels of PAI-1 are studied among patients with critical limb ischaemia. The group is involved in the design of a large international multicentre trial evaluating the effect of a new thrombocyte inhibitor among patients with peripheral arterial occlusive disease. New imaging techniques (3T-MRA, dual-energy CTA) to detect subclinical arterial lesions among patients with diabetic foot ulcer are tested. New endovascular treatment modalities for lower extremity ischaemia are evaluated.

Venous Disease

8) Prophylaxis of venous thromboembolism has focused on the effects of selective blocking of activated Factor II and X.

9) The epidemiology of venous ulcers is studied. A multicenter RCT assessing the role of perforator surgery with SEPS to minimize the risk of recurrence of venous leg ulcers long term was published. Recurrence of varicose veins following intervention is analysed in a series of prospective clinical studies, assessing both short and long term recurrence.
 

Members of the group during 2019

Principal investigator
Anders Wanhainen, Professor, Uppsala

Professor (chair) of Vascular Surgery
Martin Björck, Professor, Uppsala

Senior investigators
David Bergqvist, professor emeritus, Uppsala
Kevin Mani, docent, Uppsala
Thomas Troëng, docent, Karlskrona
David Lindström, docent, Uppsala

Post-doc (PhD)
Christer Liungman, Uppsala
Björn Kragsterman, Uppsala
Gustaf Tegler, Uppsala
Sverker Svensjö, Falun
Hans Ravn, Kolding, Danmark
Lars Karlsson, Gävle
Khatereh Djavani, Gävle
Anders Hellberg, Västerås
Tomas Block, Stockholm
Karl Sörelius, Uppsala
Dominika Högberg, Trollhättan
Birgitta Sigvant, Karlstad
Johnny Steuer, Stockholm
Jon Unosson, Uppsala
Hassan Baderkhan, Uppsala
Fredrik Linder, Uppsala
Olivia Grip, Uppsala
Anne Burdess, Edinburgh/Newcastle, UK

PhD students
Anne Cervin, Trollhättan
Achilleas Karkamanis, Uppsala
Kim Gunnarsson, Gävle
Jonas Wallinder, Sundsvall
Samuel Ersryd, Gävle
Hamid Gavali, Uppsala
Linda Lyttkens, Uppsala
Demos Dellagrammaticas, Uppsala
Fjalar Elvarsson, Västerås
Jacob Lilly, Århus, Danmark
Marek Kuzniar, Uppsala
Patrik Söderberg, Falun
Fredrik Lilja, Sundsvall
Sara Bruce, Uppsala
Tina Hellgren, Uppsala
Knut Thorbjørnsen, Gävle
Linda Haakseth, Uppsala
Lina Holmberg, Uppsala
Antonio José Garcia Pereira Filho, Karlstad

External PhD-students (to whom senior members of the research group are co-tutors) 
Hanna Ljungbåge, Kolorektal kirurgi, Uppsala
Mari Holsti, Kärlkirurgen, Umeå
Sven-Erik Persson, Kärlkirurgen, Umeå

Research nurses
Linda Lyttkens (Team Manager)
Katarina Bruun
Sofia Lindell
Maimun Abdi Poljarevic (BMA)
Susanna Lindström
Clara Rydmyr
 

Publications

All publications can be found in the digital archive DiVA.

In all of these research fields, research is based on data from the Swedish quality register in vascular surgery, Swedvasc, as well as to the cooperation that has been established with ten other countries' regional and national vascular registry, Vascunet.

Anders Wanhainen

Professor at Department of Surgical Sciences, Vascular Surgery

Email:
Anders.Wanhainen[AT-sign]surgsci.uu.se
Telephone:
+4618-6114623