Affiliated to research
I am a research group leader of the Vascular Surgery Research Group, Södersjukhuset. We conduct projects in the field of vascular diseases. The group is presented on a web page at the Institution of Clinical Science and Education, Södersjukhuset - SOSVASC. The research has a strong clinical focus including evaluating the results of both established and new therapies as well as basic science. Much of the clinical research is associated with arteriosclerosis and degenerative vascular disease. The Vascular Section of Surgery, Södersjukhuset, is the second largest clinic in the country and we annually get requests for participation in scientific multicenter studies, both in terms of method development and new treatment. In my role as a research groupleader I focuse on the ongoing PhD projects, my own projects and the multicenter trials we conduct. My main task at Karolinska Institutet, is thus to support the members of the research team, as well as helping them to create the conditions for conducting research. My own research career began with the study of malignant melanoma (PhD2002) but my focus is now on the ongoing vascular projects.
1. Methodological aspects on carotid artery intervention
PhD student: Magnus Jonsson, Dep. of Clinical Science and Education, Södersjukhuset, KI
Supervisor: David Lindstrom, Dep. of Molecular Medicine and Surgery (MMK), KI
Co-supervisors: Peter Gillgren, Dep. of Clinical Science and Education, Södersjukhuset, KI, Anders Wanhainen, Uppsala University
The project plan includes four papers and dissertation is scheduled for spring 2017. I participate in all project papers.
1. Results after 7 years of CAS in South Hospital and CAS in Sweden - single-center and national results. 2. Perioperative stroke risk in acute stenting of carotid stenosis: a population-based national Swedvasc study. 3. Long-term results of CAS - risk of stroke and death within 5 years. 4. Prediction of shuntneed at carotid endarectomy with NIRS versus stump pressure. Power calculated on 150 patients. 100 patients have been included so far (April 2015).
2. Cutaneous Malignant Melanoma
Ongoing PhD project
PhD Student: Daniela Gordon, Dep.of Medicine, Solna, KI
Supervisor: Karin Ekström Smedby, Dep.of Medicine, Solna, KI
Co-supervisors: Peter Gillgren, Dep. of Clinical Science and Education, Södersjukhuset, KI, Johan Hansson, Department of Oncology-Pathology, KI
The project plan includes four papers and the dissertation is scheduled for spring 2017. I participate in all project papers.
1. Localization of the sentinel node in melanoma on the trunk and extremities: unusual or multiple drainage does not affect survival. 2. Time trends in incidence of cutaneous melanoma by detailed anatomical location and patterns of ultraviolet radiation exposure – a retrospective population-based study. 3. Effect of Primary Site on Prognosis in Patients with Cutaneous Malignant Melanoma. Data collection is ongoing. 4. Primary Location of Cutaneous Malignant Melanoma in Patients with NRAS / BRAF Mutations. Data collection is ongoing.
Ongoing manuscript : Long-term follow-up of overall and melanoma specific survial in thick (>2mm) melanoma comparing 2-cm and 4-cm surgical margin.
Other ongoing projects with planned authorship
1. Results of endovascular treatment for aortic disease with visceral branches.
In co-operation with the Radiological department at Södersjukhuset I and PhD-student Otto Stackelberg (this project is outside his thesis work), will study all consecutive patients treated at our unit. We will evaluate the results of endovascular treatment of patients with complex aortic disease, where treatments have included stenting of the the visceral and/or renal arteries
2. Biomarkers for unstable plaques in arteriosclerotic disease.
There is a lack of reliable methods to predict patients with atherosclerosis, where the plaque, the coating on the inside of the vessel, is unstable and thus about to cause an acute occlusion or occlusion (complete blockage).A better understanding of patients at risk for unstable plaque formation and thereby with an increased risk in the near for cardiac or cerebral infarction would enable more selective treatment. The research project aims to find biomarkers of unstable atherosclerosis and thereby eliminate these shortcomings and tailor treatment. The project is conducted in collaboration with Prof. Ulf Hedins research group at the Dep. of Molecular Medicine and Surgery and has already resulted in a publication where I am co-author.
3. Procedural risk in acute carotid endarterectomy
In recent years, our Vascular section of surgery at Södersjukhuset have treated more patients with carotid stenosis than any other hospital in the country. I have been invited to a collaboration with the Dep. of Molecular and Clinical Medicine, Wallenberg Laboratory at Sahlgrenska University Hospital, Gothenburg. The project aims to identify risk factors for early surgery for symptomatic carotid stenosis The Gothenburg-group has already published a well cited article on the subject; Risk of early recurrent stroke in symptomatic carotid stenosis. The study shall also constitute one paper in the PhD-student Sofia Strömberg's thesis.
4. Natural History of Peripheral Arterial Disease
Frederick Sartipy M.D., has a PhD project. In collaboration with Dr Birgitta Sigvant, Karlstad's Central Hospital, and Professor Eric Wahlberg at Linköping University' Sartipy will study quality of life, disease panorama and death in patients with PAD. Sigvant holds a PhD in the subject and a large cohort of patients is in our database already.
5. Cellular mechanisms for instability in arteriosclerotic plaques
In collaboration with Professor Johan Frostegårds group at the Unit of Immunology and Chronic Disease at KI, we will study cellular mechanisms in unstable arteriosclerotic plaques in the carotid and femoral artery. I will take active part as well as PhD Johnny Steuer. 2-3 publications are planned.
6. We plan to investigate diagnoses in vascular surgery in patients subjected to pelvic radiotherapy. The project is a collaboration with Åsa Hallqvist Everhov, Jonas Malmstedt and Karin Ekström Smedby.
7. We study the results after treatment for primary trmbosis of the subclavian vein. This is a project in collaboration with Carl-Magnus Wahlgren and Jonas Malmstedt along with a medical student (Sara Lindblom)
8. I am co-principle investigator for the Basil-2 trial. A randomized multi-centre trial from University of Birmingham. The objective is to find out if a "vein by-pass first" or a "best endovascular first" revascularisation strategy is best, in terms of either clinical or cost-effectiviness, for severe limb ischemia due to infra-popliteal disease.
Members of the vascular research team
Johnny Steuer (PhD)
Jonas Malmstedt (PhD)
Anneli Linné (PhD)
Magnus Jonsson (MD)
Christian Smedberg (MD)
Sayid Zommorodi (MD)
Eva Torbjörnsson (NT)
External students with KI-SÖS projects
Otto Stackelberg (MD)
Seven selected publications
2-cm versus 4-cm excision margins for primary cutaneous melanoma thicker than 2 mm: a randomized, multicentre trial. Gillgren P, Drzewiecki KT, Niin M, Gullestad, HP, Hellborg H, Mansson-Brahme, E, Ingvar C, Call Borg U. Lancet. 2011 Nov 5; 378 (9803): 1635-42.
Peri-procedural risk with the Urgent Carotid Artery Stenting: A Population-based Study Swedvasc. Jonsson M, Gillgren P, Wanhainen A, Acosta S, Lindstrom D. Eur J Vasc Endovasc Surg. 2015 February 28. PII: S1078-5884 (15) 00045-3. doi: 10.1016/j.ejvs.2015.01.007.
Outcome After Seven Years of carotid artery stenting and endarectomi in Sweden - single center and the national results. Lindstrom D, Jonsson M, Formgren J, Delle M, Rosfors S, Gillgren P. Eur J Vasc Endovasc Surg. 2012 May;43(5):499-503.
Profiling of atherosclerotic lesions by Gene and tissue microarrays Reveals PCSK6 as a novel protease in unstable carotid atherosclerosis. Perisic L, Hedin E, Razuvaev A, Lengquist M, Osterholm C, Folkersen L, Gillgren P , Paulsson-Berne G, Ponten F, Odeberg J, Hedin U. Arterioscler Thromb Vasc Biol. 2013 Oct;33(10):2432-43.
Sentinel node location in trunk and extremity melanomas: uncommon or multiple lymph drainage does not affect survival. Gordon D, Smedby KE, Schultz I, Olsson H, Ingvar C, Hansson J, Gillgren P . Ann Surg Oncol. 2014 Oct;21(11):3386-94.
The role of procalcitonin in postimplantation syndrome after EVAR: a pilot study. The role of procalcitonin in postimplantation syndrome after EVAR: a pilot study. Sartipy F, Lindström D, Gillgren P , Ternhag A. Ann Vasc Surg. 2014 May;28(4):866-73.