Oznaka poročila: ARRS-RPROJ-ZP-2013/78 ZAKLJUČNO POROČILO RAZISKOVALNEGA PROJEKTA A. PODATKI O RAZISKOVALNEM PROJEKTU 1.Osnovni podatki o raziskovalnem projektu Šifra projekta L3-2319 Naslov projekta Morfološke spremembe notranje karotidne arterije po vstavitvi žilne opornice Vodja projekta 5328 Vojko Flis Tip projekta L Aplikativni projekt Obseg raziskovalnih ur 2323 Cenovni razred B Trajanje projekta 05.2009 - 04.2012 Nosilna raziskovalna organizacija 334 Univerzitetni klinični center Maribor Raziskovalne organizacije -soizvajalke 2334 UNIVERZA V MARIBORU, Medicinska fakulteta Raziskovalno področje po šifrantu ARRS 3 MEDICINA 3.06 Srce in ožilje Družbenoekonomski cilj 07. Zdravje 2.Raziskovalno področje po šifrantu FOS1 Šifra 3.02 -Veda 3 Medicinske vede - Področje 3.02 Klinična medicina B. REZULTATI IN DOSEŽKI RAZISKOVALNEGA PROJEKTA 3.Povzetek raziskovalnega projekta2 SLO Hemodinamsko pomembna zožitev notranje karotidne arterije pogosto povzroča možgansko kap. Ena izmed možnosti zdravljenja je vstavitev žilne opornice v zoženo arterijo (CAS). Kratkoročni rezultati takega zdravljenja so znani. Zelo malo pa je znanega , kako vstavitev žilne opornice vpliva na pregrajevanje bolne arterijske stene prav v področju notranje karotidne arterije. V zadnjih letih se je CAS v klinični medicini ustalil kot resna alternativa kirurškemu zdravljenju. Klinični rezultati kažejo, da je poseg relativno varen. Vendar pa redke ustrezno načrtovane randomizirane raziskave doslej niso uspele natančno pojasniti korelacijo CAS z doslej znanimi rezultati kirurškega zdravljenja . Dolgoročni rezultati CAS so redki. Po vstavitvi žilne opornice v bolno arterijo se prične arterijska stena spreminjati. Domneva se, da gre za odgovor arterije na tujek in za pretirane procese celjenja, ki so posledica poškodbe arterijske stene. Na te procese lahko vplivata dva mehanizma. V zgodnji fazi celjenja se pojavi pretirana rast neointime. V obdobju kroničnega vnetja pa se prične arterijska stena spreminjati in krčiti zaradi sprememb v ustroju stene. Žilne opornice tvorijo umetno oporo, ki naj preprečevala krčenje arterijske stene in oženje njene svetline v poznih obdobjih celjenja. Vendar pa opornice same zase vplivajo na celjenje. Hkrati se spreminja tudi izdelava opornic. Ni znano kako geometrija novih opornic vpliva na arterijsko steno in proces celjenja. Redke raziskave so spremljale spremembe v arterijski steni po vstavitvi opornic tipa Wallstent . Sistematsko dobljeni podatki o dogajanju v karotidni arteriji po vstavitvi žilne opornice manjkajo. Namen raziskave je bil odgovoriti na naslednja vprašanja: Kakšno je dolgoročno ravnotežje med pozitivnim in negativnim pregrajevanjem arterijske stene po vstavitvi žilne opornice? Ali vrsta aterosklerotične lehe vpliva na rezultat celjenja pri novih žilnih opornicah? Kakšni so dolgoročni hemodinamski učinki pregrajevanja v okolici žilne opornice? ANG Narrowing in the carotid arteries (internal carotid artery-ICA), caused by atherosclerotic plaques is a cause of many strokes. One of the procedures to prevent this is carotid artery stenting (CAS), which involves placing a fine mesh tube (stent) inside the artery to hold it open. Short term clinical results of CAS are known, however very little is known about arterial remodeling after stent placement. Long term effects of foreign material placement into diseased arterila wall in carotid artery are lacking. In recent years CAS has rapidly gained recognition worldwide as a possible alternative to surgery. Although excellent results from centers with a high-volume experience seem to demonstrate that CAS is technically feasible and safe , the few randomized controlled trials conducted so far have not clarified the equivalence of this technique compared to surgery in terms of early results in normal risk patients. Moreover, these trials did neglect to publish long term results after CAS. Recurrent stenosis and remodeling of the arterial wall after endovascular stent placement is considered the biologic overresponse to vascular injury secondary to endovascular intervention . Two major mechanisms may contribute long term changes in arterial wall. Neointimal hyperplasia may occur in an early phase of vascular response, and changes in the local constituents of the arterial wall may lead to arterial shrinking in the chronic wound-healing phase. Stents provide a scaffold to maintain the arterial lumen ant to prevent the artery from shrinking in the late phase of healing. However a stent can by itself influence the outcome of healing. Additionally self-expanding stent design systems for carotid artery have morphed from nontapered to tapered and the impact of this change is unknown. Recently the neointimal proliferation within carotid Wallstents was studied in a prospective ultrasound based study comprising more than a hundred successfully stented carotid arteries over a 24 months. Further systematic reports on dynamic changes in arterial wall over time after stent placement are lacking so far. The purpose of the present cohort study was to answer the following questions: What is the balance between negative and positive remodeling of arterial wall after stent placement over time? Does the type of plaque before intervention have a role in positive remodeling of carotid tapered stents? How is the resultant development of hemodynamic parameters around and within carotid stents, the result of arterial remodeling over time? 4.Poročilo o realizaciji predloženega programa dela na raziskovalnem projektu3 Raziskovalni projekt poteka na treh stopnjah. Na prvi stopnji poteka razvoj računalniškega modela razcepišča skupne karotidne arterije. Model bo aplikativno uporaben tudi za testiranja v navideznem računalniškem okolju. Razvoj modela še n] zaključen. Vendar je prvi modul modela kočan in poslan v objavo ( Urevc J, Žun I, Brumen M, Štok B, Flis V. Study of the effects of erythrocytes deformability on large blood vessels: the development of blood constitutive model. . Journal of biomechanics). Razvoj modela odpira vrata za potencialno sodelovanje s tujimi partnerji predvsem na aplikativni ravni, ko gre za preizkušanje zdravil ali preizkušanje novih žilnih opornic. Model namreč omogoča preizkušanje v računalniškem okolju in s tem zmanjšuje breme poskusov na živalih. Drugi dve stopnji se dotikata sprememb, ki nastanejo v notranji karotidni arteriji po vstavitvi znotrajžilne opornice. Drugi dve stopnji se približujeta zaključku. Dosedanji rezultati kažejo, da opornica ni primerna za vse bolnike. Veliko skupino bolnikov z asimptomatsko zožitvijo notranje karotidne arterije je mogoče zdraviti z zdravili. Pri teh bolnikih tako zdravljenje zmanjša tveganje za nastanek kapi, zvišuje kvaliteto življenja in znižuje stroške zdravljenja. To dejstvo je sprejeto kot neposreden rezultat dela skupine tudi kot priporočilo na nacionalni ravni. S.Ocena stopnje realizacije programa dela na raziskovalnem projektu in zastavljenih raziskovalnih ciljev4 Klinični del projekta je bil realiziran v celoti. Izkazalo se je, da raba znotraj žilnih opornic v področju notranje karotidne arterije ni ustrezna za vse bolnike. Iz tega so izšli tudi zaključki, ki so pomembni za zdravljenje bolnikov in ki so že bili sprejeti na nacionalni ravni kot splošno priporočilo. Računalniški del modeliranje krvnega pretoka skozi razcepišče skupne karotidne arterije je končan. 6.Utemeljitev morebitnih sprememb programa raziskovalnega projekta oziroma sprememb, povečanja ali zmanjšanja sestave projektne skupine5 Sprememb ni bilo. 7.Najpomembnejši znanstveni rezultati projektne skupine6 Znanstveni dosežek 1. COBISS ID 3998271 Vir: COBISS.SI Naslov SLO Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) in acute lower limb ischaemia ANG Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) in acute lower limb ischaemia Opis SLO For various reasons some patients are unable to undergo intra-arterial thrombolysis for acute limb ischaemia. This interventional case series study prospectively evaluated the effect of thrombolytic treatment with 100 mg recombinant tissue plasminogen activator (rt-PA), administered intravenously, in patients with acute thrombosis of the lower limb arteries and onset of symptoms within 12 h prior to treatment. During a 3-year period (2007-2009), 18 of 86 patients satisfied the inclusion criteria and were included in the study (age range 65 - 80 years; 11 women). Complete and partial thrombolysis was observed in eight (44.4 %) and six (33.3 %) patients, respectively. All patients experienced clinical improvement. There were no amputations during the 36-month follow-up period and no haemorrhagic complications in the first 30 days post-treatment. Five patients died (27.8 %) during follow-up from unrelated causes. This small study demonstrated that thrombolytic treatment with intravenous rt-PA in selected patients with acute limb ischaemia is feasible. For various reasons some patients are unable to undergo intra-arterial thrombolysis for acute limb ischaemia. This interventional case series study prospectively evaluated the effect of thrombolytic treatment with 100 mg recombinant tissue plasminogen activator (rt-PA), administered intravenously, in patients with acute thrombosis of the lower limb arteries ANG and onset of symptoms within 12 h prior to treatment. During a 3-year period (2007-2009), 18 of 86 patients satisfied the inclusion criteria and were included in the study (age range 65 - 80 years; 11 women). Complete and partial thrombolysis was observed in eight (44.4 %) and six (33.3 %) patients, respectively. All patients experienced clinical improvement. There were no amputations during the 36-month follow-up period and no haemorrhagic complications in the first 30 days post-treatment. Five patients died (27.8 %) during follow-up from unrelated causes. This small study demonstrated that thrombolytic treatment with intravenous rt-PA in selected patients with acute limb ischaemia is feasible. Objavljeno v Cambridge Medical Publications Ltd; Journal of international medical research; 2011; Vol. 39, no. 3; str. 1107-1112; Impact Factor: 0.896;Srednja vrednost revije / Medium Category Impact Factor: 2.978; WoS: QA, TU; Avtorji / Authors: Flis Vojko, Kobilica Nina, Bergauer Andrej, Mrdja Božidar, Milotič Franko, Štirn Barbara Tipologija 1.01 Izvirni znanstveni članek 2. COBISS ID 4000831 Vir: COBISS.SI Naslov SLO Delaying the superficial inferior epigastric artery flap: A solution to the problem of the small calibre of the donor artery ANG Delaying the superficial inferior epigastric artery flap: A solution to the problem of the small calibre of the donor artery Opis SLO Background. Superficial inferior epigastric artery (SIEA) flap has a great advantage over other flaps of the area, that is, readily non-existent donor-site problems. The main reason why the SIEA flap has never been extensively used in breast reconstruction is the small diameter and variable anatomy of its donor artery. This study presents a possibility of enlarging the SIEA diameter using the delay-phenomenon mechanism. Methods. A prospective clinical study of 26 patients was undertaken. Prior to surgery, ultrasound examinations were performed, measuring the diameter of SIEA and the velocity of blood flow in SIEA. The ipsilateral deep inferior epigastric artery (DIEA) was then ligated in all patients who had a measurable SIEA preoperatively. Two weeks later, measurements were repeated. The blood flow through SIEA was calculated and statistical analysis was applied. Results. Twenty-one patients had an identifiable SIEA on preoperative measurements. On postoperative measurements, we confirmed ligation of DIEA in 19 patients, of these 17 patients had an augmentation in diameter (mean: 29%) and 18 in blood flow (mean: 127%). Conclusions. This study shows that ligating a single of the three main arteries (DIEA, SIEA and superficial circumflex iliac artery) irrigating skin/soft tissue of the lower abdomen, although the dominant one, results in widening of diameter and enlarging of blood flow of another artery (SIEA) supplying the same angiosome. The results of the present study might be used in future to increase the diameter and flow in SIEA when the vessel diameter found on preoperative imaging was too small for clinical microsurgical transfer. The drawback of the proposed delay procedure is the sacrifice of ipsilateral DIEA and an added operative procedure. Statement. The clinical trial is registered with Clinical Trials (http://www.clinicaltrials.gov/). The clinical trial registration number is NCT01247129 Background. Superficial inferior epigastric artery (SIEA) flap has a great advantage over other flaps of the area, that is, readily non-existent donor-site problems. The main reason why the SIEA flap has never been extensively used in breast reconstruction is the small diameter and variable anatomy of its donor artery. This study presents a possibility of enlarging the SIEA diameter using the delay-phenomenon mechanism. Methods. A prospective clinical study of 26 patients was undertaken. Prior to surgery, ultrasound examinations were performed, measuring the diameter of SIEA ANG and the velocity of blood flow in SIEA. The ipsilateral deep inferior epigastric artery (DIEA) was then ligated in all patients who had a measurable SIEA preoperatively. Two weeks later, measurements were repeated. The blood flow through SIEA was calculated and statistical analysis was applied. Results. Twenty-one patients had an identifiable SIEA on preoperative measurements. On postoperative measurements, we confirmed ligation of DIEA in 19 patients, of these 17 patients had an augmentation in diameter (mean: 29%) and 18 in blood flow (mean: 127%). Conclusions. This study shows that ligating a single of the three main arteries (DIEA, SIEA and superficial circumflex iliac artery) irrigating skin/soft tissue of the lower abdomen, although the dominant one, results in widening of diameter and enlarging of blood flow of another artery (SIEA) supplying the same angiosome. The results of the present study might be used in future to increase the diameter and flow in SIEA when the vessel diameter found on preoperative imaging was too small for clinical microsurgical transfer. The drawback of the proposed delay procedure is the sacrifice of ipsilateral DIEA and an added operative procedure. Statement. The clinical trial is registered with Clinical Trials (http://www.clinicaltrials.gov/). The clinical trial registration number is NCT01247129. Objavljeno v Elsevier; Journal of plastic, reconstructive & aesthetic surgery; 2011; Vol. 64, no. 9; str. 1181-1186; Impact Factor: 1.494;Srednja vrednost revije / Medium Category Impact Factor: 1.629; WoS: YA; Avtorji / Authors: Gregorič Minja, Flis Vojko, Milotic Franko, Mrdja Božidar, Štirn Barbara, Arnež Zoran M. Tipologija 1.01 Izvirni znanstveni članek 3. COBISS ID 3764287 Vir: COBISS.SI Naslov SLO 10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1): a multicentre randomised trial ANG 10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1): a multicentre randomised trial Opis SLO Background. If carotid artery narrowing remains asymptomatic (ie, has caused no recent stroke or other neurological symptoms), successful carotid endarterectomy (CEA) reduces stroke incidence for some years. We assessed the long-term effects of successful CEA. Methods. Between 1993 and 2003, 3120 asymptomatic patients from 126 centres in 30 countries were allocated equally, by blinded minimised randomisation, to immediate CEA (median delay 1 month, IQR 0.3-2.5) or to indefinite deferral of any carotid procedure, and were followed up until death or for a median among survivors of 9 years (IQR 6-11). The primary outcomes were perioperative mortality and morbidity (death or stroke within 30 days) and non-perioperative stroke. Kaplan-Meier percentages and logrank p values are from intention-to-treat analyses. This study is registered, number ISRCTN26156392. Findings. 1560 patients were allocated immediate CEA versus 1560 allocated deferral of any carotid procedure. The proportions operated on while still asymptomatic were 89.7% versus 4.8% at 1 year (and 92.1% vs 16.5% at 5 years). Perioperative risk of stroke or death within 30 days was 3.0% (95% CI 2.4-3.9; 26 non-disabling strokes plus 34 disabling or fatal perioperative events in 1979 CEAs). Excluding perioperative events and non-stroke mortality, stroke risks (immediate vs deferred CEA) were 4.1% versus 10.0% at 5 years (gain 5.9%, 95% CI 4.0-7.8) and 10.8% versus 16.9% at 10 years (gain 6.1%, 2.7-9.4); ratio of stroke incidence rates 0.54, 95% CI 0.43-0.68, p<0.0001. 62 versus 104 had a disabling or fatal stroke, and 37 versus 84 others had a non-disabling stroke. Combining perioperative events and strokes, net risks were 6.9% versus 10.9% at 5 years (gain 4.1%, 2.0-6.2) and 13.4% versus 17.9% at 10 years (gain 4.6%, 1.2-7.9). Medication was similar in ANG both groups; throughout the study, most were on antithrombotic and antihypertensive therapy. Net benefits were significant both for those on lipid-lowering therapy and for those not, and both for men and for women up to 75 years of age at entry (although not for older patients). Interpretation-Successful CEA for asymptomatic patients younger than 75 years of age reduces 10-year stroke risks. Half this reductionis in disabling or fatal strokes. Net benefit in future patients will depend on their risks from unoperated carotid lesions (which will be reduced by medication), on future surgical risks (which might differ from those in trials), and on whether life expectancy exceeds 10 years. Background. If carotid artery narrowing remains asymptomatic (ie, has caused no recent stroke or other neurological symptoms), successful carotid endarterectomy (CEA) reduces stroke incidence for some years. We assessed the long-term effects of successful CEA. Methods. Between 1993 and 2003, 3120 asymptomatic patients from 126 centres in 30 countries were allocated equally, by blinded minimised randomisation, to immediate CEA (median delay 1 month, IQR 0.3-2.5) or to indefinite deferral of any carotid procedure, and were followed up until death or for a median among survivors of 9 years (IQR 6-11). The primary outcomes were perioperative mortality and morbidity (death or stroke within 30 days) and non-perioperative stroke. Kaplan-Meier percentages and logrank p values are from intention-to-treat analyses. This study is registered, number ISRCTN26156392. Findings. 1560 patients were allocated immediate CEA versus 1560 allocated deferral of any carotid procedure. The proportions operated on while still asymptomatic were 89.7% versus 4.8% at 1 year (and 92.1% vs 16.5% at 5 years). Perioperative risk of stroke or death within 30 days was 3.0% (95% CI 2.4-3.9; 26 non-disabling strokes plus 34 disabling or fatal perioperative events in 1979 CEAs). Excluding perioperative events and non-stroke mortality, stroke risks (immediate vs deferred CEA) were 4.1% versus 10.0% at 5 years (gain 5.9%, 95% CI 4.0-7.8) and 10.8% versus 16.9% at 10 years (gain 6.1%, 2.7-9.4); ratio of stroke incidence rates 0.54, 95% CI 0.43-0.68, p<0.0001. 62 versus 104 had a disabling or fatal stroke, and 37 versus 84 others had a non-disabling stroke. Combining perioperative events and strokes, net risks were 6.9% versus 10.9% at 5 years (gain 4.1%, 2.0-6.2) and 13.4% versus 17.9% at 10 years (gain 4.6%, 1.2-7.9). Medication was similar in both groups; throughout the study, most were on antithrombotic and antihypertensive therapy. Net benefits were significant both for those on lipid-lowering therapy and for those not, and both for men and for women up to 75 years of age at entry (although not for older patients). Interpretation-Successful CEA for asymptomatic patients younger than 75 years of age reduces 10-year stroke risks. Half this reductionis in disabling or fatal strokes. Net benefit in future patients will depend on their risks from unoperated carotid lesions (which will be reduced by medication), on future surgical risks (which might differ from those in trials), and on whether life expectancy exceeds 10 years. Objavljeno v Lancet Publishing Group; The Lancet; 2010; Vol. 376, no. 9746; str. 10741084; Impact Factor: 33.633;Srednja vrednost revije / Medium Category Impact Factor: 2.552; A'': 1;A': 1; WoS: PY; Avtorji / Authors: Halliday Allison, Harrison Michael E., Hayter Elizabeth, Kong Xiangling, Mansfield Averil, Marro Joanna, Pan Hongchao, Peto Richard, Potter John, Rahimi Kazem, Rau Angela, Robertson Steven, Streifler Jonathan, Thomas Dafydd, Flis Vojko, Miksic Kazimir, Štirn Barbara, Tetičkovič Erih Tipologija 1.01 Izvirni znanstveni članek 4. COBISS ID 4475199 Vir: vpis v poročilo Naslov SLO Major complication after Histoacryl injection for endoscopic treatment of bleeding peptic ulcer. ANG Major complication after Histoacryl injection for endoscopic treatment of bleeding peptic ulcer. Opis SLO Serious complications of endoscopic injection therapy may be avoided by using of adhesive agents to treat bleeding gastric ulcers. However, as the present case and a few similar cases show, inadvertent injection of any sclerosant can result in thrombosis of the splenic artery. Endoscopists should be aware of the close anatomic relationship between the stomach wall and the splenic artery. Inadvertent injection of Histoacryl into the splenic artery, in comparison with other agents, tends to obliterate several vessels of the celiac axis. As suggested previously, Histoacryl injection should be considered as a last resort in the endoscopic treatment in patients with bleeding ulcers. ANG Serious complications of endoscopic injection therapy may be avoided by using of adhesive agents to treat bleeding gastric ulcers. However, as the present case and a few similar cases show, inadvertent injection of any sclerosant can result in thrombosis of the splenic artery. Endoscopists should be aware of the close anatomic relationship between the stomach wall and the splenic artery. Inadvertent injection of Histoacryl into the splenic artery, in comparison with other agents, tends to obliterate several vessels of the celiac axis. As suggested previously, Histoacryl injection should be considered as a last resort in the endoscopic treatment in patients with bleeding ulcers. Objavljeno v KOBILICA, Nina, FLIS, Vojko, SOJAR, Valentin. Major complication after Histoacryl injection for endoscopic treatment of bleeding peptic ulcer. Endoscopy, 2012, [Bd.] 44, [suppl.] 2, str. E204-E205, ilustr. https://www.thieme-connect.com/ejournals/pdf/10.1055/s-0032-1308923.pdf, doi: 10.1055/s-0032-1308923. [COBISS.SI-ID 4475199], [JCR, WoS do 6. 12. 2012: št. citatov (TC): 0, čistih citatov (CI): 0, normirano št. čistih citatov (NC): 0, Scopus do 6. 2. 2013: št. citatov (TC): 1, čistih citatov (CI): 1, normirano št. čistih citatov (NC): 1] Tipologija 1.03 Kratki znanstveni prispevek 5. COBISS ID 30240729 Vir: vpis v poročilo Naslov SLO Znotrajžilno zdravljenje anevrizme ledvične arterije z novo večslojno mrežasto žilno opornico - kratko poročilo. ANG Endovascular repair of renal artery aneurysm with the multilayer stent - a short report Opis SLO Background: Complex renal artery aneurysms (RAA) involving major branches of renal artery are difficult to treat. Surgery may be associated with extensive invasiveness and morbidity in the context of major intraabdominal surgery. Stentgrafts or selective coil embolization are contraindicated when large branches are involved in the aneurysmal sac. A case of the patient with complex renal artery aneurysm involving all major arterial branches treated with a new type of multilayer stent is described. Case report: A 56-year old woman whose right kidney had been removed five years before because of renal cell carcinoma was incidentally found to have a large (22 x 26 mm) saccular aneurysm in the main left renal artery involving all three major branches of the renal artery. Via a percutaneous femoral approach a multilayer stent was deployed without complications. Blood flow inside the sac was immediately and significantly reduced. All the renal branches remained patent. Conclusion: Newmultilayer fluid modulating stent concept appears to be a very useful and attractive alternative to surgery or other endovascular techniques for those RAA involving or very close to major branch vessels, especially in patients with very high risk of loosing the only viable kidney, as in our case. Background: Complex renal artery aneurysms (RAA) involving major branches of renal artery are difficult to treat. Surgery may be associated ANG with extensive invasiveness and morbidity in the context of major intraabdominal surgery. Stentgrafts or selective coil embolization are contraindicated when large branches are involved in the aneurysmal sac. A case of the patient with complex renal artery aneurysm involving all major arterial branches treated with a new type of multilayer stent is described. Case report: A 56-year old woman whose right kidney had been removed five years before because of renal cell carcinoma was incidentally found to have a large (22 x 26 mm) saccular aneurysm in the main left renal artery involving all three major branches of the renal artery. Via a percutaneous femoral approach a multilayer stent was deployed without complications. Blood flow inside the sac was immediately and significantly reduced. All the renal branches remained patent. Conclusion: Newmultilayer fluid modulating stent concept appears to be a very useful and attractive alternative to surgery or other endovascular techniques for those RAA involving or very close to major branch vessels, especially in patients with very high risk of loosing the only viable kidney, as in our case. Objavljeno v FLIS, Vojko, MATELA, Jože, BREZNIK, Silva, HENRY, Michel. Endovascular repair of renal artery aneurysm with the multilayer stent - a short report = Znotrajžilno zdravljenje anevrizme ledvične arterije z novo večslojno mrežasto žilno opornico - kratko poročilo. Zdrav Vestn (Tisk. izd.). [Tiskana izd.], okt. 2012, letn. 81, št. 10, str. 753-758, ilustr. http://ojs.szd.si/index.php/vestnik/article/view/1032. [COBISS.SI-ID 30240729], [JCR, WoS do 6. 2. 2013: št. citatov (TC): 0, čistih citatov (CI): 0, normirano št. čistih citatov (NC): 0, Scopus do 23. 11. 2012: št. citatov (TC): 0, čistih citatov (CI): 0, normirano št. čistih citatov (NC): 0] Tipologija 1.03 Kratki znanstveni prispevek S.Najpomembnejši družbeno-ekonomski rezultati projektne skupine7 Družbeno-ekonomski dosežek 1. COBISS ID 4107583 Vir: COBISS.SI Naslov SLO Kako zdraviti asimptomatsko zožitev notranje karotidne arterije? ANG How to treat asymptomatic catorid disease? Opis SLO Avtor razpravlja o različnih možnostih zdravljenja karotidne bolezni ANG Paper discusses different treatment modalietes of carotid disease Šifra F.01 Pridobitev novih praktičnih znanj, informacij in veščin Objavljeno v Univerzitetni klinični center, Oddelek za nevrološke bolezni; Sodobni pogledi na možgansko kap; 2011; Str. 63-71; Avtorji / Authors: Flis Vojko Tipologija 1.17 Samostojni strokovni sestavek ali poglavje v monografski publikaciji 2. COBISS ID 4056639 Vir: COBISS.SI Naslov SLO Comparison of carotid endarterectomy, carotid stenting and current best medical treatment in patients with moderate asymptomatic carotid stenosis ANG Comparison of carotid endarterectomy, carotid stenting and current best medical treatment in patients with moderate asymptomatic carotid stenosis Opis SLO Prispevek opozarja na nevarnost invazivnega zdravljenja pri bolnikih z asimptomatsko karotidno stenozo ANG Paper discusses the risks of invasive treatment of asymptomatic catorid disease Šifra B.04 Vabljeno predavanje Slovenian Medical Association; Book of abstracts and scientific programme; Objavljeno v 2011; Str. 128-129; Avtorji / Authors: Flis Vojko, Tetičkovič Erih, Matela Jože, Mrdja Božidar, Milotič Franko, Štirn Barbara, Kobilica Nina, Bergauer Andrej Tipologija 1.10 Objavljeni povzetek znanstvenega prispevka na konferenci (vabljeno predavanje) 3. COBISS ID 60184321 Vir: COBISS.SI Naslov SLO Akutni abdomen ANG Acute abdomen Opis SLO Strokovna monografija ANG Monography Šifra C.02 Uredništvo nacionalne monografije Objavljeno v Pivec;Medicinski mesečnik; 2009; 495 str.; Avtorji / Authors: Žakelj Vladimir, Gadžijev Eldar, Flis Vojko, Kobilica Nina. ISBN 978-961-6494-694. Tipologija 2.02 Strokovna monografija 4. COBISS ID 66274561 Vir: COBISS.SI Naslov SLO Medicina in pravo ANG Medical law: contemoporary controversies II. Opis SLO Vpliv sodobnih medicinskih tehnologij na pravni status pacienta. ANG The impact of modern medicine on legal status of patient. Šifra C.02 Uredništvo nacionalne monografije Objavljeno v Pravna fakulteta;Zdravniško društvo; 2010; 450 str.; Avtorji / Authors: Rijavec Vesna, Reberšek Gorišek Jelka, Flis Vojko, Planinšec Viktor, Kraljic Suzana Tipologija 2.01 Znanstvena monografija 5. COBISS ID 242526720 Vir: vpis v poročilo Naslov SLO Revija: Acta medicobiotechnica. (uredništvo) ANG Journal: Acta medicobiotechnica. (editorial board) Opis SLO Uredništvo mednarodne revije ANG Member of editorial board Šifra C.04 Uredništvo mednarodne revije Objavljeno v Acta medicobiotechnica. Flis, Vojko (urednik 2008-). Maribor: Medicinska fakulteta, 2008. ISSN 18555640. http://www.actamedbio.mf.unimb.si/. Tipologija 4.00 Sekundarno avtorstvo 9.Drugi pomembni rezultati projetne skupine8 Sodelovanje pri drugih projektih: Končno poročilo o rezultatih raziskav 1. MOŽINA, Janez, JEZERŠEK, Matija, BRAČUN, Drago, FLEŽAR, Matjaž, KOMADINA, Radko, PIRTOŠEK, Zvezdan, KECELJ, Nada, KECELJ, Peter, ČELAN, Dušan, FLIS, Vojko. Medicinske inovacije z lasersko triangulacijo (MILT) : zaključno poročilo. Ljubljana: Fakulteta za strojništvo, 2010. 55 f., ilustr. [COBISS.SI-ID 11554587] 2. STANA-KLEINSCHEK, Karin, STRNAD, Simona, DOLIŠKA, Aleš, INDEST, Tea, MOZETIČ, Miran, VESEL, Alenka, FLIS, Vojko, KOBILICA, Nina, KREZE, Tatjana, FRAS ZEMLJIC, Lidija, SFILIGOJ-SMOLE, Majda, ŠAUPERL, Olivera, PERŠIN, Zdenka, HRIBERNIK, Silvo, KOS, Tanja, žižek, Vida, MLAKAR, Mitja. Vascular graft interfaces : tretje (zaključno) poročilo o izvajanju projekta "Vascular Graft interfaces" v okviru iniciative MNT ERA-NET, (MNT ERA-NET, Vascular Graft Interfaces). Maribor: Fakulteta za strojništvo, 2010. 19 f., graf. prikazi. [COBISS.SI-ID 14416918] lO.Pomen raziskovalnih rezultatov projektne skupine9 10.1.Pomen za razvoj znanosti10 SLO Pri teh bolnikih tako zdravljenje zmanjša tveganje za nastanek kapi, zvišuje kvaliteto življenja in znižuje stroške zdravljenja. ANG In these patients, such therapy reduces the risk of stroke, increases the quality of life and lowers the cost of treatment. 10.2.Pomen za razvoj Slovenije11 SLO Dosedanji rezultati kažejo, da opornica ni primerna za vse bolnike. Veliko skupino bolnikov z asimptomatsko zožitvijo notranje karotidne arterije je mogoče zdraviti z zdravili. Pri teh bolnikih tako zdravljenje zmanjša tveganje za nastanek kapi, zvišuje kvaliteto življenja in znižuje stroške zdravljenja. ANG The current results suggest that endovascular stent is not appropriate for all patients. Large group of patients with asymptomatic internal carotid artery stenosis can be treated with medication. In these patients, such therapy reduces the risk of stroke, increases the quality of life and lowers the cost of treatment. 11.Samo za aplikativne projekte in podoktorske projekte iz gospodarstva! Označite, katerega od navedenih ciljev ste si zastavili pri projektu, katere konkretne rezultate ste dosegli in v kakšni meri so doseženi rezultati uporabljeni Zastavljen cilj O da 0 ne Rezultat d Uporaba rezultatov d F.05 Sposobnost za začetek novega tehnološkega razvoja Zastavljen cilj O da 0 ne Rezultat d Uporaba rezultatov 1 d F.06 Razvoj novega izdelka Zastavljen cilj o da 0 ne Rezultat I d Uporaba rezultatov 1 d F.07 Izboljšanje obstoječega izdelka Zastavljen cilj o da 0 ne Rezultat Uporaba rezultatov d F.08 Razvoj in izdelava prototipa Zastavljen cilj o da 0 ne Rezultat d Uporaba rezultatov d F.09 Razvoj novega tehnološkega procesa oz. tehnologije Zastavljen cilj o da 0 ne Rezultat I d Uporaba rezultatov 1 d F.10 Izboljšanje obstoječega tehnološkega procesa oz. tehnologije Zastavljen cilj o da 0 ne Rezultat I d Uporaba rezultatov 1 d F.11 Razvoj nove storitve Zastavljen cilj o da 0 ne Rezultat Uporaba rezultatov d F.12 Izboljšanje obstoječe storitve Zastavljen cilj 0 DA O NE Rezultat Dosežen d Uporaba rezultatov V celoti d F.13 Razvoj novih proizvodnih metod in instrumentov oz. proizvodnih procesov Zastavljen cilj o da 0 ne Rezultat d Uporaba rezultatov 1 d F.14 Izboljšanje obstoječih proizvodnih metod in instrumentov oz. proizvodnih procesov Zastavljen cilj o da 0 ne Rezultat 1 d Uporaba rezultatov 1 d F.15 Razvoj novega informacijskega sistema/podatkovnih baz Zastavljen cilj o da 0 ne Rezultat d Uporaba rezultatov d F.16 Izboljšanje obstoječega informacijskega sistema/podatkovnih baz Zastavljen cilj o da 0 ne Rezultat d Uporaba rezultatov F.17 Prenos obstoječih tehnologij, znanj, metod in postopkov v prakso Zastavljen cilj o da 0 ne Rezultat I d Uporaba rezultatov 1 d F.18 Posredovanje novih znanj neposrednim uporabnikom (seminarji, forumi, konference) Zastavljen cilj 0 DA o ne Rezultat Dosežen d Uporaba rezultatov V celoti 3 F.19 Znanje, ki vodi k ustanovitvi novega podjetja ("spin off") Zastavljen cilj o da 0 ne Rezultat 1 d Uporaba rezultatov 1 d F.20 Ustanovitev novega podjetja ("spin off") Zastavljen cilj o da 0 ne Rezultat I d Uporaba rezultatov 1 d F.21 Razvoj novih zdravstvenih/diagnostičnih metod/postopkov Zastavljen cilj o da 0 ne Rezultat d Uporaba rezultatov d F.22 Izboljšanje obstoječih zdravstvenih/diagnostičnih metod/postopkov Zastavljen cilj 0 DA O ne Rezultat Dosežen d Uporaba rezultatov V celoti 3 F.23 Razvoj novih sistemskih, normativnih, programskih in metodoloških rešitev Zastavljen cilj O da 0 ne Rezultat 1 d Uporaba rezultatov 1 d F.24 Izboljšanje obstoječih sistemskih, normativnih, programskih in metodoloških rešitev Zastavljen cilj O DA 0 NE Rezultat d Uporaba rezultatov d F.25 Razvoj novih organizacijskih in upravljavskih rešitev Zastavljen cilj O da 0 ne Rezultat Uporaba rezultatov d F.26 Izboljšanje obstoječih organizacijskih in upravljavskih rešitev Zastavljen cilj o da 0 ne Rezultat I d Uporaba rezultatov 1 d F.27 Prispevek k ohranjanju/varovanje naravne in kulturne dediščine Zastavljen cilj O da 0 ne Rezultat d Uporaba rezultatov d F.28 Priprava/organizacija razstave Zastavljen cilj O da 0 ne Rezultat d Uporaba rezultatov 1 d F.29 Prispevek k razvoju nacionalne kulturne identitete Zastavljen cilj O da 0 ne Rezultat I d Uporaba rezultatov 1 d F.30 Strokovna ocena stanja Zastavljen cilj O da 0 ne Rezultat d Uporaba rezultatov 1 d F.31 Razvoj standardov Zastavljen cilj O da 0 ne Rezultat I d Uporaba rezultatov 1 d F.32 Mednarodni patent Zastavljen cilj o da 0 ne Rezultat d Uporaba rezultatov d F.33 Patent v Sloveniji Zastavljen cilj O da 0 ne Rezultat d Uporaba rezultatov d F.34 Svetovalna dejavnost Zastavljen cilj O da 0 ne Rezultat Uporaba rezultatov d F.35 Drugo Zastavljen cilj o da 0 ne Rezultat I d Uporaba rezultatov 1 d Komentar 12.Samo za aplikativne projekte in podoktorske projekte iz gospodarstva! Označite potencialne vplive oziroma učinke vaših rezultatov na navedena področja Vpliv Ni vpliva Majhen vpliv Srednji vpliv Velik vpliv G.01 Razvoj visokošolskega izobraževanja G.01.01. Razvoj dodiplomskega izobraževanja O O 0 O G.01.02. Razvoj podiplomskega izobraževanja o o 0 o G.01.03. Drugo: o o O o G.02 Gospodarski razvoj G.02.01 Razširitev ponudbe novih 0 o O o izdelkov/storitev na trgu G.02.02. Širitev obstoječih trgov 0 O o o G.02.03. Znižanje stroškov proizvodnje 0 O o o G.02.04. Zmanjšanje porabe materialov in energije 0 o o o G.02.05. Razširitev področja dejavnosti 0 o o o G.02.06. Večja konkurenčna sposobnost 0 o o o G.02.07. Večji delež izvoza 0 o o o G.02.08. Povečanje dobička 0 o o o G.02.09. Nova delovna mesta 0 o o o G.02.10. Dvig izobrazbene strukture zaposlenih 0 o o o G.02.11. Nov investicijski zagon 0 o o o G.02.12. Drugo: O o o o G.03 Tehnološki razvoj G.03.01. Tehnološka razširitev/posodobitev dejavnosti 0 o o o G.03.02. Tehnološko prestrukturiranje dejavnosti 0 o o o G.03.03. Uvajanje novih tehnologij 0 o o o G.03.04. Drugo: O o o o G.04 Družbeni razvoj G.04.01 Dvig kvalitete življenja O o o 0 G.04.02. Izboljšanje vodenja in upravljanja 0 o o o G.04.03. Izboljšanje delovanja administracije in javne uprave 0 o o o G.04.04. Razvoj socialnih dejavnosti O o 0 o G.04.05. Razvoj civilne družbe 0 o o o G.04.06. Drugo: O o o o G.05. Ohranjanje in razvoj nacionalne naravne in kulturne dediščine in identitete 0 o o o G.06. Varovanje okolja in trajnostni razvoj 0 o o o G.07 Razvoj družbene infrastrukture G.07.01. Informacijsko-komunikacijska infrastruktura 0 o o o G.07.02. Prometna infrastruktura 0 o o o G.07.03. Energetska infrastruktura 0 o o o G.07.04. Drugo: O o o o G.08. Varovanje zdravja in razvoj zdravstvenega varstva O o o 0 G.09. Drugo: O o o o Komentar 13.Pomen raziskovanja za sofinancerje12 Sofinancer 1. Naziv Univerzitetni klinični center Maribor Naslov Ljubljanska ulica 5, 2000 Maribor Vrednost sofinanciranja za celotno obdobje trajanja projekta je znašala: 27.230,87 EUR Odstotek od utemeljenih stroškov projekta: 25 % Najpomembnejši rezultati raziskovanja za sofinancerja Šifra 1. sodelovanje v multicentričnih raziskavah D.11 2. pobuda za razvoj novih raziskovalnih projektov D.04 3. sodelovanje na kongresih B.04 4. 5. Komentar Ocena Potencialni učinki rezultatov projekta bodo pozitivno vplivali na obravnavo bolnikov z zožitvami karotidnih arterij in na zdravljenje bolnikov z možgansko kapjo. 14.Izjemni dosežek v letu 201213 14.1. Izjemni znanstveni dosežek 14.2. Izjemni družbeno-ekonomski dosežek C. IZJAVE Podpisani izjavljam/o, da: • so vsi podatki, ki jih navajamo v poročilu, resnični in točni • se strinjamo z obdelavo podatkov v skladu z zakonodajo o varstvu osebnih podatkov za potrebe ocenjevanja ter obdelavo teh podatkov za evidence ARRS • so vsi podatki v obrazcu v elektronski obliki identični podatkom v obrazcu v pisni obliki • so z vsebino zaključnega poročila seznanjeni in se strinjajo vsi soizvajalci projekta Podpisi: zastopnik oz. pooblaščena oseba raziskovalne organizacije: Univerzitetni klinični center Maribor in vodja raziskovalnega projekta: Vojko Flis ZIG Kraj in datum: [Maribor |13.3.2013" Oznaka prijave: ARRS-RPROJ-ZP-2013/78 1 Opredelite raziskovalno področje po klasifikaciji FOS 2007 (Fields of Science). Prevajalna tabela med raziskovalnimi področji po klasifikaciji ARRS ter po klasifikaciji FoS 2007 (Fields of Science) s kategorijami WOS (Web of Science) kot podpodročji je dostopna na spletni strani agencije (http://www.arrs.gov.si/sl/gradivo/sifranti/preslik-vpp-fos-wos.asp). Nazaj 2 Napišite povzetek raziskovalnega projekta (največ 3.000 znakov v slovenskem in angleškem jeziku) Nazaj 3 Napišite kratko vsebinsko poročilo, kjer boste predstavili raziskovalno hipotezo in opis raziskovanja. Navedite ključne ugotovitve, znanstvena spoznanja, rezultate in učinke raziskovalnega projekta in njihovo uporabo ter sodelovanje s tujimi partnerji. Največ 12.000 znakov vključno s presledki (približno dve strani, velikost pisave 11). Nazaj 4 Realizacija raziskovalne hipoteze. Največ 3.000 znakov vključno s presledki (približno pol strani, velikost pisave 11) Nazaj 5 V primeru bistvenih odstopanj in sprememb od predvidenega programa raziskovalnega projekta, kot je bil zapisan v predlogu raziskovalnega projekta oziroma v primeru sprememb, povečanja ali zmanjšanja sestave projektne skupine v zadnjem letu izvajanja projekta, napišite obrazložitev. V primeru, da sprememb ni bilo, to navedite. Največ 6.000 znakov vključno s presledki (približno ena stran, velikost pisave 11). Nazaj 6 Navedite znanstvene dosežke, ki so nastali v okviru tega projekta. Raziskovalni dosežek iz obdobja izvajanja projekta (do oddaje zaključnega poročila) vpišete tako, da izpolnite COBISS kodo dosežka - sistem nato sam izpolni naslov objave, naziv, iF in srednjo vrednost revije, naziv FOS področja ter podatek, ali je dosežek uvrščen v A'' ali A'. Nazaj 7 Navedite družbeno-ekonomske dosežke, ki so nastali v okviru tega projekta. Družbeno-ekonomski rezultat iz obdobja izvajanja projekta (do oddaje zaključnega poročila) vpišete tako, da izpolnite COBISS kodo dosežka - sistem nato sam izpolni naslov objave, naziv, IF in srednjo vrednost revije, naziv FOS področja ter podatek, ali je dosežek uvrščen v A'' ali A'. Družbeno-ekonomski dosežek je po svoji strukturi drugačen kot znanstveni dosežek. Povzetek znanstvenega dosežka je praviloma povzetek bibliografske enote (članka, knjige), v kateri je dosežek objavljen. Povzetek družbeno-ekonomskega dosežka praviloma ni povzetek bibliografske enote, ki ta dosežek dokumentira, ker je dosežek sklop več rezultatov raziskovanja, ki je lahko dokumentiran v različnih bibliografskih enotah. COBISS ID zato ni enoznačen, izjemoma pa ga lahko tudi ni (npr. prehod mlajših sodelavcev v gospodarstvo na pomembnih raziskovalnih nalogah, ali ustanovitev podjetja kot rezultat projekta _ - v obeh primerih ni COBISS ID). Nazaj 8 Navedite rezultate raziskovalnega projekta iz obdobja izvajanja projekta (do oddaje zaključnega poročila) v primeru, da katerega od rezultatov ni mogoče navesti v točkah 7 in 8 (npr. ker se ga v sistemu COBISS ne vodi). Največ 2.000 znakov, vključno s presledki. Nazaj 9 Pomen raziskovalnih rezultatov za razvoj znanosti in za razvoj Slovenije bo objavljen na spletni strani: http://sicris.izum.si/ za posamezen projekt, ki je predmet poročanja Nazaj 10 Največ 4.000 znakov, vključno s presledki Nazaj 11 Največ 4.000 znakov, vključno s presledki Nazaj 12 Rubrike izpolnite / prepišite skladno z obrazcem "izjava sofinancerja" http://www.arrs.gov.si/sl/progproj/rproj/gradivo/, ki ga mora izpolniti sofinancer. Podpisan obrazec "Izjava sofinancerja" pridobi in hrani nosilna raziskovalna organizacija - izvajalka projekta. Nazaj 13 Navedite en izjemni znanstveni dosežek in/ali en izjemni družbeno-ekonomski dosežek raziskovalnega projekta v letu 2012 (največ 1000 znakov, vključno s presledki). Za dosežek pripravite diapozitiv, ki vsebuje sliko ali drugo slikovno gradivo v zvezi z izjemnim dosežkom (velikost pisave najmanj 16, približno pol strani) in opis izjemnega dosežka (velikost pisave 12, približno pol strani). Diapozitiv/-a priložite kot priponko/-i k temu poročilu. Vzorec diapozitiva je objavljen na spletni strani ARRS http://www.arrs.gov.si/sl/gradivo/, predstavitve dosežkov za pretekla leta pa so objavljena na spletni strani http://www.arrs.gov.si/sl/analize/dosez/. Nazaj Obrazec: ARRS-RPROJ-ZP/2013 v1.00 10-81-79-2A-DF-68-E3-CC-64-6A-18-A9-04-50-8C-5D-7E-BD-0E-92 MEDICINA Področje: 3.06 Srce in ožilje Objava v Lancet - sodelovanje v multicentrični raziskavi (Vojko Flis) Pu&Med Central Lancet PiibHdied a:: 2CliOi SEptembar 25; 107^1034. 10-yedr Stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1): a multicentre randomised trial Alison Ha I i day® Michael Harris on®, Elizabeth Hayter'^'^, Xiargling Kong'^, Averil Mansfield^, Joarna Marro^, Hongchao Pari'^, Richard Peto'^, John Potter'^, Kazem Rahimi'^:'^ Angela Rau' Steven Robertson^, Jonathan StreifleH, Dafydd Thomas^, and on behalf of the Asymptomatic Carotid Sjrgery Trial (ACST) Collaborative Groupt ^Nuffield DeDartment of Surgical Sciences, John Radcliffe Hospital. O?(fiord, UK Findings—lifiO ?a.tLa=.t^ w^ze .iLLo-E.ited imr^ediate CEA vei-iua 1560 ^LLoc^ted dsfaria] of auy c5iT(JtLd.p:ocedjiie. Tlia propoLtioiii -Dpeintad ooi-whiLe itLlL aivniptoniadc ware 4 S^n 17.ie5i' (nud 91iyn i-j at i yean). Feii-Dp^Titi^ e risi: of stroltE oi' de:.tli WLtbi:: S'O' wa: ^■O^n ^n C3 26 ri)Cni-dL::ib]iziE "^L-ake"] plu:: 34 ci^-ablio^ -ai' fatal pajLOTHiätr.Te E^ euJt'] in CEAa). EscLadmE peiiopei.iLva ec.Teiiti .lud uou-^tiToke moitaLLt^', :-tLiQke mi: (icmiediate I'j dafeiTed CEA) ware 4-1% vHiim lO O^b it 3 ™t-: (sain 5-9%, 95% CI 4 0-7 S) sud 10 3% -^-aiiui lS-9% at lO^-esi-. (s.^iu initio csf stfoka iticiefencfi latei 0 i4, 95% CI 0-43-0-öS, p=:0 0001. 62 ^^-sLis IC4 had a disablizE -utr fatal 'jwsks, sud 37 ■■.T&mü £4 otliei-:. hada uon-dL^iablLLLs itrofce. CcsmbiziLiiE periopei^rtr^^ sveavj. .-Hiid i^tnoikeD, uet risfci n VETius IO-S^- d at S 2 and vei-iU3 at 10 yEai- 1-2-7-9). MedicatioLi-nai iimilar iu both ^o'^p:: ttuous^-DUT tbe study, iLio:t ^veLE on ajitLthronbc-ti-E ;aid .iLLtih^TJEirteLL-si^-E liaräpy. Net bEue^Ti ware ^iEii:fi-car.tbotb foi tb-D^e ou lipid-IowEiTns i^aiäpy aud Doi tb(Jia not, .^iid botb foL nieoj and foi wolüed iip- to 75 yiaai L of ase at eiitiy (aItLo-\:EL not fba' oldei p.'HLeLLTi). Interpretation—SuccsüfuL CEA fbr aryoiptonati-E p.^tieuT^- yomiEei- thaa 75 yeaiT; of .ig'a radiicE: lO-yeai' ^tioke risi:::. Halftli:^ laductior. is mdi^.^bliuE ol fatal str-nkci. Net benefit in futmie patiar.ts will depend on tbeir riifc: &dzi Jicspeiated canorid lESLoni. fabicL'wil] be ned^cac. b>' madicatiori). on fiitiiiE ^ JEical Li:l;i (wLidiuii^t dif^ei fr-om. tbo^e in tiijils), and on'wbjatbei lit"e Escpectanc^' eMeedr; lOyeaiTi.