Factors influencing the effect on employment status were investigated in 250 patients (males: females 224:26) who underwent coronary artery bypass surgery between March 1983 and November 1985. The median age at operation was 57.9 (range 36.6-69.4) years and the median follow-up time 32 (19-52) months. Preoperatively 149 patients (59.6%) were receiving sick pay or disability pension because of their heart disease. Only 64 (25.6%) were gainfully employed, in contrast to 97 (38.8%) at follow-up. Of those who were working at the time of operation, all but eight returned to work postoperatively. At follow-up 183 (80.3%) were free from symptoms or much improved, with degree of improvement somewhat greater in those who were working postoperatively. The period of sick leave and the preoperative waiting time were significantly shorter for patients who were working postoperatively than for those who were awarded disability pension. Age, previous myocardial infarction, duration of preoperative angina and type of work were also found to influence postoperative employment status.

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The study was an attempt to evaluate the benefit of intravascular ultrasound imaging (IVUS) as a supplement to follow-up angiography after endovascular stent implantation. A consecutive series of 15 patients underwent stent implantation in the peripheral or coronary arteries. Ten Palmaz stents, 3 Palmaz-Schatz stents and 2 Wallstents were used. After a period from 1 to 6 months (mean 3.2 months) follow-up angiography was performed. In 12 cases the angiography was combined with IVUS of the stent and the adjacent vessel segments. In one case IVUS failed due to the tortuous course of the vessel, in another case the stent was occluded, and in one case IVUS was considered too hazardous. In stents of diameter ≥5 mm, ultrasound (US) did not reveal more information concerning vessel and stent diameter, stent stenosis and intraluminal surface contact than angiography alone. Smaller stents were insufficiently visualized by conventional radiologic methods. In small stents only IVUS permitted an exact stent identification and differentiation between stent stenosis and stenosis of the native vessel. At US imaging artifacts, caused by the highly reflectant metallic stent struts, interfered with the native vessel wall and partly obscured its structural details.

In vitro experiments were performed in order to investigate the appearance of different types of central venous catheters at intravascular ultrasonography. The experiments were repeated with artificially produced thrombi which were made adherent to the catheter wall. All thrombi larger than I mm could be identified. In a clinical study including 12 patients who had a central venous catheter, transfemoral intravascular ultrasonography was performed. The catheters had been in place for an average period of 54 days (range 1-360 days). In 3 patients a catheter thrombus, mural thrombus, or occlusive vein thrombosis was found. In 2 of these patients the catheter was occluded, in the 3rd patient it was malpositioned into the contralateral brachiocephalic vein. There were no complications following the ultrasonographic procedures. Mean catheterization time was 7.5 min (range 3-20 min). The advantages of this new method compared with conventional phlebographic studies and its impact on further clinical investigations are discussed.