Coagulation, fibrinolysis, and platelet activation in patients undergoing open and endovascular repair of abdominal aortic aneurysm

Journal of Vascular Surgery

Volumn 54, Issue 3, 2011, Pages 865-878

  Davies, Robert S M ^a   Abdelhamid, Mohamed ^a   Wall, Michael L ^a   Vohra, Rajiv K ^a   Bradbury, Andrew W ^a   Adam, Donald J ^a  

^a UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ACTIVATED PROTEIN C; ANTITHROMBIN III; BIOLOGICAL MARKER; D DIMER; FIBRIN; FIBRIN MONOMER; FIBRINOGEN; FIBRINOGEN DEGRADATION PRODUCT; PLASMIN INHIBITOR; PLASMINOGEN ACTIVATOR INHIBITOR 1; PLASMINOGEN ACTIVATOR INHIBITOR 3; PROTHROMBIN; THROMBIN; THROMBIN ANTITHROMBIN COMPLEX; TISSUE FACTOR PATHWAY INHIBITOR; TISSUE PLASMINOGEN ACTIVATOR;

ABDOMINAL AORTA ANEURYSM; BLOOD CLOTTING; BLOOD CLOTTING DISORDER; BLOOD LEVEL; COCHRANE LIBRARY; COMPLEX FORMATION; EMBASE; ENDOVASCULAR ANEURYSM REPAIR; FIBRINOLYSIS; FOLLOW UP; HEMOSTASIS; HUMAN; MEDLINE; PERIOPERATIVE PERIOD; PRIORITY JOURNAL; REVIEW; THROMBOCYTE ACTIVATION; THROMBOCYTE COUNT; THROMBOSIS; THROMBUS; VASCULAR SURGERY;

EID: 80052552645     PISSN: 07415214     EISSN: 10976809     Source Type: Journal    
DOI: 10.1016/j.jvs.2011.04.010     Document Type: Article

References (88)

1. A.E. Seyfer, A.V. Seaber, F.A. Dombrose, and J.R. Urbaniak Coagulation changes in elective surgery and trauma Ann Surg 193 1981 210 213 (Pubitemid 11153106)
2. M.T. Knight, R. Dawson, and D.G. Melrose Fibrinolytic response to surgery Labile and stable patterns and their relevance to post-operative deep venous thrombosis Lancet 2 1977 370 373 (Pubitemid 8164395)
3. M.D. McDaniel, W.H. Pearce, J.S. Yao, E.C. Rossi, V.A. Fahey, and D. Green Sequential changes in coagulation and platelet function following femorotibial bypass J Vasc Surg 1 1984 261 268 (Pubitemid 15061407)
4. G.J. Collins Jr, J.A. Barber, R. Zajtchuk, D. Vanek, and L.A. Malogne The effects of operative stress on the coagulation profile Am J Surg 133 1977 612 616 (Pubitemid 8105332)
5. K.R. Woodburn, A. Rumley, G.D. Lowe, and J.G. Pollock Fibrinogen and markers of fibrinolysis and endothelial damage following resolution of critical limb ischaemia Eur J Vasc Endovasc Surg 10 1995 272 278
6. D. Ro, E. Zekanowska, M. Kotschy, W. Hryncewicz, and M. Jurkowska [Effect of vascular surgery on values of thrombin-antithrombin III complexes in patients with atherosclerosis of lower limb arteries] [Article in Polish] Pol Tyg Lek 49 1994 360 362
7. O. Naesh, J.T. Friis, I. Hindberg, and K. Winther Platelet function in surgical stress Thromb Haemost 54 1985 849 852 (Pubitemid 16179931)
8. A.W. Bradbury, D.J. Adam, K.R. Makhdoomi, W.P. Stuart, J.A. Murie, and A.M. Jenkins A 21-year experience of abdominal aortic aneurysm operations in Edinburgh Br J Surg 85 1998 645 647 (Pubitemid 28247538)
9. A. Dardik, J.W. Lin, T.A. Gordon, G.M. Williams, and B.A. Perler Results of elective abdominal aortic aneurysm repair in the 1990s: a population-based analysis of 2335 cases J Vasc Surg 30 1999 985 995
10. A. Kazmers, L. Jacobs, A. Perkins, S.M. Lindenauer, and E. Bates Abdominal aortic aneurysm repair in Veterans Affairs medical centers J Vasc Surg 23 1996 191 200 (Pubitemid 26070706)
11. R.D. Sayers, M.M. Thompson, A. Nasim, P. Healey, N. Taub, and P.R. Bell Surgical management of 671 abdominal aortic aneurysms: a 13 year review from a single centre Eur J Vasc Endovasc Surg 13 1997 322 327 (Pubitemid 27170890)
12. A.D. Dueck, D.S. Kucey, K.W. Johnston, D. Alter, and A. Laupacis Long-term survival and temporal trends in patient and surgeon factors after elective and ruptured abdominal aortic aneurysm surgery J Vasc Surg 39 2004 1261 1267 (Pubitemid 38952595)
13. C. Galle, V. De Maertelaer, S. Motte, L. Zhou, P. Stordeur, and J.P. Delville Early inflammatory response after elective abdominal aortic aneurysm repair: a comparison between endovascular procedure and conventional surgery J Vasc Surg 32 2000 234 246 (Pubitemid 30644936)
14. D.J. Adam, C.A. Ludlam, C.V. Ruckley, and A.W. Bradbury Coagulation and fibrinolysis in patients undergoing operation for ruptured and nonruptured infrarenal abdominal aortic aneurysms J Vasc Surg 30 1999 641 650 (Pubitemid 29487557)
15. EVAR trial participants Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1): randomised controlled trial Lancet 365 2005 2179 2186
16. R.M. Greenhalgh, L.C. Brown, G.P. Kwong, J.T. Powell, and S.G. Thompson EVAR trial participants Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial Lancet 364 2004 843 848
17. EVAR trial participants Endovascular aneurysm repair and outcome in patients unfit for open repair of abdominal aortic aneurysm (EVAR trial 2): randomised controlled trial Lancet 365 2005 2187 2192
18. M. Prinssen, E.L. Verhoeven, J. Buth, P.W. Cuypers, M.R. van Sambeek, and R. Balm A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms N Engl J Med 351 2004 1607 1618 (Pubitemid 39350421)
19. P. Swartbol, L. Norgren, U. Albrechtsson, W. Cwikiel, J. Jahr, and T. Jonung Biological responses differ considerably between endovascular and conventional aortic aneurysm surgery Eur J Vasc Endovasc Surg 12 1996 18 25 (Pubitemid 26261552)
20. L. Englberger, H. Savolainen, P. Jandus, M. Widmer, D. Do do, and A. Haeberli Activated coagulation during open and endovascular abdominal aortic aneurysm repair J Vasc Surg 43 2006 1124 1129 (Pubitemid 43825684)
21. P. Swartbol, L. Truedsson, and L. Norgren Adverse reactions during endovascular treatment of aortic aneurysms may be triggered by interleukin 6 release from the thrombotic content J Vasc Surg 28 1998 664 668 (Pubitemid 28481221)
22. H. Zhang, C.M. Holt, N. Malik, L. Shepherd, and S.K. Morcos Effects of radiographic contrast media on proliferation and apoptosis of human vascular endothelial cells Br J Radiol 73 2000 1034 1041
23. R. Polanowska, M. Wilczyska, W. Slawiski, J.H. Goch, W. Augustyniak, and C.S. Cierniewski Changes in platelet activity and tissue plasminogen activator during arteriography in patients with chronic limb ischaemia Thromb Res 65 1992 663 665
24. Centre for Evidence-Based Medicine Levels of evidence and grades of recommendations 2002 Research and Development Oxford
25. R. Adolph, D.A. Vorp, D.L. Steed, M.W. Webster, M.V. Kameneva, and S.C. Watkins Cellular content and permeability of intraluminal thrombus in abdominal aortic aneurysm J Vasc Surg 25 1997 916 926 (Pubitemid 27227689)
26. E.J. Gibney, and D. Bouchier-Hayes Coagulopathy and abdominal aortic aneurysm Eur J Vasc Surg 4 1990 557 562
27. V. Fontaine, M.P. Jacob, X. Houard, P. Rossignol, D. Plissonnier, and E. Angles-Cano Involvement of the mural thrombus as a site of protease release and activation in human aortic aneurysms Am J Pathol 161 2002 1701 1710 (Pubitemid 35265529)
28. T.W. Carrell, K.G. Burnand, N.A. Booth, J. Humphries, and A. Smith Intraluminal thrombus enhances proteolysis in abdominal aortic aneurysms Vascular 14 2006 9 16
29. J. Danesh, S. Lewington, S.G. Thompson, G.D. Lowe, R. Collins Fibrinogen Studies Collaboration Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis JAMA 294 2005 1799 1809 (Pubitemid 41434626)
30. E. Ernst Plasma fibrinogenan independent cardiovascular risk factor J Intern Med 227 1990 365 372 (Pubitemid 20192114)
31. F.B. Smith, A.B. Lee, F.G. Fowkes, J.F. Price, A. Rumley, and G.D. Lowe Hemostatic factors as predictors of ischemic heart disease and stroke in the Edinburgh Artery Study Arterioscler Thromb Vasc Biol 17 1997 3321 3325 (Pubitemid 28016094)
32. J.A. Dormandy, E. Hoare, J. Colley, D.E. Arrowsmith, and T.L. Dormandy Clinical, haemodynamic, rheological, and biochemical findings in 126 patients with intermittent claudication Br Med J 4 1973 576 581
33. T.W. Meade, S. Mellows, M. Brozovic, G.J. Miller, R.R. Chakrabarti, and W.R. North Haemostatic function and ischaemic heart disease: principal results of the Northwick Park Heart Study Lancet 2 1986 533 537 (Pubitemid 16054632)
34. W.B. Kannel, P.A. Wolf, W.P. Castlli, and R.B. D'Agostino Fibrinogen and risk of cardiovascular disease The Framingham Study JAMA 258 1987 1183 1186
35. F.G. Fowkes, C.L. Anandan, A.J. Lee, F.B. Smith, I. Tzoulaki, and A. Rumley Reduced lung function in patients with abdominal aortic aneurysm is associated with activation of inflammation and hemostasis, not smoking or cardiovascular disease J Vasc Surg 43 2006 474 480 (Pubitemid 43332728)
36. H.S. Al-Barjas, R. Arins, P. Grant, and J.A. Scott Raised plasma fibrinogen concentration in patients with abdominal aortic aneurysm Angiology 57 2006 607 614 (Pubitemid 44564317)
37. A. Holmberg, D. Bergqvist, B. Westman, and A. Siegbahn Cytokine and fibrinogen response in patients undergoing open abdominal aortic aneurysm surgery Eur J Vasc Endovasc Surg 17 1999 294 300 (Pubitemid 29141372)
38. A.D. Blann, C. Devine, J. Amiral, and C.N. McCollum Soluble adhesion molecules, endothelial markers and atherosclerosis risk factors in abdominal aortic aneurysm: a comparison with claudicants and healthy controls Blood Coagul Fibrinolysis 9 1998 479 484 (Pubitemid 28508788)
39. K. Singh, K.H. Bønaa, B.K. Jacobsen, L. Bjørk, and S. Solberg Prevalence of and risk factors for abdominal aortic aneurysms in a population-based study: the Tromsø Study Am J Epidemiol 154 2001 236 244 (Pubitemid 32701159)
40. S. Shindo, H. Matsumoto, K. Kubota, A. Kojima, M. Matsumoto, and K. Satoh Is the size of an abdominal aortic aneurysm associated with coagulopathy? World J Surg 29 2005 925 929 discussion 929 (Pubitemid 41800730)
41. K. Yamazumi, M. Ojiro, H. Okumura, and T. Aikou An activated state of blood coagulation and fibrinolysis in patients with abdominal aortic aneurysm Am J Surg 175 1998 297 301 (Pubitemid 28183553)
42. A. Hosaka, T. Miyata, H. Aramoto, H. Shigematsu, T. Nakazawa, and H. Okamoto Clinical implication of plasma level of soluble fibrin monomer-fibrinogen complex in patients with abdominal aortic aneurysm J Vasc Surg 42 2005 200 205 (Pubitemid 41139221)
43. D.J. Adam, P.C. Haggart, C.A. Ludlam, and A.W. Bradbury Hemostatic markers before operation in patients with acutely symptomatic nonruptured and ruptured infrarenal abdominal aortic aneurysm J Vasc Surg 35 2002 661 665
44. A.J. Lee, F.G. Fowkes, G.D. Lowe, and A. Rumley Haemostatic factors, atherosclerosis and risk of abdominal aortic aneurysm Blood Coagul Fibrinolysis 7 1996 695 701 (Pubitemid 26392162)
45. M.M. Jelenska, J. Szmidt, K. Bojakowski, T. Grzela, and M. Palester-Chlebowczyk Compensated activation of coagulation in patients with abdominal aortic aneurysm: effects of heparin treatment prior to elective surgery Thromb Haemost 92 2004 997 1002 (Pubitemid 39545522)
46. D.F. Fisher Jr, D.H. Yawn, and E.S. Crawford Preoperative disseminated intravascular coagulation associated with aortic aneurysms A prospective study of 76 cases Arch Surg 118 1983 1252 1255 (Pubitemid 13022372)
47. D.J. Parry, H.S. Al-Barjas, L. Chappell, T. Rashid, R.A. Arins, and D.J. Scott Haemostatic and fibrinolytic factors in men with a small abdominal aortic aneurysm Br J Surg 96 2009 870 877
48. E.P. Brass, W.B. Forman, R.V. Edwards, and O. Lindan Fibrin formation: the role of the fibrinogen-fibrin monomer complexes Thromb Haemost 36 1976 37 48
49. K. Nakahara, Y. Kazahaya, Y. Shintani, K. Yamazumi, Y. Eguchi, and S. Koga Measurement of soluble fibrin monomer-fibrinogen complex in plasmas derived from patients with various underlying clinical situations Thromb Haemost 89 2003 832 836 (Pubitemid 36603425)
50. A. Holmberg, A. Siegbahn, B. Westman, and D. Bergqvist Ischaemia and reperfusion during open abdominal aortic aneurysm surgery induce extensive thrombin generation and activity Eur J Vasc Endovasc Surg 18 1999 11 16 (Pubitemid 29373630)
51. J. Wallinder, D. Bergqvist, and A.E. Henriksson Haemostatic markers in patients with abdominal aortic aneurysm and the impact of aneurysm size Thromb Res 124 2009 423 426
52. A. Ihara, T. Kawamoto, K. Matsumoto, J. Kawamoto, A. Katayama, and M. Yoshitatsu Relationship between hemostatic markers and circulating biochemical markers of collagen metabolism in patients with aortic aneurysm Pathophysiol Haemost Thromb 33 2003 221 224 (Pubitemid 39664142)
53. A. Wanhainen, T.K. Nilsson, D. Bergqvist, K. Boman, and M. Björck Elevated tissue plasminogen activator in patients with screening-detected abdominal aortic aneurysm J Vasc Surg 45 2007 1109 1113 (Pubitemid 46817837)
54. F. Sofi, R. Marcucci, B. Giusti, G. Pratesi, B. Lari, and I. Sestini High levels of homocysteine, lipoprotein (a) and plasminogen activator inhibitor-1 are present in patients with abdominal aortic aneurysm Thromb Haemost 94 2005 1094 1098 (Pubitemid 41645954)
55. N.A. Nelken, S.J. Soifer, J. O'Keefe, T.K. Vu, I.F. Charo, and S.R. Coughlin Thrombin receptor expression in normal and atherosclerotic human arteries J Clin Invest 90 1992 1614 1621
56. A. Haeberli Prothrombin fragment; F1+2 J. Jespersen, R.M. Bertina, F. Haverkater, Laboratory techniques in thrombosis - a manual 1999 Kluwer Dordrecht-Boston-London 217 222
57. H.K. Lau, and R.D. Rosenberg The isolation and characterization of a specific antibody population directed against the thrombin antithrombin complex J Biol Chem 255 1980 5885 5893
58. C.T. Esmon, and W.G. Owen The discovery of thrombomodulin J Thromb Haemost 2 2004 209 213 (Pubitemid 40186031)
59. R.A. Marlar, A.J. Kleiss, and J.H. Griffin Mechanism of action of human activated protein C, a thrombin-dependent anticoagulant enzyme Blood 59 1982 1067 1072 (Pubitemid 12125601)
60. B. Dahlbck, and B.O. Villoutreix The anticoagulant protein C pathway FEBS Lett 579 2005 3310 3316 (Pubitemid 40804679)
61. K. Strandberg, M. Kjellberg, R. Knebel, H. Lilja, and J. Stenflo A sensitive immunochemical assay for measuring the concentration of the activated protein C-protein C inhibitor complex in plasma: use of a catcher antibody specific for the complexed/cleaved form of the inhibitor Thromb Haemost 86 2001 604 610 (Pubitemid 32743273)
62. T. Kölbel, K. Strandberg, I. Mattiasson, J. Stenflo, and B. Lindblad Activated protein C-protein C inhibitor complex: a new biological marker for aortic aneurysms J Vasc Surg 43 2006 935 939
63. M.J. Hickey, S.A. Williams, and G.J. Roth Human platelet glycoprotein IX: an adhesive prototype of leucine-rich glycoproteins with flank-center-flank structures Proc Natl Acad Sci U S A 86 1989 6773 6777
64. B. Savage, S.J. Shattil, and Z.M. Ruggeri Modulation of platelet function through adhesion receptors A dual role for glycoprotein IIb-IIIa (integrin alpha IIb beta 3) mediated by fibrinogen and glycoprotein Ib-von Willebrand factor J Biol Chem 267 1992 11300 11306
65. A.A. Milne, D.J. Adam, W.G. Murphy, and C.V. Ruckley Effects of asymptomatic abdominal aortic aneurysm on the soluble coagulation system, platelet count and platelet activation Eur J Vasc Endovasc Surg 17 1999 434 437 (Pubitemid 29213518)
66. H. Mukaiyama, S. Shionoya, T. Ikezawa, T. Kamiya, M. Hamaguchi, and H. Saito Abdominal aortic aneurysm complicated with chronic disseminated intravascular coagulopathy: a case of surgical treatment J Vasc Surg 6 1987 600 604 (Pubitemid 18018002)
67. J.E. Fox Shedding of adhesion receptors from the surface of activated platelets Blood Coagul Fibrinolysis 5 1994 291 304 (Pubitemid 24138066)
68. P.S. Aho, T. Niemi, A. Piilonen, R. Lassila, R. Renkonen, and M. Lepntalo Interplay between coagulation and inflammation in open and endovascular abdominal aortic aneurysm repair - impact of intra-aneurysmal thrombus Scand J Surg 96 2007 229 235 (Pubitemid 47535738)
69. T. Kölbel, K. Strandberg, T. Donath, I. Mattiasson, J. Stenflo, and B. Lindblad Activated protein C-protein C inhibitor complex in patients with abdominal aortic aneurysms: is it associated with diameter and growth rate? Vasc Endovascular Surg 42 2008 135 140 (Pubitemid 351550919)
70. T. Kölbel, T. Donath, K. Strandberg, D. Flondell-Sité, T. Khme, and A. Gottster Is increased thrombin activation in patients with abdominal aortic aneurysms dependent on area or volume of aneurysm thrombus mass? Angiology 61 2010 113 118
71. X.F. Wang, L. Liu, T.O. Cheng, Z.A. Li, Y.B. Deng, and J.E. Wang The relationship between intracardiovascular smoke-like echo and erythrocyte rouleaux formation Am Heart J 124 1992 961 965
72. J.J. Hwang, F.N. Ko, Y.H. Li, H.M. Ma, G.J. Wu, and H. Chang Clinical implications and factors related to left atrial spontaneous echo contrast in chronic nonvalvular atrial fibrillation Cardiology 85 1994 69 75 (Pubitemid 24241076)
73. L.A. Killewich, R.F. Macko, A.W. Gardner, K. Cox, M.P. Lilly, and W.R. Flinn Defective fibrinolysis occurs after infrainguinal reconstruction J Vasc Surg 25 1997 858 864 discussion 865
74. H. Prsson, A. Holmberg, A. Siegbahn, and D. Bergqvist Activation of coagulation and fibrinolytic systems in patients with CLI is not normalized after surgical revascularisation Eur J Vasc Endovasc Surg 27 2004 186 192 (Pubitemid 38111687)
75. B.A. Perler, R. Christopherson, B.A. Rosenfeld, E.J. Norris, S. Frank, and C. Beattie The influence of anesthetic method on infrainguinal bypass graft patency: a closer look Am Surg 61 1995 784 789
76. A. Holmberg, D. Bergqvist, and A. Siegbahn Coagulation and fibrinolysis after open infrarenal abdominal aortic aneurysm repair in a long-term perspective Thromb Res 96 1999 99 105 (Pubitemid 29502210)
77. M. Monaco, L. Di Tommaso, P. Stassano, R. Smimmo, V. De Amicis, and A. Pantaleo Impact of blood coagulation and fibrinolytic system changes on early and mid term clinical outcome in patients undergoing stent endografting surgery Interact Cardiovasc Thorac Surg 5 2006 724 728 (Pubitemid 44901232)
78. A. Odegrd, J. Lundbom, H.O. Myhre, S. Hatlinghus, K. Bergh, and A. Waage The inflammatory response following treatment of abdominal aortic aneurysms: a comparison between open surgery and endovascular repair Eur J Vasc Endovasc Surg 19 2000 536 544 (Pubitemid 30333084)
79. F. Serino, D. Abeni, E. Galvagni, S.G. Sardella, A. Scuro, and M. Ferrari Noninvasive diagnosis of incomplete endovascular aneurysm repair: D-dimer assay to detect type I endoleaks and nonshrinking aneurysms J Endovasc Ther 9 2002 90 97 (Pubitemid 34263902)
80. W. Speiser, P. Speiser, E. Minar, C. Korniger, H. Niessner, and K. Huber Activation of coagulation and fibrinolysis in patients with arteriosclerosis: relation to localization of vessel disease and risk factors Thromb Res 59 1990 77 88 (Pubitemid 20274746)
81. A. Strano, D. Hoppensteadt, J.M. Walenga, J. Fareed, C. Sabbá, and E. Berardi Plasma levels of the molecular markers of coagulation and fibrinolysis in patients with peripheral arterial disease Semin Thromb Hemost 22 Suppl 1 1996 35 40 (Pubitemid 26268421)
82. M. Koksch, F. Zeiger, K. Wittig, A. Siegemund, C.B. Reininger, and D. Pfeiffer Coagulation, fibrinolysis and platelet P-selectin expression in peripheral vascular disease Eur J Vasc Endovasc Surg 21 2001 147 154 (Pubitemid 32243908)
83. M. Kristiansson, M. Soop, L. Saraste, and K.G. Sundqvist Cytokines in stored red blood cell concentrates: promoters of systemic inflammation and simulators of acute transfusion reactions? Acta Anaesthesiol Scand 40 1996 496 501 (Pubitemid 26151562)
84. Y. Hashimoto, A. Kobayashi, N. Yamazaki, Y. Sugawara, Y. Takada, and A. Takada Relationship between age and plasma t-PA, PA-inhibitor, and PA activity Thromb Res 46 1987 625 633 (Pubitemid 17085250)
85. J.G. van der Bom, M.L. Bots, H.H. van Vliet, H.A. Pols, A. Hofman, and D.E. Grobbee Antithrombin and atherosclerosis in the Rotterdam Study Arterioscler Thromb Vasc Biol 16 1996 864 867 (Pubitemid 26234984)
86. J. Barani, A. Gottster, I. Mattiasson, and B. Lindblad Platelet and leukocyte activation during aortoiliac angiography and angioplasty Eur J Vasc Endovasc Surg 23 2002 220 225 (Pubitemid 41079461)
87. A. Namiki, H. Toma, M. Nakamura, K. Matsuda, H. Hara, and H. Hara Hemostatic and fibrinolytic activation is less following cutting balloon angioplasty of the coronary arteries Jpn Heart J 45 2004 409 417 (Pubitemid 41518884)
88. M. Tschopl, D.A. Tsakiris, G.A. Marbet, K.H. Labs, and K. Jger Role of hemostatic risk factors for restenosis in peripheral arterial occlusive disease after transluminal angioplasty Arterioscler Thromb Vasc Biol 17 1997 3208 3214 (Pubitemid 28016079)