Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A growing proportion of over 65-year-old persons in the population will increasingly confront physicians with peripheral arterial occlusive disease. Intermittent claudication is the characteristic symptom of stage II disease at which most patients consult their physician. Known risk factors like cigarette smoking, diabetes, hypertension and hyperlipidemia have to be assessed. Manifestations of atherosclerosis in other vascular beds such as carotids and coronaries should be sought. Clinical angiologic evaluation with inspection, palpation of pulses, auscultation of vessels at rest and after exercise as well as measurement of the walking distance permits assessment of peripheral perfusion quite well. Oscillography and Doppler-sonography are increasingly used. Duplex-scanning can replace angiography in many cases. Conventional and digital subtraction-angiography have their specific uses. Diagnostic and therapeutic measures recommended for peripheral arterial occlusive disease are summarized.
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PMID:[Rational approach to peripheral arterial occlusive diseases]. 227 Mar 76

The treatment of intermittent claudication in our polyclinic is fivefold: general treatment of atherosclerosis including: suppression of nicotine intoxication, animal fats free diet replaced by vegetal diet (fish permitted) supply of vitamins B and C. Local treatment: increase of the vascularisation by: leg muscles exercises; frequently repeated intra-arterial injections, in the femoral artery, of 1 p. cent lidocaine which tend to decrease the vascular tone permanently by systematic destruction of the intramural sympathetic nodes (according to Henri Reboul).
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PMID:[Intermittent claudication. Its direct treatment using intra-arterial injections]. 235 38

A mathematic model is created to determine the economic cost per year of anticipated prolongation of life that would result from a program of abdominal ultrasonographic (US) screening for abdominal aortic aneurysm. The protocol involves US screening at age 60, 67, and 74 years with additional annual follow-up US and examination if an aneurysm of less than 40 mm is detected. Larger aneurysms are assumed to be sent for early elective resection. The benefits and risks for a subset of men with symptoms of intermittent claudication (IC) as an additional risk factor of atherosclerosis is calculated for comparison. Many of the factors on which these calculated costs and benefits are based are approximations and inferences. These include operative mortality for elective and emergent cases, charges for each such condition, cost of US, and anticipated survival following successful aneurysmectomy both with and without concomitant IC. Sensitivity analysis is performed to show how variations in the major parameters alter the outcome of the calculated cost per year of anticipated extension of life.
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PMID:Ultrasonographic screening for abdominal aortic aneurysm: analysis of surgical decisions for cost-effectiveness. 250 Jul 80

Laser-assisted angioplasty has been used on 47 occasions in 45 patients for the management of atherosclerosis of the superficial femoral and proximal popliteal arteries. Twenty-four procedures were performed to treat disabling intermittent claudication and 23 procedures were performed for a "threatened limb" (rest pain, ischaemic ulceration or digital gangrene). Technical success was achieved in 40 (85%) cases; the mean length of occluded segment was 7.7 cm. The presence of heavily calcified occlusions contributed significantly (P less than 0.001) to technical failure. In 28 (70%) of the successfully treated cases, the recanalized arteries were patent at one month and in 21 (53%) cases they have remained patent during the follow-up period. In five of nine cases with a nine-month follow-up, the arteries still were patent. The mean length of the occluded segments that were treated initially was 7.1 cm in those that remained patent compared with 8.2 cm in those that reoccluded. Thirty-six (77%) patients were discharged from hospital on the day after the procedure. Laser-assisted angioplasty is a promising new technique that is applied best to short-segment, non-calcified occlusions and should reduce the requirement for femoropopliteal arterial bypass surgery.
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PMID:Early experiences with laser-assisted thermal angioplasty for peripheral vascular disease. 252 19

Since 1980, we have applied lasers experimentally in the following three categories in the fields of cardiovascular surgery. That is, Group 1: New myocardial revascularization in the patients whose coronary arteries are too small or diffuse due to atherosclerosis, Group 2: Laser vascular anastomosis especially for small-caliber vessels, such as coronary artery bypass grafting, Group 3: Laser angioplasty for obstructive arterial disease. Subsequently, efficacy of laser application could be obviously recognized in these fields. On the basis of excellent results of our experimental studies, laser was clinically employed for 112 patients with anginal pain, intermittent claudication and renal failure. They consisted of new myocardial revascularization in one case and vascular anastomosis in 89 cases including 7 cases (LIMA-LAD2, SVG-LAD5) of the coronary artery bypass grafting and laser angioplasty in 22 cases including 5 cases (LAD3, RCA2) of intraoperative laser coronary angioplasty. Optimal conditions of vascular anastomosis were 20-40mW in output and 6-12sec/mm in irradiation time. On the other hand, optimal conditions for laser angioplasty were 6 watts in output and 3sec in irradiation time for each shot. Laser irradiation was carefully repeated according to the grade of atherosclerotic changes. These patients are doing well without any complications throughout laser. Our experimental and clinical experiences of laser application in the fields of the cardiovascular surgery were presented in detail.
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PMID:[Experimental and clinical studies on the laser application in the cardiovascular surgery; analysis of clinical experience of 112 patients]. 258 72

Laser Doppler flowmetry (LDF) was used to evaluate skin post-ischaemic reactive hyperaemia. Four groups of subjects were examined: healthy young and elderly controls (groups A and B) and patients with intermittent claudication or critical ischaemia (groups C and D). The occlusion tourniquet was placed just proximal to the patella, and measurements were performed on the toe pulp (study 1) and leg skin (study 2). The hyperaemic response on both pulp and leg skin was delayed, diminished and prolonged in claudicators compared with controls. On the toe pulp most patients with critical ischaemia had no hyperaemic response at all, indicating that the local vasodilatory capacity was exhausted at rest. The time from tourniquet deflation to pulp peak hyperaemia was the parameter that most clearly separated between the groups [Group A: 21.5 secs (median), group B: 17 secs, group C: 73 secs and group D: greater than 300 secs]. The time from tourniquet deflation to the first increase in flux is probably dependent on hemodynamic factors in the large extremity vessels, and it is possible that this parameter could be used to define levels of hemodynamic significant stenosis in patients with lower limb atherosclerosis. The results also indicate that laser Doppler flowmetry performed during stress testing may be of value in determining appropriate amputation levels.
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PMID:Laser Doppler flowmetry in evaluation of skin post-ischaemic reactive hyperaemia. A study in healthy volunteers and atherosclerotic patients. 264 62

Multiple risk factors interplay in the formation of foot ulceration and/or limb amputation in the diabetic patient. This study defines the prevalence of foot pathology, lower extremity complications, and known risk factors for ulceration in a cross-sectional analysis of 92 diabetic patients in a Veterans Affairs Metabolic Clinic. Sixteen percent of patients had a history of lower extremity complications including pedal ulceration and/or amputation, previously requiring 1480 hospital days of care. Sixty-eight percent of patients had structural pathology in the foot, including: 51 percent callus, 32 percent hammertoes, 8 percent bunions, and 1 percent Charcot foot. Thirty-four percent of patients were insensate, while 25 percent had autonomic neuropathy. Twenty-two percent of patients had atherosclerosis obliterans as defined by an ankle brachial index less than 0.9; 13 percent suffered from intermittent claudication. The following pathologies were significantly more prevalent in diabetic patients with a history of ulceration and/or amputation compared to those patients without ulceration or amputation: hammertoe deformity (p less than .0001), abnormal cutaneous pressure sensation (p less than .05), abnormal R-R interval (p less than .05), intermittent claudication (p less than .05), and abnormal ankle brachial index (p less than .05). An important finding was that 41 percent of insensate patients were not aware of their sensory deficit. In addition, two-thirds of the patients with vascular disease had palpable pulses. All patients with diabetes should be entered into a basic foot education program. The high prevalence of lower extremity pathology coupled with the inadequacy of history and physical examination in detecting neuropathy and vascular disease emphasize the need for vigorous screening to determine whether patients are at high risk of ulceration/amputation. These patients should be entered into aggressive prophylactic treatment programs.
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PMID:Prevalence of foot pathology and lower extremity complications in a diabetic outpatient clinic. 266 42

Platelet aggregation inhibitors are used in numerous clinical situations on the basis of claims that platelets are involved. As a result of controlled clinical trials, some of these situations have become formal indications for some of these drugs. The situations in which platelet aggregation inhibitors are used include: arteritis of the lower limb at the intermittent claudication stage, leg ulcers of arterial origin, emboligenic arteritis with focus of platelet hyperfixation, progression of atherosclerosis as assessed by angiography, implantation of vascular surfaces, diabetic retinopathy, retinal venous thrombosis, cycle cell anaemia and perhaps thrombocythaemia. Other, more discussed indications of antiplatelet drugs are mentioned.
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PMID:[Platelet antiaggregants in other pathologies]. 268 45

The causes frequently ascribed to coarctation of the abdominal aorta include atherosclerosis, trauma, inflammatory aortitis, and extrinsic compression. We present a case of coarctation of the abdominal aorta with stenosis of the left renal artery due to fibrodysplasia in a 35-year-old woman, hospitalized for treatment of intermittent claudication and hypertension. This coarctation was resected and end-to-end anastomosis with reimplantation of the left renal artery was performed. Results of an anatomopathologic examination of the resected aortic specimen and the trunk of the left renal artery revealed typical lesions of fibromuscular dysplasia. The specific features of lesions in this case were compared with those from the literature.
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PMID:Coarctation of the abdominal aorta and stenosis of the left renal artery with hypertension caused by fibrodysplasia. 274 63

A case is reported of a 10 year-old girl admitted to hospital because of severe intermittent claudication. Occlusion of the left popliteal artery was diagnosed. Since successful surgical intervention the patient has been symptom-free. No causative factor was detected for this premature occlusion. During intensive laboratory check-up an extreme diminution in sensitivity of the platelets to prostacyclin and a receptor defect were discovered. This defect seems to be genetically determined. The extent to which this as yet unreported platelet defect might have contributed to the development of atherosclerosis at such an early age is discussed.
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PMID:[Defects in the prostaglandin system. II. Familial platelet-prostacyclin receptor defect (Wien-Hietzing defect)--pathogenetic significance for (early) development of atherosclerosis?]. 298 63


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