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)

The vascular patient has a systemic disease, atherosclerosis, and this may be present in all arteries in varying degrees. Thus, preoperative evaluation of the vascular patient is essential to identify areas of risk. The cardiovascular system is the chief source of mortality and morbidity. Primary emphasis will be placed on the diagnostic tests involved and the nursing responsibility to the patient.
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PMID:Preoperative medical evaluation of the vascular patient. 128 27

Renal artery stenosis is an uncommon, but curable cause of systemic hypertension. The most common causes of stenosis are atherosclerosis, and fibromuscular dysplasia. Diagnosis may be difficult due to the lack of a suitable screening test, and a high index of suspicion needs to be maintained. Treatment may be with pharmacotherapy, renal angioplasty, or surgery and the choice of therapy needs to be tailored to the individual patient. Once a stenotic lesion is discovered in a hypertensive patient, the functional significance is not always clear cut. Fibromuscular dysplasia may be a systemic disease in some cases, and may affect the central nervous system.
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PMID:Renovascular hypertension and demyelimating disease in a young woman. 259 48

Inflammatory aneurysm of the aorta is not merely a variant of atherosclerosis, but more probably it is a manifestation of a peculiar systemic disease related to idiopathic retroperitoneal and mediastinal fibrosis. Rarely, aortitis and coronary arteritis may coexist with the inflammatory aneurysm; one of each of such unusual cases are described. Because inflammatory aneurysms of the aorta tend to occur in elderly persons, aortitis and coronary arteritis, when present, cannot be distinguished from the concomitant age-related atherosclerosis without a careful histologic examination.
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PMID:Inflammatory aneurysm of the aorta, aortitis, and coronary arteritis. 317 25

The ability to recognize diverse clinical forms of xanthomas, such as tuberous, planar, eruptive and tendinous, is important in the detection of underlying systemic disease. A variety of primary genetic disorders, as well as numerous secondary conditions such as diabetes, obstructive liver disease, thyroid disease, renal disease, and pancreatitis, can lead to hyperlipoproteinemia that results in the formation not only of xanthomas but also of life-threatening vascular atherosclerosis. An understanding of the pathogenesis of the underlying lipoprotein alterations provides a rational approach to therapy utilizing dietary manipulations and drugs. Such treatment is capable of correcting most disorders of lipid metabolism, and, if appropriate therapy is initiated at the first sign of xanthoma evolution, it may prevent progression of atherosclerosis, provide resolution of xanthomas, and in some instances prevent serious pancreatitis.
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PMID:Xanthomas and hyperlipidemias. 403 Nov 42

To determine whether an above-knee polytetrafluoroethylene (AK-PTFE) femoropopliteal bypass graft might be an acceptable alternative to a below-knee reversed autogenous saphenous vein (BK-ASV) bypass graft, we compared 51 AK-PTFE grafts to 39 concurrently performed BK-ASV grafts. All patients were staged by preoperative noninvasive vascular laboratory criteria into limiting claudication or limb salvage groups and by intraoperative arteriography according to degree of runoff. There was no significant difference in the primary graft patency at 36 months between the AK-PTFE group (63%) and the BK-ASV group (72%). Secondary graft patency among the AK-PTFE group was improved by minor distal graft revision to 88% at 36 months. The preoperative noninvasive hemodynamic evaluation status was an influential factor; the graft patency rate among the patients with limiting claudication was superior to that among the limb salvage group, but the degree of runoff as shown by intraoperative angiography did not appear to have an effect on cumulative patency. Resting Doppler ankle/brachial artery pressure ratios did not predict subsequent occlusion of AK-PTFE grafts. Atherosclerosis is a progressive and systemic disease that frequently involves both the coronary and tibial vessels. AK-PTFE spares autogenous saphenous vein so that it can be reserved for use in coronary artery bypass or in subsequent treatment of more distal tibial vessel disease.
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PMID:Above-knee polytetrafluoroethylene femoropopliteal bypass graft: Is it a reasonable alternative to the below-knee reversed autogenous vein graft? 685 8

A substantial number of young men with erectile dysfunction have neither systemic disease nor a trauma in their history. We are familiar with impotence after major trauma but it is an unanswered question whether subclinical trauma may also induce arterial degeneration with subsequent erectile dysfunction. In a period of 36 months 129 patients underwent penile arteriography. After excluding those with major surgery, trauma or psychogenic impotence 91 angiograms were reevaluated. Special attention was paid to atherosclerotic and to focal occlusive arterial disease (> 50% stenosis) in the hypogastric-cavernous branch. 12 angiograms showed normal arteries, 59 typical atherosclerotic and 20 focal occlusive arterial disease. The mean age of patients with atherosclerosis was 53 +/- 8 years versus 35 +/- 14 years of those with focal lesions (p < 0.0001). 30% with focal arterial lesions were subject to subclinical trauma. 68% with atherosclerotic disease had clinical relevant atherosclerotic risk factors. Latency between onset of erectile dysfunction and presentation at the impotence clinic was 51 months in patients with focal lesions and 39 months in those with atherosclerotic disease (nonsignificant). We conclude that subclinical trauma of the hypogatric-cavernous arteries can induce focal arterial lesions with significant impairment of perfusion. This pathology may contribute to erectile dysfunction. These patients are significantly younger and they suffer from clinically evident impotence approximately 18 years earlier than patients whose impotence is clearly of atherosclerotic origin. Focal arterial lesions due to subclinical trauma are described for the first time as an etiology of erectile dysfunction. Further studies are needed to confirm these results.
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PMID:Subclinical trauma to perineum: a possible etiology of erectile dysfunction in young men. 765 7

Giant cell arteritis (GCA) is closely identified with the temporal arteritis-polymyalgia rheumatica syndrome of the elderly. It is also a systemic disease that can cripple and kill. Up to 15% of patients with temporal arteritis may have angiographic evidence of extracranial GCA, and aortic insufficiency, ruptured aortic aneurysm, aortic dissection, stroke, or myocardial infarction may be the initial manifestation of systemic GCA. A review of 72 cases of aortic and extracranial GCA, all with histopathologic verification of the disease, revealed that 25% of patients with aortic and extracranial large-vessel GCA had asymptomatic temporal arteritis; the ascending aorta and aortic arch were most frequently involved (39%), followed by the subclavian and axillary arteries (26%), and the femoropopliteal arteries (18%). Nine patients (12.5%) underwent an upper or lower limb amputation. Of the 18 patients whose death was directly attributable to extracranial GCA the causes were ruptured aortic aneurysm (6), aortic dissection (6), stroke (3), and myocardial infarction (3). The findings of these 72 cases caution against attributing all aortic and large-vessel arterial disease in the elderly to atherosclerosis and emphasize that timely surgical intervention may be necessary for life-saving and limb-salvage in patients with aortic and extracranial GCA.
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PMID:Aortic and extracranial large vessel giant cell arteritis: a review of 72 cases with histopathologic documentation. 766 46

As atherosclerosis is a multi-systemic disease, each patient presenting clinical manifestation of atherosclerosis such as a stroke or RIND should be, from a vascular point of view, globally evaluated. The availability of Doppler ultrasound technique enables us to discover the presence of Peripheral Artery Disease (PAD) which is not always overt in the patient's history. Furthermore the presence of PAD is associated with a poorer prognosis in stroke patients.
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PMID:Prevalence and prognostic value of peripheral arterial disease in stroke patients. 820 10

Serious vascular complications limit the success of renal transplantation in diabetic patients. Nearly half of diabetic transplant recipients die within 3 years after transplantation from a vascular complication. However, it has been difficult to determine before transplantation which patients are likely to do poorly. Because atherosclerosis is a systemic disease, we hypothesized that diabetic transplant candidates with pretransplant coronary artery disease would be at high risk for vascular complications even if asymptomatic at the time of pretransplant evaluation. Our hypothesis was that insulin-dependent (IDDM) transplant candidates with coronary artery disease identified with pretransplant coronary angiography would have an increased number of vascular events (amputation, cerebral vascular accident [CVA], or myocardial infarction [MI]) within 3 years of follow-up. We prospectively studied 198 consecutive diabetic transplant candidates grouped on the basis of coronary artery disease. Group 1 patients had no stenosis that was 50% or greater, group 2 patients had one or more stenoses between 50% and 74%, and group 3 patients had one or more stenoses of 75% or greater. During median follow-up of 41 months, 64 patients experienced 98 amputations, 28 MIs, and seven CVAs. At 36 months of follow-up, 55% of group 3 patients, 30% of group 2 patients, and 11% of group 1 patients had experienced a vascular event (P < 0.001). Cox regression confirmed the association of coronary artery disease with subsequent vascular events. Patients with coronary artery disease had a sevenfold increased risk of amputation and a fourfold increased risk of myocardial infarction. Six of seven CVAs occurred in patients with coronary artery disease. We conclude that coronary artery disease identified at pretransplant evaluation is associated with an increased risk of noncoronary vascular complications within 3 years after evaluation.
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PMID:Atherosclerotic vascular complications in diabetic transplant candidates. 910 51

Although considerable progress has been made in the prevention and treatment of atherosclerotic cardiovascular disease, new therapeutic strategies are still needed. Atherosclerosis is a systemic disease and represents an attractive target for the development of somatic gene transfer intended to modulate systemic factors with the goal of inhibiting disease progression. This approach should be differentiated from localized vascular gene delivery to isolated atherosclerotic lesions such as that intended to prevent restenosis. Systemic gene therapy for atherosclerosis can involve either: 1) gene replacement therapy in patients with defined genetic disorder causing premature atherosclerosis, or 2) overexpression of proteins which directly or indirectly inhibit atherosclerosis or stabilize vulnerable lesions. The former is conceptually straightforward, and a pilot clinical gene therapy trial for one of these diseases, homozygous familial hypercholesterolemia, has already been reported. The latter has significant potential for eventual application to a large number of patients at risk for progressive atherosclerosis, independent of the specific cause. However, substantial progress in vector development and the demonstration of efficacy in relevant animal models will be required before gene therapy for atherosclerosis becomes a clinical reality.
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PMID:Gene therapy for atherosclerosis. 914 25


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