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)

Between January, 1965, and December, 1975, 204 patients (138 men and 66 women) underwent aortoiliac reconstruction for atherosclerotic occlusive disease. Eighteen patients (9%) had a hypoplastic aortoiliac segment and an analysis of these 18 patients constitutes the basis of this report. There were 17 women and one man, and their ages ranged from 28 to 60 years, with an average of 43 years. Hyperlipidema was present in nine of 13 patients tested. All patients were heavy cigarrete smokers and had lower extremity claudication with weak or absent pulses. Carotid or subclavian artery disease was found in 50%. Angiography demonstrated hypoplasia of the aorta distal to the renal arteries with either occlusion, diffuse narrowing, or, most often, an "hourglass" stenosis. The iliac and femoral arteries also were narrowed. Reconstruction was achieved primarily by aortobilateral-iliac or femoral bypass. There were no operative deaths and all patients were improved initially. It appears that normally occurring atherosclerosis in this portion of the aorta, along with congenital narrowing, accounts for symptoms at an early age. The predominence in women is a puzzle. The prognosis does not appear to be too grim. This may be due to absence of diabetes mellitus and the infrequency of coronary artery disease. All patients are still alive; there has been one major amputation following graft infection 1 1/2 years after operation. When progression of atherosclerosis occurs, it seems to involve the superficial femoral, carotid, and subclavian arteries.
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PMID:Atherosclerosis and the hypoplastic aortoiliac system. 14 60

Femoral angiograms were done to evaluate change in early atherosclerosis in 12 patients with type IV hyperlipoproteinemia and 13 with type II hyperlipoproteinemia. The patients' average age was 48 years; only one had claudication. Elevated blood lipids and blood pressure were treated with drugs and diet. Repeat angiograms after an interval of 13 months showed regression of atherosclerosis in nine patients, no change in three, and progression in 13. Comparison of preangiogram levels with average levels between angiograms showed significant reduction in serum cholesterol, triglyceride, and blood pressure in the group with lesion improvement but not in the group with lesion progression. Sporadic examples of human atherosclerosis regression are known, but most other studies in man indicate only atherosclerosis progression. Our different result appears due to our selection of patients and radiographic method. We have studied patients with earlier atherosclerosis than previous workers, using a radiographic procedure more sensitive to small changes in lesions.
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PMID:Regression and progression of early femoral atherosclerosis in treated hyperlipoproteinemic patients. 18 58

Forty-six patients with xanthomatosis and elevated very low density lipoproteins (VLDL) levels (in different types of hyperlipoproteinaemia) were classified on the basis of the WHO criteria and the cholesterol/triglyceride ratio in VLDL. A large majority (31/46) of the patients referred to the Department of Dermatology could be classified as hyperlipoproteinaemia type III, only 8/46 as type IIB and 7/46 as type IV/V. This distinction seems to be relevant as the xanthomatous lesions differed distinctly between these three types of hyperlipoproteinaemia. Xanthochromia striata palmaris was present in 29/31 cases of hyperlipoproteinaemia type III and was not found in type IV/V patients, who had distinctive papuloeruptive xanthomas. During a follow-up in 35/46 patients all xanthomas disappeared within 2 years except the xanthelasma palpebrarum and tendinous xanthomas. All type IV/V patients (7/7) but only one type III patient (1/31) had abnormal glucose tolerance. Only 2/18 type III patients less than 45 years showed claudication and none of the young type III patients had angina pectoris. In contrast, all four type IIB patients less than 45 years had clinical signs of atherosclerosis. However, angina pectoris and/or claudication were present in 5/13 type III patients over 45 years old. The mean serum cholesterol level was equally elevated in both groups but the cholesterol was mainly present in VLDL in type III and in low density lipoproteins (LDL) in type IIB. In 9/31 type III patients the LDL level was also elevated but was easily normalized by a diet low in carbohydrate, whereas the elevated LDL level in type IIB was therapy-resistant. The recognition of xanthomatous lesions, specifically xanthochromia striata palmaris, as an early sign of type III hyperlipoproteinaemia, can lead to the early diagnosis and successful treatment of these patients, and thus possibly prevent the development of premature atherosclerosis.
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PMID:Xanthomatosis and other clinical findings in patients with elevated levels of very low density lipoproteins. 22 20

Five patients, previously treated with pelvic irradiation for cancer of the cervix uteri, ovaries or bladder are presented. They developed occlusions of the distal aorta and/or the iliac arteries 2 to 6 years after irradiation. The presenting symptoms caused by the vascular obstructions were claudication or rest pain. All patients were operated upon with revascularization procedures and thereby relieved from their symptoms. One vascular graft occluded but reoperation was successful. The mechanism by which radiation causes atherosclerosis is discussed. All patients were heavy cigarette smokers. The patients with signs of atherosclerosis outside the irradiated area were the ones with the shortest time interval between radiation and symptoms of ischaemia. It is proposed that irradiation acts synergistically to other atherogenetic factors and this should be kept in mind when radiation therapy is planned in patients with high risk of developing atherosclerosis.
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PMID:Localized arterial occlusions in patients treated with pelvic field radiation for cancer. 41 68

Smoking is the most prevalent 'risk factor' causing atherosclerosis. The association is strongest for disease in arteries to the legs. Continued smoking worsens claudication, increases the risk of progression to gangrene, and decreases long-term patency rates of arterial reconstructions.
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PMID:Relationship of smoking to peripheral arterial disease. 48 64

Smoking habits and random measurements of the proportion of haemoglobin bound to carbon monoxide (COHb%) were examined for their association with atherosclerotic diseases in 1068 men aged 55 to 74 years from rural areas of Finland. COHb% and smoking history were similarly associated with claudication and coronary heart disease. Random measurements of COHb% did not show a better overall relation to the prevalence of atherosclerotic diseases than smoking history, though COHb% showed a stronger association with a probable previous myocardial infarction. Further studies are needed to clarify the role of carbon monoxide in atherosclerosis.
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PMID:Smoking, carbon monoxide, and atherosclerotic diseases. 62 Mar 2

The authors repeat part of their report to the 79th French Congress of Surgery, presented in September, 1977. They recall that chronic obstructive arteriopathies affect from 1.5% to 4% of the population, and that in half of the cases, the symptoms are those of a simple intermittent claudication. Atheromatosis is the main cause, but to this must be added many other risk factors, smoking and metabolic disorders, especially glucidic and lipidic ones. There is spontaneous worsening in only half the cases. Other vascular and coronary ailments and problems of the cerebral vessels are responsible for most of the deaths of patients affected by arteriopathies of the lower limbs. The precise pain mechanism of the intermittent arterial claudication, its physio-pathological significance, like the mechanisms of vasomotricity and the development of the collateral circulation, are not yet completely clear. A therapeutic attitude can only be taken keeping in mind these developmental and physiopathological data: claudication is a symptom that does not necessarily mean that the limb is threatened.
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PMID:[Intermittent claudications of arterial origin: some epidemiological and physiopathological features]. 74 Jul 21

The study was aimed at evaluating the effect of pyridinolcarbamate in patients with atherosclerosis obliterans of the lower limbs. A single intravenous administration of the drug did not induce changes in resting blood flow, but elicited a significant decline in capillary filtration rate. In a double-blind cross-over trial patients reported a significant prolongation of walking distance after 6 months of pyridinolcarbamate treatment. Sensation of cold in the lower limbs was not affected. Pyridinolcarbamate did not influence peak values of blood flow through the calf but they appeared significantly earlier. No significant changes were seen at the evaluation of the elevation and dependency test and performance using tiptoeing test. Likewise the findings of systolic pressure in the lower limbs, pulse wave morphology, and claudication distance on treadmill did not confirm a therapeutic effect of pyridinolcarbamate.
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PMID:The effect of pyridinolcarbamate after acute and chronic administration in patients with atherosclerosis obliterans. 84 32

It has never been considered whether type A (coronary prone) behavior can also be found in patients with peripheral atherosclerotic disease (intermittent claudication). This question has been studied by means of the 14-item (Bortner) questionnaire. The questionnaire was filled out by 10 patients (self-assessment) with coronary artery disease and intermittend claudication, 13 with intermittent claudication alone and 10 with comparably severe, but not arteriovascular disease and independently by their wives (relative's assessment). In the self-assessment the test discriminated significantly between the three groups (Kruskal-Wallis p less than 0.05). The correlation coefficient (Spearman) between expression of type A behavior and extent of atherosclerosis was 0.3720 (p less than 0.02). In the relative's assessment the groups were also differentiated significantly (Kruskal-Wallis p less than 0.05). The correlation coefficient (Spearman) was 0.4080 (p less than 0.009). The results indicate that patients with intermittent claudication demonstrate a predilection for type A behavior, which is more pronounced in those with additional coronary artery disease. The multiple stepwise regression indicated that type A behavior is related to atherosclerosis independently of other factors.
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PMID:[Personality traits (type A) in patients with intermittent claudication. 1. Results of the Bortner test]. 92 47

Angioplasty of the profunda femoris should be the primary approach to revascularization of the limb whenever it is feasible. Claudication distance can be significantly improved in almost all patients and prolonged limb salvage achieved in the majority of patients. In some high risk patients, the entire procedure can be accomplished expeditiously and atraumatically under local anesthesia, using a single groin incision. When the pattern of distribution of atherosclerosis provides the surgeon with the choice of performing either angioplasty of the profunda femoris or femoral popliteal bypass, the former option should be tried initially with resort to the latter if ischemia is not adequately relieved. In many instances when distal bypass is not possible or is unlikely to function effectively, angioplasty of the profunda femoris may provide the only opportunity to relieve ischemic symptoms. Operative blood flow measurements support the thesis that the collateral function of the profunda femoris artery is able to compensate for extensive obstructive disease in both the superficial femoral and popliteal segments.
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PMID:The role of angioplasty of the profunda femoris artery in revascularization of the ischemic limb. 93 26


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