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)

Lower extremity atherosclerosis results in significant morbidity in women, particularly in women following the menopause. Up to 25% of women aged 55 to 74 years are affected by this disease. When noninvasive testing is used to determine the prevalence of lower extremity atherosclerosis, and men in this age group are equally represented. Cigarette smoking, diabetes mellitus, and menopause are risk factors for atherosclerosis of particular interest in women. The prevalence of cigarette smoking is rising rapidly among women, and diabetes appears to be a greater risk factor for atherosclerosis in women than in men. Risk factor reduction, in addition to an exercise program, are important parts of the treatment program for stable claudication. In both men and women with more severe symptoms, an ankle/branchial index (ABI) of less than 0.3 is associated with more severe symptoms, an ankle/brachial index (ABI) of less than 0.3 is associated with a poor prognosis. Men and women fare equally well following revascularization for severe peripheral atherosclerosis. However, there are some data to suggest that women may be offered peripheral revascularization at a lower rate.
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PMID:Peripheral arterial-vascular disease in women: prevalence, prognosis, and treatment. 755 10

From 1982 to 1992, 25 patients with subclavian steal syndrome (SSS) were admitted with 20 undergoing surgery. Etiology included atherosclerosis 56% (14/25), Takayasu's disease 36% (9/25), 14 of them were smokers. Stenosis or occlusion of the left subclavian artery were found in 14, the right in 7, and bilateral in 4. 14 cases had vertigo symptoms, 24 cases had claudication of the arm, 9 of them complained transient ischemic attack (TIA). Carotid to subclavian bypass were performed for 15 cases. Two patients underwent axilloaxillary bypass with evidence of both clinical and laboratory improvement. Aorta-Carotid graft bypass was done in 2 cases with good result in one. PTA was done for a girl with innominate severe stenosis but symptom recurred three months later. Symptoms of the upper extremity ischemia were relieved in 75% of the patients, and of the cerebrovascular ischemia in 50%. Our conclusion is that surgical therapy remains the treatment of choice in symptomatic patients.
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PMID:[Subclavian steal syndrome: a report of 25 cases]. 784 5

The aim was to test within a randomized double-blind trial whether the platelet inhibitor ticlopidine might improve peripheral blood flow and distal pressures in patients with aortofemoral arteriosclerosis. One hundred and one patients with intermittent claudication were studied after one year, after two to three years, and after five years of treatment with ticlopidine, 500 mg/day, or placebo. Analysis was performed according to years on treatment. Baseline flow values as assessed by venous occlusion plethysmography were significantly and similarly deranged in the ticlopidine and placebo groups as compared with a reference group of healthy subjects. Ankle/brachial index was unrelated to either leg blood flow variables or walking distance. After five years of treatment (median follow-up time) a slight tendency to a slower progression of disease was observed in the ticlopidine group as compared with placebo. However, intergroup differences were not significant. Therefore, the potential benefit of ticlopidine in this respect is from a clinical point of view certainly only marginal. Minor increases in claudication distances were found with no difference between groups. Smoking habits and lipoproteins were mainly unaltered at the end of the study. It is concluded that platelet inhibition for up to five years has no clear beneficial effect on leg blood flow variables, ankle/brachial index, or walking distances and probably no clinically relevant retarding effect on the slow progression of atherosclerosis. This lack of influence must be distinguished from the antithrombotic effect of ticlopidine, shown as a decreased incidence of acute cardiovascular events and mortality in the authors' multicenter study, STIMS (the Swedish Ticlopidine Multicenter Study).
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PMID:Long-term effects of ticlopidine on lower limb blood flow, ankle/brachial index and symptoms in peripheral arteriosclerosis. A double-blind study. The STIMS Group in Lund. Swedish Ticlopidine Multicenter Study. 809 43

Haemostatic and rheological factors may predict cardiovascular disease. We studied patients with intermittent claudication to see if the progression of peripheral arterial disease and the risks of coronary events could be predicted by baseline packed cell volume, plasma fibrinogen, blood and plasma viscosites, von Willebrand factor antigen, cross-linked fibrin degradation products (XLFDP), urinary fibrinopeptide A, and plasma leucocyte elastase. In 617 patients with claudication followed up for one year, baseline XLFDP was related most strongly to coronary events, relative risk 4.4 (95% CI 1.3-19.0) between top and bottom quintiles. Plasma fibrinogen was the strongest independent predictor of death from coronary disease. XLFDP was the only factor, in addition to age and cigarette smoking, that was independently associated (p = 0.008) with deterioration in peripheral arterial disease. We conclude that, in patients with peripheral arterial disease, plasma concentration of XLFDP, a measure of ongoing fibrin formation and degradation, is a strong predictor of both disease progression and future coronary risk. These results accord with the hypothesis that fibrin formation contributes to progression of coronary and peripheral atherosclerosis.
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PMID:Cross-linked fibrin degradation products, progression of peripheral arterial disease, and risk of coronary heart disease. 810 Sep 15

We believe that the use of prosthetic grafts is justified in the treatment of long occlusions of the superficial femoral artery. However the surgery should only be done in cases where patients are suffering from severe claudication and in cases of critical ischemia of the lower limbs. We report herein the mid-term results of an European multicentric prospective study of a new prosthesis which is compliant, ultraporous and made of polycarbonate. We found a patency similar to that obtained with PTFE grafts as reported in the literature. In these indications, the choice of prosthetic grafts allows for a better management of atherosclerosis arterial disease. Thus autologous saphenous veins are still available to treat coronary artery disease or femoro tibial occlusion which remain a frequent evolution in that type of patient.
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PMID:[Long occlusion of the superficial femoral artery: revascularization by compliant prosthesis]. 815 72

Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are common diseases in the elderly. The arteritis usually affects medium sized vessels, but large vessel involvement can also occur leading to arm claudication, bruits, loss of pulses and pallor of the upper extremities. The differential diagnosis of large vessel arteritis includes atherosclerosis and Takayasu's disease. Atherosclerosis, which affects patients of similar age to GCA is usually confined to the lower limbs and can be differentiated on the basis of the clinical setting and investigations such as the ESR, arteriography and temporal artery biopsy. Takayasu's arteritis' although histologically and arteriographically indistinguishable from GCA, is predominantly a disease of young women. A patient is described who presented with upper limb ischemia. A clinical examination revealed absence of right radial pulses and presence of murmurs at level of the carotids. The blood pressure was unrecordable in the upper right limb. The ESR was 102 mm/hr and the C-reactive protein was 11.66 mg/dl. A selective arteriography of the aortic arch and its branches revealed a right subclavian artery obstruction with good collateral circulation and a left subclavian artery stenosis. The biopsy of left temporal artery showed a typical GCA in acute stage. Treatment with prednisolone 30 mg/day was started and four weeks later, the ESR had fallen to normal. In addition this case confirms that PMR implies a systemic arteritis.
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PMID:[Giant cell arteritis and polymyalgia rheumatica presenting as subclavian artery obstruction]. 823 15

The most common cause of claudication is atherosclerosis obliterans. However, when it presents in adolescence, other causes should be considered. We describe the case of a 15-year-old girl who had severe intermittent claudication 8 years after a limb-lengthening procedure for a hypoplastic femur. The lesion responsible was an isolated fibromuscular dysplastic segment of the distal superficial femoral artery and proximal popliteal artery. The etiology, treatment, and histopathology are discussed.
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PMID:Claudication in an adolescent with a hypoplastic femur. 826 73

We report 72 non-diabetic patients with obliterant atherosclerosis, stadium II, (intermittent claudication). The medium age of these patients was 62 +/- 4.5 years old. They were randomly included into four groups. Three were treated with Ozone: one of them by endovenous way, other intramuscular way, and the last one by rectal way; meanwhile, in the fourth group the patients were submitted to conventional medical treatment (control group). In the three ozone-groups there weren't differences when they were compared between then. But there was a significant improvement in comparison with the control group. The claudication distance in the treadmill increased to the 2.5 km/hour. Ankle/arm pressure rates hadn't significant differences, this corroborates the ozone action on the microcirculation. The least uncomfortable, the more harmless and the more economic way was the rectal way.
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PMID:[Arteriosclerosis obliterans and ozone therapy. Its administration by different routes]. 828 65

From March 1990 to May 1991, arterial stents were placed in seven patients because of a tight stenosis (five patients) or a total chronic occlusion (two patients) located in the infrarenal aorta. In one case, the aortic occlusion extended to both common iliac arteries. After balloon dilatation, aortic stents were successfully positioned in all cases. Bilateral common iliac recanalization and stent placement were performed in one case. No complications occurred in any of the patients. No complications occurred in any of the patients. Follow-up data were derived from clinical assessments and angiographic results. After a 15.1-month mean follow-up period (range 12-24 months), the seven aortic stents remained patent. Three iliac artery procedures were performed in two of the patients as well. Claudication recurred in three of the seven patients which was related to a common iliac occlusion (one case) or distal progression of atherosclerosis (two cases). Aortic stents seem to be suitable for treating failed angioplasty of aortic lesions but the procedure remains technically difficult when there is associated severe atherosclerosis of the proximal common iliac arteries. Nevertheless, considering the morbidity rate (0%) and the patency rate in this series, this technique could become an alternative to surgical treatment for infrarenal aortic occlusive lesions.
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PMID:Infrarenal aortic stents: initial clinical experience and angiographic follow-up. 840 80

Symptoms for spinal stenosis apparently result from an incongruity between the capacity and contents of the spinal nerve passages. These symptoms are most frequently seen in men in their fifth or sixth decade of life. Spinal extension generally exacerbates the claudication-type symptoms (lower-extremity pain and paresthesia), whereas spinal flexion diminishes these symptoms. Differential diagnosis is needed to rule out vascular claudication due to atherosclerosis. Decisions regarding surgery should be made based not only on diagnostic imaging but also on a thorough history and clinical examination.
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PMID:Lumbar spinal stenosis. 859 23


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