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)

We report a case of a 50-year-old woman with traumatic dissection of the right common carotid artery secondary to attempted suicidal hanging. Initial examination showed marks of strangulation on the neck, facial edema, and multiple conjunctival petechiae accompanied by difficulty in breathing and loss of consciousness. She gradually recovered except for her left upper limb weakness. Rehabilitation, with a diagnosis of left brachial plexus injury, was started. Two years later, she occasionally felt numbness of the left upper extremity. On her second admission, a bruit was heard on the right side of her neck. Neurological examination did not reveal any change. CT scan showed atrophic changes. Angiography demonstrated approximately 80% stenosis of the right common carotid artery which was thought to be responsible for the attacks of numbness. Right carotid endarterectomy was performed. Histological findings revealed dissection of the medial layer of the arterial wall. Complaints of numbness disappeared postoperatively, and angiography showed good patency at a follow-up examination. We conclude that the stenosis of the common carotid artery was not due to atherosclerosis but due to the dissection as a result of hanging.
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PMID:[A case of common carotid artery stenosis due to hanging]. 144 93

In the English literature, only 27 cases of arterial thrombosis associated with Crohn's disease have been described. The present case appears to be the first reported case in the Japanese literature. A 43-year-old man was treated for intestinal obstruction caused by Crohn's disease and complicated by superior mesenteric vein thrombosis by surgical resection of 150cm of small bowel in June 1981. In March 1983, the right external iliac artery had become occluded and part of the left external iliac artery had assumed an irregular shape and the right ilio-femoral bypass surgery using PTFE was carried out. Three months later occlusive ileus reoccurred and angiograms showed that the superior mesenteric and right hepatic arteries had 30% and 20% stenosis respectively. Small bowel in 50cm in length was resected with subsequent administration of salicylazosulfapyridine at a dose of 3g per day. There was no reappearance of bowel symptoms. The patient again complained of numbness in the right leg in February 1988 and a left external iliac-right common femoral crossover bypass operation was carried out using a ringed 8mm Dacron graft. Intraoperatively, it was found that the left external iliac and the right common femoral arteries had intimal thickening but no atherosclerosis.
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PMID:[Arterial thrombosis associated with Crohn's disease: a case report]. 239 69

A case of fibromuscular dysplasia at the internal carotid origin is reported. A 45-year-old, right-handed woman who was in good health, experienced 5-6 second episodes of numbness and tingling in her right hand and lip. She had no history of medical illness or trauma. The patient suffered the same sort of attack almost seven years after her first episode. General examination was unremarkable. There was no sign of residual neurologic deficit. Cerebral angiography demonstrated a discrete filling defect at the internal carotid origin. There was no evidence of atherosclerosis in the intracranial or extracranial vessels. The lesion occluded approximately 58% of the lumen. A carotid endarterectomy was performed and a "web shaped" tissue was removed from the posterior aspect of the right internal carotid artery. Microscopic examination of the surgical specimen demonstrated intimal fibrosis, consistent with the diagnosis of fibromuscular dysplasia. In addition to our patients, eight other cases of cephalic fibromuscular dysplasia have been reported in the form of an internal carotid web. This type of lesion is unique because the changes involve only the intima of the vessels without involvement of the medial structure as is seen in the usual form of fibromuscular dysplasia. Moreover, 5 out of 9 patients reported had the repeated episodes of the ischemic symptom, suggesting patients with this particular lesion have higher risk for stroke than those with the usual "string of beads" lesion. In these patients, surgical treatment should be considered, especially if medical therapy is unsuccessful.
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PMID:[Fibromuscular dysplasia at the internal carotid origin: a case of carotid web]. 832 4

Intermittent claudication (IC) comprises the most common presenting symptoms of peripheral arterial disease (PAD), which itself is a manifestation of systemic atherosclerosis. Typical symptoms of IC are aching pain, numbness, and fatigue in the lower extremities. Symptoms are induced by walking or exercise and usually resolve with rest. The cornerstone of treating IC is risk-factor reduction and a supervised exercise regimen. Pharmacotherapy specifically indicated for the treatment of IC includes a new drug, cilostazol, and the traditional drug, pentoxifylline. Cilostazol also has antiplatelet, antithrombotic, and vasodilatory activity, as well as a positive effect on serum lipids. Eight multicenter clinical trials, seven in the U.S. and one in the U.K., used objective and subjective clinical endpoints to assess the treatment efficacy of cilostazol. Objective endpoints included maximal and pain-free walking distance (MWD and PFWD, respectively), the ankle-brachial index, peripheral hemodynamic measurements, and serum lipid levels. Subjective endpoints, assessed by patient questionnaires, included perceived functional status and health-related quality of life. Cilostazol treatment showed statistically significant increases in MWD and PFWD within 4 weeks, as well as improvements in physical functional status at 24 weeks, compared with placebo and pentoxifylline. Increases in high-density lipoprotein cholesterol and decreases in plasma triglycerides were also noted. Subjective assessments appeared to match objective parameters.
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PMID:Measuring treatment effects of cilostazol on clinical trial endpoints in patients with intermittent claudication. 1189 86

A 19-year-old female college student had numbness and the sensation of coldness of her left toes. She had a 3-year smoking history. Gangrene of the left foot developed rapidly. Angiography revealed peripheral arterial occlusion of both legs and arms. Detailed laboratory examination excluded collagen disease, a hypercoagulable state, and juvenile atherosclerosis. Below-knee amputation of the left leg was performed. Typical histologic findings of Buerger's disease were observed in the crural arteries and saphenous veins. The clinical course was uneventful after the patient stopped smoking. This is the second case report of Buerger's disease in a woman in the second decade of life. It is important that a correct diagnosis of Buerger's disease be established, because the disease process is benign, compared with collagen disease, if the patient stops smoking.
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PMID:Buerger's disease in a 19-year-old woman. 1284 8

We describe a 52-year-old woman who experienced transient motor weakness and numbness of the left extremities and presented 2 days later with severe hemiparesis and sensory impairment of the right extremities and right lingual palsy. Magnetic resonance imaging (MRI) revealed bilateral upper medial medullary infarction, primarily in the left ventral portion. The findings of both three-dimensional (3D) computed tomographic and conventional angiography suggested dissection of both intracranial vertebral arteries (VAs). Medial medullary infarction is generally caused by atherosclerosis within a VA or anterior spinal artery. This is the first report of bilateral medial medullary infarction due to dissection of both intracranial VAs.
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PMID:Bilateral medial medullary infarction due to bilateral vertebral artery dissection. 1500 5

To determine the peculiarities of clinical presentations of vertebrobasilar transient ischemic attacks in elderly and aged patients (42 patients aged 61-90 years) have been studied using clinical, laboratory, neuroimaging and ultrasound methods. Hemodynamically significant stenosis of vertebral or basilar arteries caused by atherosclerosis was found in 16 patients. It was associated with hypoplasia or kinking of vertebral arteries in 4 patients. Six patients had atrial fibrillation, 15 isolated arterial hypertension and 4 an unspecified type of the disease. Transient ischemic attacks in patients with hemodynamically significant stenosis of vertebral or basilar arteries were characterized by the highest rate and shortest duration of repeated attacks. The most severe clinical course was characteristic of transient ischemic attacks in patients with atrial fibrillation. It was featured by the longest duration of symptoms, highest rate of vision loss, limb numbness and weakness during the attack, high rate of focal neurological signs and high rate of old cerebral infarcts and vascular white matter abnormalities on neuroimages as well as the elevated plasma level of C-reactive protein. Transient ischemic attacks in patients with isolated arterial hypertension were characterized by relatively mild clinical course of the disease.
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PMID:[Clinical peculiarities of pathogenetic subtypes of vertebrobasilar transient ischemic attacks in elderly and aged patients]. 1819 30

Peripheral artery disease, defined as atherosclerosis in the lower extremities, affects nearly 8.5 million people in the United States. Due to the frequent asymptomatic manifestation of peripheral artery disease, diagnosis may be delayed and its true incidence underestimated. However, some patients may experience aching pain, numbness, weakness, or fatigue, a condition termed intermittent claudication. Peripheral atherosclerosis is associated with cardiovascular risk and physical impairment; therefore, treatment goals are aimed at decreasing cardiovascular risk, as well as improving quality of life. Little debate exists regarding the management of cardiovascular risk reduction, which consists of both antiplatelet therapy and risk factor modification. Despite recently published guidelines, the treatment of intermittent claudication is less well established and the management remains controversial and uncertain. Exercise remains the first-line therapy for intermittent claudication; however, pharmacologic treatment is often necessary. Although only two prescription drugs have been approved by the U.S. Food and Drug Administration for the treatment of intermittent claudication, several supplements and investigational agents have been evaluated. Therapeutic optimization should balance the anticipated improvements in quality of life with the potential safety risks.
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PMID:Pharmacologic therapy for intermittent claudication. 1939 62

Subclavian steal syndrome (SSS) is caused by hypoplasia of a vertebral artery or stenosis or occlusion of the subclavian artery or the brachiocephalic artery with subsequent retrograde filling of the subclavian artery via the contralateral vertebral artery. Symptoms of SSS are due to vertbrobasilar insufficiency or ischemia of the ipsilateral upper extremity, and they may include dizziness, syncope, ataxia, arm claudication, hand numbness or a decrease in brachial blood pressure on the affected side. However, most SSS cases are asymptomatic and they are classified as subclavian steal phenomenon (SSP). Atherosclerosis is the common cause of SSS, and Takayasu arteritis, neurofibromatosis, trauma, embolization, congenital vascular anomalies and surgical interruption of the subclavian artery can be identified among the other causes. We describe a rare case of hypervascular thyroid nodule presenting with features of SSP. The patient was hospitalized with acute cerebral infarction due to middle cerebral artery (MCA) severe stenosis. The patient had conservative therapy in the acute stage, and underwent STA-MCA anastomosis for MCA stenosis in the chronic stage. SSS was asymptomatic although there was laterality in blood pressure in the patient's bilateral upper limbs. Thyroid tumor was regarded as benign by radiological findings, laboratory data, and physical examination. If SSS becomes symptomatic, removal of the thyroid tumor may be indicated.
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PMID:[Subclavian steal phenomenon associated with hypervascular thyroid tumor]. 2052 19

A 76-year-old man with a history of multiple laparotomies and severe coronary artery disease was referred to our hospital after the sudden development of pain and numbness in the lower extremities. Computed tomography showed a thrombosed abdominal aortic aneurysm and diffuse aortic atherosclerosis; compatible with a "shaggy aorta." A good response to thrombolytic therapy permitted elective scheduling of abdominal aortic surgery after coronary artery bypass grafting. We operated via an extended left retroperitoneal approach through a thoracoabdominal incision. Epiaortic ultrasonography revealed that only the supraceliac aorta was free of mobile thrombi and had minimal plaque; we therefore placed a proximal aortic cross-clamp there. Anatomic aortic reconstruction was then performed successfully using an aorto-biiliac graft to restore adequate distal blood flow. There were no vital-organ ischemic complications, and the postoperative course was satisfactory.
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PMID:Thrombosed abdominal aortic aneurysm associated with an extensively "shaggy" aorta repaired anatomically via a thoracoabdominal approach with supraceliac aortic clamping: report of a case. 2074 Mar 51


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