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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ischemic colitis or proctitis shows three evolutionary stages. a. complete recovery, b. fibrous stenosis, and c. acute ischemia leading to gangrene. The two first stages result more frequently from hemodynamic disorders than from vascular occlusions because, in the presence of the latter, collateral circulation develops. In addition, the colonic ischemia occurs in a septic medium in the presence of an abundant microbial flora which may be highly pathogenic.
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PMID:[Blood flow disorders of the colon and rectum and their therapy]. 54 43

During the forty-month period ending July, 1976, intraaortic balloon counterpulsation was used as an adjunct to medical or surgical therapy in 273 patients. Thirty-seven developed complications. Limb ischemia occurred in 16; it resolved in 12, resulted in gangrene of the toes in 1 and leg gangrene in 2, and was the casue of death in 1 patient. Aortic dissection was confirmed in 7 patients and strongly suspected in another 4. Eight of the 11 patients with dissection underwent cardiac procedures with heparinization at two days to three months after balloon insertion with no untoward effects. Septicemia developed in 2 patients, 1 of whom died of cardiogenic shock. Localized groin sepsis occurred in 8 patients, 2 of whom required removal of infected Dacron graft material. Awareness of the complications of balloon insertion, proper attention to details of balloon management at the time of insertion and removal, and continuous monitoring through a central-lumen balloon should decrease the incidence of complications.
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PMID:Results and complications of intraaortic balloon counterpulsation. 59 68

The authors report four cases of vascular complications of closed injuries of the shoulder, which appeared later, some time after the initial accident. There was one false aneurysm of the axillary artery at the forty sixth day after a fracture of the upper humeral diaphysis with elongation of the brachial plexus; one case of acute ischemia of the upper limb 3 years after a dislocation of the shoulder; one case of thrombosis with gangrene of the hand twelve years after a fracture-dislocation of the head of the humerus and one case of chronic ischemia of the forearm with severe changes in the vessels below one year after a fracture of the clavicle which had caused an aneurysm of the subclavian artery. The clinical, pathological and physiopathological study showed the enormous possibilities of the collateral circulation in the axilla. An arterial lesion may thus remain undiagnosed during the initial trauma. The authors emphasise the importance of the initial examination with a search for disappearance of the peripheral pulses. In the light of these four cases, it seems necessary to explore as a routine any arterial lesion complicating a shoulder injury.
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PMID:[Late signs of vascular complications of closed trauma of the shoulder (author's transl)]. 64 5

Severe ischemia and distal gangrene of lower extremities due to obstruction of the popliteal artery and its branches need not require major amputation. Autogenous vein grafts to the distal anterior tibial, posterior tibial, peroneal and dorsalis pedis arteries can avoid tissue loss in many instances.
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PMID:Femoral tibial bypass grafts. The alternative to amputation. 66 29

This is an analysis of 130 cases with embolism of the pulmonary artery with a lethal outcome, which had developed in patients suffering from occlusion of the lower extremities. It is noted that the origin of embolism of the system of the pulmonary artery depends on the severity of ischemia of the tissues of the affected extremity and pointed out that this menacing complication develops both in the stage of ischemia and in the postischemic period. For the prevention of pulmonary embolism in patients with severe ischemia or gangrene of the lower extremities, it is recommended that operative treatment (corrective operations on the arteries or amputation) should be combined with inspection of the major veins.
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PMID:[Pulmonary embolisms as a complication of acute arterial obstruction of the lower extremities]. 69 63

Cell death complicating ischemia has profound local or systematic effects on the organism. We have tried to protect the small intestine and severed extremities from the effects of ischemia by using various drugs and techniques. Occlusion of the superior mesenteric artery for 1.5 hours in anesthesized, fed rats had a 97 per cent mortality. This was improved by pretreatment with methylprednisolone and amplicillin given together. Histologic preservation was seen in treated survivors. Chlorpheniramine, diphenylhydantion and methylprednisolone or amplicillin given alone had little, if any, effect. In dogs, reimplantation of severed extremities subjected to a 1.5 to two hour warm ischemic period resulted in toxic systemic picture, and 100 per cent mortality. This was improved by perfusion with Collins solution and postoperative injection of methylprednisolone. The incidence of gangrene was decreased. The judicious use of some drugs and preservation techniques may protect organs and the organism from the consequence of ischemia.
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PMID:Protection of organs during experimental ischemia. 71 50

The present mortality rate of more than 80% for patients with superior mesenteric arterial thrombosis or embolism will remain unacceptable until earlier diagnosis is achieved. Although leukocytosis is often an early feature and may seem elevated out of proportion to the severity of the illness, the later developments of abdominal rigidity, intestinal paralysis, and vascular collapse indicate transmural gangrene and peritonitis. At this stage, the eventual high mortality of acute ischemia is established whatever the urgency of the operation or the skill with which it is performed. The syndrome must be suspected immediately when a patient in an older age group complains of sudden abdominal pain in the presence of associated cardiac arrhythmia, valvular disease or congestive heart failure, particularly if other sites of peripheral embolization are identified.
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PMID:Acute intestinal ischemia. 73 76

At the present time ergotism is due primarily to excessive use or abuse of ergot preparations for migraine headaches. The diagnosis may be made with the evidence of vascular ischemia in the presence of a history of migraines and its treatment with this drug. The therapy for the vasospasm is directed chiefly at the discontinuation of the ergot preparation, with further treatment aimed at the relief of symptoms or prevention of complications. A case is presented of lower extremity ischemia with impending gangrene of both feet in a patient with a history of chronic schizophrenia. Arteriograms revealed symmetrical vasospasm in the lower extremities as well as spasm of the superior mesenteric artery and its intestinal branches. This is believed to be the first documented case of mesenteric vasospasm due to ergotism. Treatment was instituted with low molecular weight dextran, tolazoline, and reserpine with rapid and complete resolution. Caution is advised in the use of ergot preparations in neuropsychiatric disorders.
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PMID:Mesenteric and peripheral vascular ischemia secondary to ergotism. 83 86

We have reviewed the records of 25 patients who underwent a transmetatarsal amputation at San Francisco General Hospital. The average patient age was 63 years old. Twelve of the patients were diabetic, while transmetatarsal amputations were performed in eleven with simple arteriosclerosis. Two patients underwent amputations for either trauma or nonhealing ulcer. Thirteen of the patients healed their amputation, and twelve of these became ambulatory. Eleven required higher amputation, because of nonhealing due to infection in seven and progressive ischemia in four. One patient died on the first postoperative day of pneumonia. The failure group was younger, contained more diabetics, and had a higher incidence of infection. The operative procedure of transmetatarsal amputation is described. We believe that patients with distal gangrene without spreading infection should be considered for transmetatarsal amputation, reserving initial below-knee amputation for those with greater involvement of the foot.
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PMID:Transmetatarsal amputation. 92 34

The author presents two cases of serious trauma of the extremities complicated with lesions of the arteries. Both cases were treated in the cardiovascular surgery clinic in Ljublgana. In the first case besides on osteosynthesis of a fractured femur, a termoterminal anastomosis was performed on the totally severed Superficial Femoral Artery. In spite of the the Thrombectomin that was later performed on the Posterior Tibial Artery, gangrene of the foot set in, and exitus lethalis, due to a cerebral process. In the second case, besides a fractured femur, the patient had an arterial stupor of the popliteal Artery with periarterial hematomas. A revision of the Popliteal Artery was made. The ruptured Femoral Vein was ligated. Despite surgical intervention, gangrene of the foot set in, and a below the leg amputation was carried out. Due to renal insufficiency, this patient had to undergo peritoneal dialysis. The common denominator of both cases was acute ischemia of the distal portions of the lower extremities, and pathological processes throughout the eitire organism and, above all, of the renal function. In the general theapy of such cases, the author insists on adequate; revascularization, and concrrent regulation of hypovolemia, measures in preventing acidosis, and concern for late diuresis.
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PMID:[Revascularization syndrome]. 94 15


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