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

Lower-extremity arterial occlusive disease in individuals younger than 50 years is rare. We report on 4 young adults with lower limb ischemia, each of them with a different cause. According to literature premature atherosclerosis is the most common cause and is followed by thromboangiitis obliterans, coagulation abnormalities and popliteal artery entrapment syndrome. We suggest a diagnostic concept which could help to avoid undue delay.
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PMID:[Differential diagnosis of ischemia of the lower extremities in young adults]. 825 32

A 42-year-old man who had undergone below-the-knee amputations for Buerger's disease 9 and 14 years earlier required emergency surgery for intestinal ischemia caused by arterial occlusive lesions in the mesentery. The cecum and proximal part of the ascending colon were resected, and marked hyperemic thickening of the wall and severe fibrous adhesions were found. Postoperative angiography revealed occlusions in the superior mesenteric and right external iliac arteries. The resected specimen showed mucosal necrosis of the cecum and circular ulcers at Bauhin's valve and at the ascending colon. Microscopically, small mesenteric vessels were occluded by organized and recanalized thrombi with preserved vascular architecture. The patient has remained free of any further intestinal symptoms for 1 year following his discharge from hospital.
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PMID:Intestinal ischemia resulting from Buerger's disease: report of a case. 829 68

The case of a young man with an unusual presentation of thromboangiitis obliterans with ischemia of the small bowel, 2 years before peripheral vascular disease of the extremities was clinically expressed, is reported.
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PMID:Buerger's disease presenting as acute small bowel ischemia. 846 8

Thromboangiitis obliterans (TAO) occurs almost exclusively in young male smokers. Its involvement of the small and medium-sized arteries and veins leads to ischemic complaints and/or changes in the extremities. The possibility of organ involvement is a matter of controversy. The authors report a case of TAO with multiple organ involvement, including myocardial, splenic, and cerebral infarctions; pulmonary embolisms; and probable intestinal ischemia during a twenty-three-year course.
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PMID:Multiple organ manifestations in thromboangiitis obliterans (Buerger's disease). A case report. 861 17

A new method to treat obliterative atherosclerosis and thromboangiitis is proposed. The method consists in local osteal trepanation of the ischemic extremity. The access to the bones was preferably performed in bioactive points. The operation called osteotrepanation was performed in 307 patients. 219 of them had obliterative atherosclerosis, 75--thromboangiitis obliterans, 13--Raynaud's disease. In 63% of patients there was 3d and 4th stage of extremity ischemia. In 90.5% of patients improvement was observed. After 1 year the improvement of blood circulation in the extremity was observed in 92.8% of patients, after 5 years--in 92,8% also. Revascularizing osteal trepanation is a method of choice in thromboangiitis obliterans and in impossibility to perform reconstructive surgery in case of grafts thrombosis.
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PMID:[The treatment of obliterating arterial diseases of the extremities by a revascularizing osteotrepanation method]. 917 46

After many changes, Buerger's disease stands as an independent clinicopathologic entity, but a better understanding of Buerger's disease has been impeded by the lack of unanimous diagnostic criteria of the disease. Since specificity of Buerger's disease is characterized by peripheral ischemia of an inflammatory nature and with a self-limiting course, diagnostic criteria of Buerger's disease should be discussed from clinical point of view. Our clinical criteria for the diagnosis of Buerger's disease are: (1) smoking history; (2) onset before the age of 50 years; (3) infrapopliteal arterial occlusions; (4) either upper limb involvement or phlebitis migrans; and (5) absence of atherosclerotic risk factors other than smoking. Confident clinical diagnosis of Buerger's disease may be made only when all five requirements have been fulfilled. A set of strict and well-defined clinical diagnostic criteria is essential for any study of Buerger's disease to ensure the homogeneity of the selected patient population for valid comparisons.
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PMID:Diagnostic criteria of Buerger's disease. 995 26

A SERIOUS CONDITION: Critical ischemia results when severe chronic ischemia worsens, creating a threatening situation for tissue survival in the lower limbs. The degree of ischemia is related to the extent of impairment in microcirculation, adding further deleterious effects to stenoses and/or obstructions of the large vessels. MANAGEMENT DIFFICULTIES: Surgery is the mainstay therapy for critical ischemia of the lower limbs. Medical therapy is indicated as first intention treatment in only 10 to 15% of the patients and in a small proportion after partial or total surgical failure when immediate secondary amputation appears to be avoidable. TREATMENTS USED: Antithrombosis agents and drugs with a hemorrheologic effect are used in case of surgical failure or non-indication for surgery. Iloprost is one of the most extensively studied hemorrheology agents. Its use improves the chances of avoiding amputation within a mid-term delay. BUERGER DISEASE: Buerger disease is a specific condition different from the two other major causes (artherothrombosis and diabetes mellitus). The therapeutic management and functional prognosis are much different.
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PMID:[The role of drug therapy in the treatment of critical ischemia of the lower limbs]. 1022 68

The results of treatment of 202 patients with chronic critical ischemia of the extremities by the method of revascularising osteotrepanation are presented. There were 139 patients with atherosclerosis (AO) and 63 with thromboangiitis obliterans (TO). 69% of (AO) patients showed improvement of the circulation exactly after the operation 73%--in 1 year, 65%--in 3 years and 52%--in 5 years. In TO patients these percentases were--88%, 78%, 73%, 58%, respectively. It was established that the operation is most effective in TO and in distal forms of atherosclerosis. In occlusions of aorto-iliac segment it is indicated when rautine reconstruction procedure is impossible. In patients with severe and protracted painful syndrome unresponsive to narcotics, with "positional" oedemas and humid gangrene of the foot the operation is not advisable. Curative effect increases when revascularising osteotrepanation is combined with profundoplasty, sympathectomy, femoro-popliteal bypass grafting and devitalisation of the adrenal glands.
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PMID:[Revascularising osteotrepanation in treatment of lower limbs critical ischemia]. 1023 1

Arteriosclerosis obliterans (ASO) and Buerger's disease are representative arterial occlusive disease which causes chronic lower limb ischemia. In ASO, ischemia is produced by atherosclerotic stenosis and/or occlusion of major arterial trees mainly from the abdominal aorta to the femoral arteries, and in Buerger's disease, smaller arteries distal to the calf and the elbow are generally affected by non-specific panarteritis. Thrombotic occlusion at the affected vessels and proximal and/or distal progression of the secondary thrombosis often deteriorate leg ischemia. In chronic limb ischemia, microcirculation distal to affected vessels is also deteriorated by activation of white blood cells and platelets which induce vasoconstriction, injury of intimal cells, platelet aggregation, increased permeability, etc. Fontaine's classification of chronic limb ischemia based on clinical signs and symptoms is useful for grading severity of ischemia and selecting an optimal treatment. Recently, the concept of chronic critical limb ischemia is advocated, which is a condition that the limb amputation will be inevitable without restoration of blood flow. Diagnostic modalities for chronic arterial occlusion and assessment for severity of ischemia are outlined.
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PMID:[Clinico-pathological aspects of the lower limb ischemia in chronic arterial occlusive disease]. 1042 67

The long term course of thromboangiitis obliterans as well as frequency and extent of major or minor limb amputations depend almost exclusively on the smoking behaviour of the patients. Superficial phlebitis accompanying an acute relapse responds well to high-dose aspirin or NSAIDs. Critical limb ischemia is treated by intra-arterial or intravenous prostaglandins (Alprostadil, Iloprost). Lokal measures for finger, toe, or foot gangrene do not differ from comparable sequelae of atherosclerotic vascular disease. Revascularisation procedures (angioplasty, surgery) have a high rate of technical failure and are indicated only in rare atypical situations. Corticosteroids are the therapy of choice for both vasculitides of large muscular arteries, i.e. temporal arteritis (M. Horton) and Takayasu arteritis. Combination therapy is restricted to steroid refractory disease; while this is the exception in temporal arteritis, it occurs in up to 50% of patients with Takayasu arteritis. Critical limb ischemia due to giant cell arteritis may persist even if the inflammatory activity of the disease is well controlled. Revascularisation procedures in Takayasu arteritis may have good results; as with all other therapeutic measures in this disease, they should be provided by specialized centers. Treatment of Raynaud's phenomenon requires patient evaluation for signs or symptoms of an underlying disease, i.e. some kind of connective tissue disease. Strength and frequency of attacks depend on a number of different factors (triggers) which in a given patient may not be completely understood. Exposition prophylaxis for known triggers and vasodilator drugs are the main therapeutic measures in Raynaud's phenomenon. Careful documentation of disease activity provided, non-classical remedies (behavioural psychotherapy, acupuncture) may be attempted.
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PMID:[Special aspects of therapy of non-atherosclerotic vascular diseases]. 1066 28


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