Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-six peripheral arterial emboli complicating 14 cases of mural thrombi of the aorta were diagnosed between January 1978 and December 1986. None of these patients had any cardiovascular history; their mean age was 49 years. Presenting signs were acute ischemia of the lower limbs in 12 cases and chronic ischemia in two. Arteriograms and CT scan were diagnostic. The mural thrombi were infrarenal in 13 cases and suprarenal in one. Treatment of the thrombus was surgical in all but one patient. In four cases, treatment of the underlying cause was simultaneous with embolectomy; in nine patients, treatment was secondary because further workup was needed. In one case, the patient died following embolectomy before definitive treatment could be undertaken. Results were considered good in 11 cases (unlimited walking distance, no recurrent emboli), and poor in three cases (two major amputations and one death). The incidence of mural thrombi is not known. In our experience, they accounted for 3.8% of nonaneurysmal aortoiliac lesions operated upon during a nine-year period and were responsible for 5% of peripheral arterial emboli. Mural thrombosis of the aorta constitutes a dangerous condition with a potentially lethal final outcome. Recurrent emboli are inevitable without surgical treatment of the source.
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PMID:Mural thrombus of the aorta. 319 Oct 2

Eighty-four consecutive intact atheromata from the carotid bifurcation were examined macroscopically and by standard microscopic techniques. Preoperative angiograms of these cases were reviewed by a single radiologist with special attention to detecting the presence of ulceration. Pathologic and angiographic findings were compared and correlated with the patient's clinical presentation. Macroscopic findings of ulceration were present in 43 cases (51%). Thirty-four specimens contained intramural hemorrhage and 27 showed evidence of mural thrombus. Mural thrombus was significantly associated with evidence of ulceration (p less than 0.01). Intramural hemorrhage was commonly associated with ulceration (25/34) but was also seen in nonulcerated plaques (p greater than 0.05). Angiographic diagnosis of ulceration was made in 54 cases (64%). While angiography identified 78% of macroscopic ulcers (34/43; p = 0.05), seven typical ulcerations were missed angiographically and there were 18 angiographic false positive results (18/54:33%). Macroscopic ulcerations were most common in patients with symptoms of hemispheric ischemia (p less than 0.1). The angiographic diagnosis of ulceration did not correlate with the patient's clinical presentation (i.e., hemispheric ischemia, nonhemispheric ischemia, or asymptomatic stenosis). These results support the thesis that macroscopic ulceration is an important cause of hemispheric ischemia. Angiography does not reliably predict the presence of macroscopic ulceration and this limitation should be kept in mind when patients with hemispheric symptoms are evaluated. Such patients should not be denied consideration for endarterectomy simply because the angiogram fails to demonstrate ulceration.
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PMID:Angiographic and pathologic correlates in carotid artery disease. 395 53