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

Popliteal artery entrapment can result in claudication and limb-threatening ischemia in the young adult. The purpose of this study was to evaluate prospectively those patients with popliteal artery entrapment. To define the syndrome, the methods used in diagnosis and the type of anatomic anomaly were established for each patient. From 1977 to 1988, 12 patients were found to have popliteal artery entrapment. The average age was 27 years, with all but three patients under age 40 years. All patients complained of calf claudication, and one had acute ischemia. The ankle pulses decreased with maneuvers in 10 patients; four patients had a resting ankle/brachial index less than one. All had diminished ankle/brachial indexes when a treadmill test was performed at 4.2 mph, 10% grade, for 10 minutes. All patients had biplanar arteriography with passive dorsiflexion and active plantar flexion. All results showed abnormal extrinsic compression or occlusion of the popliteal artery. Twenty limbs were affected; eight of 12 patients (67%) had bilateral entrapment. Type IV (37%) lesions were the most common, with type II (32%) and type III (26%) following closely. One (5%) type I lesion and no type V lesions were found. This is the largest single series of patients with popliteal entrapment in the United States. A treadmill test followed by biplanar arteriography established the diagnosis in all patients. Bilateral involvement was twice that reported in previous studies. Popliteal artery entrapment should be considered in the young adult with claudication and may be seen with greater frequency in an increasingly active population.
 ...
PMID:Popliteal artery entrapment: an evolving syndrome. 281 May 35

The contribution of chronic limb ischemia to long-term nonunion of a lower extremity fracture was suggested in a single published case report from our group 13 years ago. We have since encountered three additional patients with nonunited lower extremity fractures occurring in limbs with arterial ischemia. In each of these four patients limb revascularization was undertaken in an effort to stimulate healing of the fracture. These patients had chronic (mean 6 months) nonunion of tibial (three) or femur (one) fractures associated with severe lower extremity ischemia (ankle/brachial index m = 0.33; range 0.24 to 0.5). All patients had histories of chronic lower extremity ischemia before the fracture (ischemic rest pain, 2; claudication, 2). All patients underwent angiography followed by lower extremity revascularization. Restoration of normal arterial supply to the fracture site was followed by healing of the fracture in all patients. To our knowledge, this represents the first reported series of patients undergoing elective limb revascularization to stimulate healing of the fracture. Widespread appreciation of this relationship by orthopedic surgeons may be of considerable clinical importance.
 ...
PMID:Role of revascularization to treat chronic nonhealing fractures in ischemic limbs. 281 May 39

A double blind study was conducted on patients afflicted with obstructive arteriopathy of the lower limbs in order to verify the efficacy and tolerability, in long term treatment, of a new low molecular weight heparin (Alfa LMW1). Of the 55 patients studied, 28 were treated with Alfa LMW1 given subcutaneously in doses of 8,000 I.U. AXa daily for 6 months; the remainder 27 were treated with Placebo. Efficacy of Alfa LMW1 was evaluated by monitoring the lower limb segmental pressures and some pressure ratios (thigh/arm, ankle/arm). Moreover, by means of the treadmill test, also checked were: time of claudication; ankle/arm pressure ratio before and after exercise and time required to return to initial pressure. By means of the strain gauge plethysmography, basal flow and peak flow after ischemia were also evaluated. The results obtained indicated a significant difference in efficacy between the two therapies, most notable after the third month. While in the Alfa LMW1 group a significant (p less than 0.01) and progressive improvement by the third month of treatment was seen, in the Placebo group a slight improvement was registered only at the end of the study and this was significantly inferior with respect to the comparison group.
 ...
PMID:A new low molecular weight heparin in the treatment of peripheral arterial disease. 285 Mar 26

A 26-year-old male shortly after an acute respiratory disease was affected by a thrombophlebitis of the left leg. After a few days he had two syncopal attacks. Later on, a myocardial ischemia was diagnosed. Subsequently the patient began to complain of a bilateral claudication of the calves; after an attack of fever, the ischemia of the lower limbs worsened with recurring pain at rest. At the same time, in absence of any symptom, a myocardial ischemia occurred again and the presence of a thrombus was observed in the right atrium. After surgical removal of it, the ischemic troubles of the lower limbs once again began to worsen with the occurrence of bilateral gangrene of the feet. An amputation of both the legs was promptly performed at the level of the thighs. The histological examination of the arteries of the amputated legs showed segmental arteritis with partially recanalized thrombi of the popliteal, left femoral and tibioperoneal arteries. In the meantime, the titres for Coxsackie virus B2 and B6 were found slightly increased. One month later, the left radial pulse disappeared for a few days. The histopathological findings may relate this arteritis to a form of Buerger's disease even if a systemic thromboangiitis obliterans is not commonly accepted. In case that the acute respiratory infection represented the true onset of the sickness, it seems conceivable that the hypothesis of a viral infection gave raise to arteritis with morphological features recalling those of Buerger's disease.
 ...
PMID:An uncommon systemic arteritis--a case report. 286 78

Axillofemoral bypass (AXB) was performed on 100 patients who had claudication (19), pain at rest (42), gangrene or ulcer (22), aortic sepsis (14), or unresectable abdominal aneurysm (3). Unilateral (27 grafts), double unilateral (1), or axillobifemoral (72) grafts with Dacron (58), polytetrafluoroethylene (PTFE) (28), ring-supported Dacron or PTFE (12), or other material (2) were performed by 13 surgeons. Eight patients died within 30 days and three major amputations were necessary. Fifty-two (57%) of the 92 survivors had a total of 92 graft complications during a mean follow-up period of 21.5 months. Thirty-two patients underwent 57 reoperations of various types, incurring an additional three deaths and three amputations. Sixty (65%) of the original 92 survivors of AXB avoided reoperation. The 89 patients who survived the original and repeat procedures were followed up through the end of 1984 (62 patients), to late death (23), or to late graft removal (4), whichever occurred first. At these end points, 83 of the 89 (93%) patients had patent grafts. The graft patency rate of the original 100 AXBs by life table was 54% at 36 months; but with reoperation, it was 72%. Among those patients who left the hospital after AXB, the survival rate at 36 months was 69%. Statistically insignificant trends toward improved early patency were noted with bilateral femoral anastomoses, total iliac occlusion, and less severe ischemia. AXB provided safe palliation of severe arterial disease, with overall graft patency exceeding postoperative patient survival according to life-table analysis. However, the safety of AXB was tempered by frequent complications and the necessity for many reoperations to provide maximum efficacy.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Axillofemoral bypass: a tool with a limited role. 293 65

Complete occlusion or high-grade stenosis of the common femoral artery (CFA) occurs infrequently, whether as an isolated lesion or associated with similar lesions in other arteries. Ten patients with this condition comprise this report. Three had severe claudication, while seven required treatment for limb salvage. Two of the patients with claudication and one with critical ischemia had isolated CFA lesions. The remaining seven had CFA disease in tandem with either inflow aortoiliac disease or associated distal occlusions. Physical examination and vascular laboratory studies failed to suggest the diagnosis in every instance. Angiography was definitive in revealing the location and extent of pathology. Patients with localized disease were treated by patch angioplasty, balloon dilatation, or by graft replacement and profundaplasty. All others required more extensive reconstructions, with important variations from standard technique being necessary because of the CFA lesion. Amelioration of symptoms was achieved in all patients.
 ...
PMID:Management of common femoral artery occlusion. A report of ten cases. 294 64

We reviewed 142 percutaneous transluminal angioplasties (PTAs) in the iliac (n = 94) and femoropopliteal (n = 48) positions of 107 patients. Emphasis was placed on the ultimate clinical outcome, which was determined from a pool of clinical, hemodynamic, and angiographic data. Limb-threatening ischemia was the indication for intervention in 53% of the cases. The median follow-up interval was 17 months. Overall success was achieved in 50% of cases in both iliac and femoral positions at one year after PTA. The following factors were found to correlate with a successful clinical outcome: PTA for claudication vs limb-threatening ischemia (P less than .001); focal as opposed to diffuse stenosis or occlusion (P less than .02); immediate return of distal pulses (P less than .001); the absence of diabetes (P less than .05); and the presence of a patent outflow tract (P less than .001). Treatment results with PTA will vary widely according to the nature of the patient population and the criteria for determining success.
 ...
PMID:Percutaneous angioplasty for peripheral arterial occlusive disease. Correlates of clinical success. 295 Aug 41

We investigated the behavior of beta-thromboglobulin (beta-TG) and platelet factor 4 (PF 4) during exercise--upright bicycle ergometry--in 30 patients (median age, 62.4 years) with arteriographically proven peripheral arterial occlusive disease (PAOD) in a chronic stable phase. In 15 patients the exercise study was done twice; the second time was concurrent with administration of acetylsalicylic acid (ASA) in a dosage of 1.0 g/day, while the first time was without ASA therapy. There were no significant differences in either the group of patients with or that without ASA with regard to the platelet-specific proteins at rest, immediately after, and 30 min after exercise. Blood collected simultaneously (n = 6) from an arm vein and from a femoral artery and femoral vein also revealed no significant differences. Our findings support the conclusion that exercise-induced peripheral ischemia with severe symptoms of claudication does not produce platelet alpha-granule release.
 ...
PMID:Lack of elevation of beta-thromboglobulin and platelet factor 4 in plasma during exercise in patients with chronic peripheral arterial occlusive disease. 295 58

The early and late results of local thrombolysis with low-dose streptokinase followed by balloon dilatation in 64 patients with an occluded femoropopliteal artery are reviewed. The primary success rate was 77% for the native arteries; it was higher (80%) for short (less than 10 cm) as compared with long occlusion (40%) and for patients with claudication as compared with those with advanced ischemia (89% versus 48%). Eleven complications were observed in 10 patients, most frequently a local hematoma at the puncture site. Ascending thrombosis and absence of lysis or incomplete lysis were the main reasons for failure. The cumulative patency rate after 1 and 2 years follow-up was 87% and 82%, respectively.
 ...
PMID:Local thrombolysis in femoropopliteal occlusion: early and late results. 296 Apr 51

The technique described uses a composite prosthesis to combine infrarenal aortic resection with aorto-bifemoral bypass while preserving pelvic circulation. Its short-term objective is to prevent colic ischemia and its long-term objective to avoid impotence and gluteal claudication. This technique has the advantages of being simple, rapid and less aggressive than other procedures. It was applied in 6 cases over the last 2 years and was successful in all of them.
 ...
PMID:[Composite arterial prosthesis for aortofemoral reconstruction with preservation of hypogastric flow]. 315 7


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>