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)

A 43-year-old female alcoholic had massive hematobilia secondary to arterial trauma of a liver biopsy. The arterial bleeding site was successfully embolized through an angiographic catheter with Gelfoam sponge. No liver ischemia occurred and the patient has remained well.
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PMID:Successful transcatheter embolic control of massive hematobilia secondary to liver biopsy. 97 74

A problem in lung transplantation is tracheal or bronchial dehiscence from ischemia. To determine if an angiogenic factor applied to the airway would improve capillary regrowth, a three-ring segment of trachea was completely severed and sutured in rats. In one group of animals the ischemic segment was wrapped with Gelfoam soaked in an angiogenic factor, transforming growth factor-alpha. In a second group the ischemic area was wrapped with Gelfoam soaked with only the vehicle. In a third group the devascularized area received no additional treatment. One animal from each group was killed daily for 7 days after operation. The tracheal vasculature was cast and viewed by light and scanning electron microscopy. None of the four animals that died early were in the transforming growth factor-alpha group. All animals lost weight between the day of operation and death, but this was least in the transforming growth factor-alpha group (p = 0.05). The light microscopy showed ischemic changes and the development of granulation tissue. The scanning electron microscopy of the vascular casts showed extensive loss of the vessels in the cut area. On day 1 the vessels of all animals dilated and their walls became rough. By day 3 a few corkscrew vessels penetrated the ischemic zone. By day 4 the animal that received transforming growth factor-alpha had more capillaries than the others. By day 6 revascularization in the transforming growth factor-alpha animal was abundant. Besides budding, new capillaries appeared to develop by lateral growth. After the fifth day vessels about 30 to 50 microns in diameter bulged focally. On the bulges, ridges the size, shape, and pattern of capillaries formed. Capillary formation in this manner has not been reported previously. Revascularization emerged sooner and more extensively with transforming growth factor-alpha. No adverse effect of transforming growth factor-alpha was found.
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PMID:The effect of transforming growth factor-alpha on airway angiogenesis. 128 Jul 50

Despite omentopexy of the bronchial anastomosis, donor airway ischemia remains a problem after lung transplantation. This study examined the hypothesis that surface abrasion and topical application of basic fibroblast growth factor (bFGF) would enhance omental revascularization of trachea in a rabbit heterotopic autograft model. Tracheal segments were excised, primary tracheal anastomoses performed, and the segments placed in the peritoneal cavity wrapped in omentum. Animals were randomized to one of six groups according to tracheal segment treatment: control, surgical abrasion, Surgicel wrap with topical bFGF, Surgicel wrap with bFGF vehicle, Gelfoam wrap with bFGF, and topical bFGF alone. One week later, animals were heparinized, perfused with Aquablak dye, and killed. Tracheal segments were excised and sectioned for light microscopic quantitative assessment of viability and dye perfusion. There was no significant improvement in viability or perfusion between abraded tracheal segments or segments treated with bFGF/Gelfoam or bFGF alone when compared with control segments. Airways wrapped in Surgicel had significantly greater ischemic injury compared with the control group, regardless of bFGF application. Neither surgical abrasion nor topical bFGF increased omental revascularization of transplanted tracheal segments after 7 days.
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PMID:Role of basic fibroblast growth factor in revascularization of rabbit tracheal autografts. 171 56

The ventrolateral medullary surface (VMS) has been shown to have chemosensitive areas that can alter blood pressure and respiration. It has also been shown that lesions near the VMS can affect the intensity of the cerebral ischemic response (CIR). To determine which regions of the central chemosensitive areas of the ventral medullary surface contribute to the pressor response caused by cerebral ischemia, we used focal cooling of the caudal Loescheke's (CL), intermediate Schlaefke's (IS), and rostral Mitchell's (RM) areas of VMS during ischemia of the brain. Experiments were performed on 17 pentobarbital sodium-anesthetized, paralyzed, and artificially ventilated cats after denervation of the vagi and sinoaortic nerves. Bilateral occlusion of the external carotid and vertebral arteries resulted in a significant increase of arterial pressure (from 129 +/- 4 to 174 +/- 8 mmHg, P less than 0.01) and an increase in splanchnic sympathetic activity. However, heart rate and cervical sympathetic activities were not appreciably affected by cerebral ischemia. Bilateral cooling of the IS area to as low as 10 degrees C led to a decrease or disappearance of phrenic activity but failed to affect the magnitude of the pressor response. Also cooling of the CL and RM areas and application of Gelfoam pledgets soaked in lidocaine (4%) to these areas did not affect the CIR. However, covering the whole VMS with 0.2 ml of 4% lidocaine or cold cerebrospinal fluid (10 degrees C) abolished the ischemic reflex.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of focal cooling of central chemosensitive areas on cerebral ischemic response. 287 45

Intramedullary spinal cord arteriovenous malformation (AVM) can be a devastating disease. It is not usually amenable to surgery without producing severe neurologic deficit. Previously, the risk of cord ischemia was considered a contraindication to therapeutic embolization. Three patients with intramedullary spinal cord AVMs were examined and treated using polyvinyl alcohol foam, mixed with Gelfoam in two cases. In all three cases there was marked improvement, in two to complete normalcy and in the other to near-normalcy. Successful therapy involves the appropriate angiographic mapping, choice of embolus size and composition, and challenge of function by either test occlusion or long perfusion with contrast material.
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PMID:Embolization of intramedullary arteriovenous malformations of the spinal cord. 308 26

It has been generally accepted that the direct approach to the cavernous sinus under the normal temperature is very difficult and dangerous. Bleeding from the cavernous sinus is thought to be very difficult to control. However, when the patient is kept in semi-sitting position during the operation, the venous pressure of the cavernous sinus can be decreased nearly to 0 and the cavernous sinus can be opened without any serious bleeding. Either insertion of Biobond soaked Oxycel or alternative insertion of fibrinogen soaked Gelfoam and thrombin soaked Gelfoam into the opened cavernous sinus is made to control bleeding. In the case of C-C fistula, if the cavernous portion of the carotid artery is trapped by application of temporary clips to the cervical portion of the external and internal carotid artery and the C2 portion of the internal carotid artery, one could perform the operation without any uncontrollable serious bleeding in the same manner. In such cases, in order to prevent ischemia of the brain during interruption of the internal carotid flow, EC-IC bypass is indicated and performed about two weeks prior to the direct attack of the cavernous sinus. The operation consists of subfronto-pterional transsylvian approach, removal of the anterior clinoid process, removal of the superior, lateral and inferior walls of the optic foramen as far anteriorly as possible, opening of the anterior inferior cavity and the medial cavity through the medial triangle in order to isolate the C3 and C4 portions of the internal carotid artery, and then exposure of the C5 portion of the internal carotid artery via the Parkinson's triangle.
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PMID:[Surgical approaches to the cavernous sinus--repair of a C-C fistula at the C5 portion of the internal carotid artery]. 372 70

In arterio-venous malformations, arterial trans-catheter embolization can be considered as a definitive treatment, a pre-operative devascularizing technique, and a palliative treatment of those not surgically operable malformations. A very important point is choosing the correct way where to introduce the catheter and the embolizing devices. The most known devices are: synthetic fibrin foam (Gelfoam, Spongostan), Gianturco coils, and among the non reabsorbable devices a polyvinylic alcohol foam (Ivalon), the isobutyl-2-cyanoacrylate and silicone. Furthermore detachable balloons and bristle-brushes can be used. Many parameters must be taken into consideration: hemodynamic fluxes of the lesion, type of vascularization, extension of the lesion, aim of the embolization, possible risks. When embolizing large territories, the protocol must foresee several performances for the control of the embolized vessels, the presence of collateral circulation, the extension of the embolization and other afferent arteries to the lesion. Regarding the permanent occlusions it is preferable to utilize fragments of Ivalon, small silicone spheres or liquid silicone; finally, reabsorbable device must be used in the distal embolizations and non reabsorptible in the proximal embolizations. The best results have been achieved in the traumatic lesions where a direct communication exists between an artery and a vein. Among the arterio-venous malformations the best results have been achieved in cranio-facial angiomas with low flux. The possible complications are consequences of ischemia: necrotic musculo-cutaneous, cerebral or troncular changes.
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PMID:[Arterial transcatheter embolization in arterio-venous fistulae therapy (aithor's transl)]. 616 98

Extensive lower limb paresis developed in three patients with terminal cancer following internal iliac (hypogastric) artery embolization. This procedure was carried out for control of hemorrhage in two of the patients and for reduction of the bulk of metastatic tumor in another. The embolic materials used resulted in extensive obliteration of small and large vessels of the posterior and anterior divisions of the internal iliac artery. The paresis is attributed to the resulting ischemia of the sciatic and femoral nerves; previous radiotherapy may also have been a contributing factor. To reduce the incidence of paralysis, identification of the bleeding vessels and selective embolization are recommended. If this cannot be achieved, and the catheter lies in the main stem, it is recommended that the emboli should not be smaller than Gelfoam pledgets (1 X 1 X 10 mm) to preserve the peripheral circulation and lessen the risk of complication.
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PMID:Paresis following internal iliac artery embolization. 684 68

To clarify the pathogenesis and endoscopic features of ischemic lesions of the colon, experimental ischemia was induced in dogs by arterial ligation, gelfoam injection, and clipping. In addition, clinical and endoscopic features of ischemic lesions in ischemic colitis cases in human were studied. In the experimental model, arterial ligation including marginal arteries frequently induced erosions in the large intestine, whereas ligation of the colic artery alone did not induce apparent mucosal lesions of the large intestine. Gelfoam injection to produce thrombi into caudal mesenteric artery or middle colic artery induced ulcers with a high rate of incidence and frequently accompanied by intestinal perforation. Temporal impairment of blood supply by arterial clipping produced erosion, but not ulcers. A high incidence of erosion was obtained in a group that underwent clipping for a prolonged period and a group of receiving Alosenn. Mucosal blood flow measured by the hydrogen gas clearance method was significantly decreased at 1 hr and 4 hr after gelfoam injection compared with those after arterial ligation. In human cases of ischemia following arterial surgery, endoscopic features were similar to those lesions of the experimental ischemia induced by gelfoam injection. These results suggest that thrombi in peripheral small arteries may play a major role in the pathogenesis of ischemic lesions of the large intestine.
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PMID:[Experimental and clinical studies on ischemic lesions of the large intestine]. 772 85

Middle colic artery aneurysms are very uncommon. A few cases of occlusion of superior mesenteric artery aneurysms without bowel ischemia are reported. We describe successful uncomplicated embolization of a ruptured middle colic artery aneurysm with a Gelfoam plug.
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PMID:Embolization of a ruptured middle colic artery aneurysm. 778 36


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