Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eighty-nine male veterans presenting to a vascular surgery clinic with symptomatic lower extremity atherosclerosis were prospectively screened by duplex scan for asymptomatic carotid artery stenosis (CAS). Their chief complaint was: claudication (90%), rest pain (6%), and ischemic ulcer or gangrene (4%). The mean ankle-brachial index (ABI) was 0.77. Twenty-five CAS > 50% were detected in 18 (20%) patients. Twelve CAS > 75% were detected in 11 (12%) patients. There was no difference between patients with and without CAS > 50% with regards to mean ABI, history of angina, diabetes, hypertension, prior coronary artery bypass, or history of smoking. Carotid bruit was associated with ipsilateral CAS > 50% [p < 0.0001, sensitivity (52%), specificity (88%), positive predictive value (41%), negative predictive value (92%)]. As a result of the screening, eight elective carotid endarterectomies have been performed to date in six (7%) patients with one transient twelfth cranial nerve paresis as the only postoperative complication. We conclude that: (1) male patients presenting with symptomatic lower extremity atherosclerosis have a 20% prevalence of asymptomatic CAS > 50%, (2) there is no correlation between the degree of lower extremity ischemia and CAS > 50%, (3) carotid bruit is significantly associated with CAS > 50%, but has a low sensitivity, and (4) routine CAS screening should be considered for all male patients with symptomatic lower extremity atherosclerosis regardless of whether a bruit is present.
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PMID:Asymptomatic carotid artery stenosis screening in patients with lower extremity atherosclerosis: a prospective study. 923 93

Ocular symptoms can be the first sign of carotid artery stenosis. In our carotid endarterectomy patients group were ocular symptoms present in 15%, as the only sign (without accompanying neurological signs) in 10.5%. Amaurosis fugax was a dominant sign in 56 cases, blindness in 5, quadrantanopia in 3; trochlear and oculomotor nerve paresis in one case. Angiography finding of more than 60% ICA stenosis according NASCET criteria was an indication for surgery. The operative technique per se was a microsurgical endarterectomy with selective peroperative shunt application. The 30-d morbidity was 3%--with one case of central retinal artery embolization and subsequent blindness and another case of major residual neurological deficit due to hyperperfusion syndrome and the resultant capsular hemorrhage. Shunt was applied in 3% of cases and microscope was used always since the beginning of the dissection up to the final suture. Considering low perioperative morbidity/mortality rates the carotid endarterectomy represents an important means of brain ischaemia profylaxis. In the process of hemodynamically significant ICA stenosis, indication for surgical management the authors emphasize the role of ocular signs and symptoms and thus the importance of an ophthalmology consultant.
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PMID:[Ocular symptoms as an indication for carotid endarterectomy]. 1703 23

Endovascular treatment is becoming a safe and efficacious modality in the management of carotid artery stenosis in Takayasu arteritis (TA). A 24-year-old woman of TA presented with blurred vision, recurrent syncope and upper limb claudication. Angiography revealed right CCA 95 %, left CCA 90 % stenosis and occlusion of other arch vessels. She underwent right CCA angioplasty and stenting. She developed left-sided hemi paresis. Check angiogram revealed plaque protrusion in the proximal part of the stented segment. Intra-arterial urokinase bolus was given and overlapping stenting done. Re-occlusion by plaque protrusion immediately after stenting like in our case is not reported.
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PMID:Reocclusion and stroke due to immediate plaque protrusion following endovascular treatment of carotid artery successfully treated with intra-arterial urokinase and stent in stent in a patient with Takayasu arteritis with severe disease of all arch vessels. 2356 87