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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fibromuscular dysplasia is a nonatherosclerotic, noninflammatory vascular disease that involves primarily the renal and internal carotid arteries and less often the vertebral, iliac, subclavian, and visceral arteries. Although its pathogenesis is not completely understood, humoral, mechanical, and genetic factors as well as mural ischemia may play a role. The natural history is relatively benign, with progression occurring in only a minority of the patients. Typical clinical manifestations are renovascular hypertension, stroke, subarachnoid hemorrhage, abdominal angina, or claudication of the legs or arms. In patients with symptoms, percutaneous transluminal angioplasty has emerged as the treatment of choice in most involved vascular beds.
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PMID:Arterial fibromuscular dysplasia. 330 88

A cross-sectional study on the prevalence of atherosclerotic vascular disease (ASVD) and its risk factors in non-insulin-dependent diabetic and nondiabetic subjects was carried out from 1982 to 1984 in East Finland (Kuopio) and West Finland (Turku), two areas known to differ markedly in prevalence of ASVD in the nondiabetic population. A total of 510 diabetic and 649 nondiabetic subjects aged 45-64 yr were examined in East Finland and 549 diabetic and 724 nondiabetic subjects of the same age in West Finland. In both areas and in both sexes the prevalence of coronary heart disease (CHD), stroke, and intermittent claudication was higher in diabetic than in nondiabetic subjects. Both in diabetic and nondiabetic subjects the prevalence of ASVD was higher in East Finland than in West Finland. In men, the East-West difference in the prevalence of symptomatic CHD and claudication was greater in diabetic than in nondiabetic subjects. In both areas and in both sexes the serum lipid pattern was more atherogenic and hypertension was more frequent in diabetic than in nondiabetic subjects. In both diabetic and nondiabetic subjects, serum total-cholesterol level was somewhat higher and hypertension was more frequent in East Finland than in West Finland. The East-West difference in serum total-cholesterol was greater in diabetic than in nondiabetic subjects. In multiple logistic analyses including cardiovascular risk factors, diabetes status, and area of residence, residence in East Finland was found to be, in addition to diabetes, a strong independent factor associated with CHD, particularly in men.
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PMID:Atherosclerotic vascular disease and its risk factors in non-insulin-dependent diabetic and nondiabetic subjects in Finland. 340

Under sterile conditions, dogs were instrumented for continuous measurement of hemodynamics, and an Ameroid constrictor was positioned around either the left carotid, left femoral, or left anterior descending coronary artery to produce slowly progressive narrowing of the vessel. Cyclic flow reduction (CFR) developed in the carotid artery in seven of nine dogs on day 5.1 +/- 0.8 (mean +/- S.E.M.) at a frequency of 6.7 +/- 0.6 cycles per 30 min. This phenomenon was abolished for 30 +/- 5 and 45 +/- 15 min with intravenous administration of 50 and 100 micrograms/kg, respectively of the thromboxane receptor antagonist, BM 13.505, 4-[2-(4-chloro-benzene-sulfonamide)-ethyl]-benzene acetic acid. Total carotid artery occlusion occurred on day 7.9 +/- 0.8. CFR developed in the femoral artery in one of three dogs on day 4 at a frequency of 7 cycles per 30 min and was abolished for 82 min after BM 13.505 (50 micrograms/kg i.v.). The vessel became totally occluded on day 7. Finally, CFR developed in the left anterior descending coronary artery in three of five dogs on day 9.3 +/- 4.9 at a frequency of 6.2 +/- 0.9 cycles per 30 min. CFR was abolished for 37 min after BM 13.505 (50 micrograms/kg i.v.) and for several hours after an oral dose of aspirin (650 mg). Total coronary occlusion was observed on day 17.4 +/- 2.6. The present results demonstrate that CFR can be induced in various arteries in conscious, chronically instrumented dogs by slowly progressive narrowing via Ameroid constrictors. This phenomenon may serve as a model for transient ischemic attack, claudication, and unstable angina. Because the conscious state is maintained, drug interactions with anesthetics are avoided. The usefulness of inhibitors of platelet aggregation in this model documents the potential benefit of such compounds in various vascular disease states.
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PMID:Induction of cyclic flow reduction in the coronary, carotid, and femoral arteries of conscious, chronically instrumented dogs. A model for investigating the role of platelets in severely constricted arteries. 341 77

We reviewed the recommendations and outcomes for all patients with diabetes mellitus and end-stage renal disease referred to the Medical Center Hospital of Vermont from 1971 through December 1983. During this period, we recommended transplantation in 53 of 73 patients evaluated. Thirty-two transplants were performed in 30 patients. Of the 30 patients, 10 had clinical vascular disease prior to transplantation, i.e., claudication, amputation, active angina, myocardial infarction, or stroke. Seven of the 10 had only claudication or amputation. These 10 patients showed a clear excess in graft failure and mortality. One- and 2-year graft survival was 37 and 13%; patient survival was 48 and 24%. By comparison, the 20 patients without evident vascular disease had 1- and 2-year graft survival rates of 83 and 75% and patient survival rates of 85% at both 1 and 2 years. The incidence of cardiovascular death in the group with vascular disease was 45% at 1 year and 63% at 2 years, as compared with none in the group without vascular disease. The high graft loss and mortality in this group after transplantation should be a major consideration when therapeutic alternatives are considered in diabetics with end-stage renal disease.
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PMID:Renal transplantation in diabetes mellitus. Influence of preexisting vascular disease on outcome. 351 20

The effect of captopril was studied in 40 hypertensive patients (WHO stages I and II) with peripheral vascular disease of the lower limbs (Fontaine stages IIa and IIb). We assessed systolic and diastolic arterial pressure, heart rate in supine and upright position, relative and absolute pain free intervals, and ankle/arm pressure index at rest and after treadmill exercise test. In the first part of the study 20 patients were divided into two groups, one of which was treated with chlorthalidone (25 mg/day) and the other with captopril (50 mg two times a day) for 8 weeks. Statistically significant improvements were only obtained in the captopril-treated group. They concerned the ankle/arm pressure index at rest (P less than 0.05) and after exercise (P less than 0.05) and the absolute pain free interval (P less than 0.05) as well as systolic arterial pressure. Furthermore, 20 more patients were treated with captopril (50 mg two times a day) for 8 weeks, and improvements were found in ankle/arm pressure index at rest (P less than 0.01) and after exercise (P less than 0.001) and in relative and absolute pain free intervals (P less than 0.001) as well as in systolic and diastolic arterial pressure. These results indicate an increase in flow to the limbs of patients with vascular disease treated with captopril, and suggest that captopril is an effective drug without contraindications for the treatment of hypertension associated with claudication.
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PMID:Captopril in the treatment of hypertension associated with claudication. 353 62

In a 27-year-old man with claudication, computed tomography (CT) demonstrated a popliteal cyst and an adventitial cyst of the popliteal artery. Adventitial cystic disease was unexpected because the patient had a diminished pedal pulse on plantar flexion of the foot, a physical finding suggesting popliteal artery entrapment syndrome. CT was useful in the initial examination of this young patient with suspected popliteal vascular disease because of its accuracy and noninvasiveness.
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PMID:Adventitial cystic disease of the popliteal artery. 382 30

General and vascular surgeons are consulted occasionally to evaluate young adults with ischemia of the lower extremity. Between 1975 and 1985, 51 adults under 40 years of age who had arterial occlusive disease of the lower limb were managed. Although premature atherosclerosis was the most common problem (50%), claudication or limb-threatening ischemia also resulted from other sources (thromboembolism, popliteal artery entrapment, Buerger's disease, collagen vascular disease, and Takayasu's arteritis). Identifying the exact cause was sometimes difficult. The authors were impressed with the number of young adults who had delay in diagnosis and treatment (30 patients, 59%) before referral for a surgical opinion. In this paper, the attempt has been made to uncover the reasons for delayed diagnosis and to suggest a systematic approach that should lead to early recognition of lower extremity ischemia in this age group.
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PMID:Lower extremity arterial disease in young adults. A systematic approach to early diagnosis. 405 11

In addition to the determination of the presenting symptom of patients with peripheral vascular occlusive disease, evaluation of these patients may include the noninvasive measurements of ankle/arm pressure ratio, limb blood flow, and treadmill testing to evaluate the severity of the reduction in blood flow. We have included metabolic studies to assess the effect of this reduced blood flow in patients with stable intermittent claudication (n = 20), and with end-stage ischemia (night and rest pain) (n = 11), and in a control group without vascular disease (n = 8). No correlations were found between the resting limb blood flow, ankle/arm pressure ratios, maximum walking distance, and stated walking distance for the patients with stable claudication. Although the oxygen consumption was reduced only in the patients with end-stage ischemia, the percent oxygen extraction was increased to the same level in the patients with stable claudication and those with end-stage ischemia. Intramuscular stores of high-energy phosphates and glycogen were maintained in all groups with the lactate/pyruvate ratio increased only in the patients with end-stage ischemia. The complex interrelationships between the rate and distribution of blood flow with exercise and enzyme adaptation in patients with vascular disease make current resting hemodynamic and metabolic evaluations a poor reflection of the severity of the clinical condition within each patient group. Therefore laboratory testing may offer no advantage over clinical presentation in the overall evaluation of these patients.
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PMID:Laboratory evaluation of patients with vascular occlusive disease. 405 49

A 62-year-old male with severe claudication and rest pain of the left leg resulting from a totally occluded superficial femoral artery and a 95% stenosis of the deep femoral artery was treated with laser angioplasty after attempts at surgical revascularization were unsuccessful. A 200 mu silica fiber was inserted through a catheter and advanced into the lesion using 2 watts of delivered energy from an argon laser source. The fiber was then withdrawn from the lesion using 7 watts of energy to enlarge the lumen. No complications occurred, and posterior tibial blood flow was reestablished, as shown by Doppler flow measurements and resolution of clinical symptoms. We report a new technique of transcatheter fiberoptic-directed argon laser radiation (laser angioplasty) for the treatment of occlusive vascular disease.
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PMID:Salvage of an ischemic limb by laser angioplasty: description of a new technique. 670 89

Whole-blood viscosity (measured at 128, 23 and 0.2 s-(1) was significantly increased in 29 females with Raynaud's syndrome, 13 males with vibration-induced Raynaud's syndrome, and 18 males with calf claudication secondary to atherosclerosis, as compared with 50 healthy controls matched for sex, age and smoking habit. Viscosity was higher at low temperature (27 and 22 degrees C) in all three types of vascular disease and, despite symptoms of cold hypersensitivity, patients with Raynaud's syndrome did not show selective hypersensitivity at low temperature. Patients with vascular disease, irrespective of aetiology, also showed an increase in the acute-phase reactants haptoglobin, fibrinogen, and factor VIII antigen, together with reduced fibrinolytic activity and minor activation of platelets. These alterations in viscosity and haemostatic factors in vascular disease are probably related to the degree, rather than the aetiology, of endothelial damage and their cumulative effect may contribute to local stasis and thrombosis, particularly in cold extremities.
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PMID:Hyperviscosity and thrombotic changes in idiopathic and secondary Raynaud's syndrome. 677 75


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