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

Thirty patients with Takayasu's arteritis treated surgically were followed for more than ten years postoperatively, 28 women and 2 men. The average age at the initial operation was 29 years. The clinicopathological finding was classified in four types; the distribution of cases was 6 in Type I, 17 in Type II, 4 in Type III, and 3 in Type IV. Surgical procedures performed were carotid artery reconstruction in 9 patients, thoraco-abdominal aortic bypass in 5, renal artery reconstruction in 10, combined procedures in 2, aneurysmectomy in 2, and other procedures in 2 patients. Twenty-six patients survived; four died during the study period. Twenty-three patients (77%) are well with good function of the reconstructed arteries. Six women had safe deliveries after successful operations. However, anastomotic false aneurysms occurred in 5 patients. The surgical management of Takayasu's arteritis must be distinguished from that of atherosclerotic vascular disease.
J Cardiovasc Surg (Torino)
PMID:Surgical treatment for Takayasu's arteritis. A long-term follow-up study. 257 Jul 82

Open heart surgery is being performed with increased frequency in elderly patients. Results vary considerably probably as the profile of the surgical population changes. A comparison was established by means of univariate analysis between two consecutive series of 100 patients undergoing bypass grafting or valvular replacement. Group A patients were 70 years of age or older; group B patients were less than 65 years of age. Various clinical, operative, and postoperative parameters were monitored. A significant difference was found between the two groups. Elderly patients tended to be white, female, with poor left ventricular and renal function, had carotid or peripheral vascular disease, and new onset of symptoms. Fewer patients had single-vessel disease and received internal mammary artery grafts. Operative mortality rate was higher in group A subjects and postoperative neurologic complications were also more frequent in this group. Factors influencing operative mortality were the association between vascular disease, presence of left main coronary artery disease, and urgency of the procedure. The mortality rate was 17.2% in 29 patients with associated vascular disease and 4.8% (3/63) in those without vascular disease (p = 0.048). Operative mortality was 4.1% without left main coronary artery disease, 15% with left main coronary artery disease (p = 0.083), and 4% in 84 patients having elective operations versus 31.2% in patients having 16 emergency procedures (p = 0.001). Short-term follow-up revealed a higher late mortality rate in elderly subjects and suggested an increased incidence of early pulmonary embolus. Nevertheless, elective cardiac surgery may be safely performed in septuagenarians with an expected operative mortality rate under 5%.
J Thorac Cardiovasc Surg 1989 Nov
PMID:Cardiac surgery in septuagenarians: is there a difference in mortality and morbidity? 257 33

Serotonin (5HT) constricts large arteries in vitro, an effect which seems contrary to 5HT-induced increases in blood flow observed in vivo. We used angiography to assess large artery responses, and blood flow (Q, electromagnetic flowmeter) to assess arteriolar responses to 5HT, norepinephrine (NE), and antagonists in the femoral circulation of the intact, anesthetized dog. 5HT constricted large arteries at a threshold dose of less than 10 micrograms/min, giving a 45 +/- 3% reduction of popliteal artery diameter at 100 micrograms/min (p less than 0.001). NE failed to constrict large arteries. With 100 micrograms/min 5HT, Q increased (delta Q = 108 +/- 26 ml/min; p = 0.001). NE decreased Q. Ketanserin, a 5HT and alpha 1-adrenergic antagonist, exerted a dose-dependent inhibition of 5HT-induced large artery constriction. Methysergide partially blocked the 5HT-induced large artery constriction. Ketanserin potentiated the Q response to 5HT whereas higher doses of methysergide reduced the Q response to 5HT. Neither indomethacin nor propranolol altered either response. Failure of NE to constrict large arteries in vivo and ketanserin antagonism of constriction produced by 5HT suggest the response to 5HT involves the 5HT2 receptor. No role for the 5HT2 receptor in blood flow responses is suggested. These observations may have implications for therapy of occlusive vascular disease.
J Cardiovasc Pharmacol
PMID:Differential large and small vessel responses to serotonin in the dog hindlimb in vivo: role of the 5HT2 receptor. 258 Jan 49

Two cases of extracranial carotid artery aneurysm are reported. Treatment of this uncommon but interesting vascular disorder is still under discussion even if the present tendency is to treat them actively, by reconstructive techniques. We present our surgical experience and discuss the diagnostic problems and management.
J Cardiovasc Surg (Torino)
PMID:Extracranial carotid artery aneurysms. Report of two cases. 260 Jan 24

Much has been published on the surgical treatment of leg ischaemia but relatively little is known about the incidence of claudication and the fate of the majority of patients presenting with chronic leg ischaemia who never come to surgery. A review of the available literature suggests the following conclusions: (1) about 1.5% of men under 49 and 5% of men over 50 will develop symptoms of intermittent claudication. The incidence of asymptomatic arterial disease is much higher; (2) the incidence of claudication in women is only slightly less, but the local disease follows a more benign course; (3) compared to the general population of comparable age the mortality of men presenting with chronic leg ischaemia is two to three times higher after 5 years; (4) about 50% of deaths will be due to myocardial ischaemia, 15% to stroke and 10% to vascular disease in the abdomen. In only 25% will the principal cause of death be unconnected with the circulation; (5) there is virtually no reliable information available at the moment on the incidence of non-fatal myocardial infarction or stroke in these patients.
J Cardiovasc Surg (Torino)
PMID:Fate of the patient with chronic leg ischaemia. A review article. 264 61

Prior to lower extremity revascularization, patients underwent CA or IADSA as the only radiologic study. A total of 30 patients were entered into each group and subsequently underwent a reconstructive procedure. Each study in the CA group was deemed accurate at the time of surgery, in assessing suitability of vessels for anastomosis. Of the patients undergoing surgery based exclusively on IADSA, 5 were noted in whom this examination provided insufficient detail or were misleading, resulting in attempted reconstructions at inappropriate sites. These results were statistically significant and indicate that IADSA should not be used as the only imaging technique in the preoperative evaluation of lower extremity vascular disease. IADSA is most useful as a complementary technique to CA and should be performed during the same examination when the latter fails to identify distal runoff vessels. In the majority of cases, CA alone will provide sufficient information and should be used as the initial contrast study.
J Cardiovasc Surg (Torino)
PMID:A prospective comparison of intra-arterial digital subtraction and conventional angiography prior to lower extremity revascularization. 266 75

The prognosis of patients with a flat (Class 5) or nearly flat (Class 4) pulse volume recording was studied in relation to the signs and symptoms of vascular disease in 517 patients. Within one year of follow up, 97.9% of 96 patients with jeopardized limbs and flat tracings required surgery, whereas 72.4% of 29 patients with no or minimal symptoms required reconstruction (p less than 0.001); 85.7% of patients with Class 4 tracings and jeopardized limbs required surgery, whereas 41.9% of those with minimal symptoms and Class 4 recordings developed need for reconstruction (p less than 0.001). The requirement for surgery Class 5 patients is significantly higher than in those with Class 4 tracings. The general trend of pulse volume recording amplitude to correlate with ankle systolic blood pressure was confirmed. One year mortality in Class 5 patients was 43.2%. The majority of patients with severely abnormal pulse volume recordings eventually come to surgical reconstruction. The timing of surgery is based on the clinical status of the jeopardized limb, not solely on the presence of a pulse volume tracing abnormality.
J Cardiovasc Surg (Torino)
PMID:The fate of extremities with flat lower calf pulse volume recordings. 270 37

Auto-antibodies such as anti-elastin, anti-collagen, anti-nuclear and anti-arterial, circulating immune complexes, and cellular responses to collagen I and III are known to be present in Buerger's disease (EO). Deposits of IgG, C3 and C4 have also been found in the vascular lesions of endarteritis obliterans (EO) in young men. The purpose of this study was to correlate clinical evidence of vascular disease with the presence of the circulating immune complexes. Thirty-three patients suffering from Buerger's disease (EO), 20 patients suffering from atherosclerosis (AT) and 20 normal controls (Norm) were studied. All were male, heavy smokers, and age-matched. Five techniques were used: direct nephelometry, nephelometry with protamine, two polyethyleneglycol precipitation methods (PegIgG and PegC4), and an immuno-enzymatic C1q fixation test (C1qE). The results seem to confirm the presence of circulating immune complexes in peripheral arterial disease in young men who are heavy smokers, particularly those suffering from EO.
J Cardiovasc Surg (Torino)
PMID:Circulating immune complexes in Buerger's disease. Endarteritis obliterans in young men. 280 5

The ablation of atherosclerotic tissue by laser energy was a promising new idea in the treatment of atherosclerotic vascular diseases. Initial studies showed a lot of beneficial effects but also a lot of complications like perforations and thermal injuries. The introduction of a new fiber optic system with a metalcapped quartzfiber, changing the laser energy into thermal energy, showed significant improvements. First animal studies revealed a higher success rate and a significantly decreased risk of perforation. Based on these results first clinical studies in the femoro-popliteal region were started. Meanwhile 129 patients with stenoses or occlusions of the femoral arteries have been treated with this new fiber optic system under fluoroscopic control. Patency rate was 93% for stenoses and 89% for total occlusions. In all cases the procedure was completed by a balloon angioplasty. Reinvestigations revealed a cumulative one-year-patency rate of 77%. This is well comparable to long-term results of balloon angioplasty. First clinical applications of this so called "hot-tip" in coronary arteries proved the possibility of reopening stenoses or occlusions in the small vessels. Still further improvements in flexibility and steerability of the catheter systems have to be made, before this method can become routine too. By further improvement laser angioplasty will find its place besides balloon angioplasty and surgery in the treatment of the atherosclerotic vascular disease.
Thorac Cardiovasc Surg 1988 Jun
PMID:Experimental and clinical angioplasty with a laser probe fiberoptic catheter system. 297 Jun 92

The pathology of the heart following surgical correction for congenital cardiac defects has not been fully explored. This study is based on valvar aortic stenosis, atrioventricular septal defect, complete transposition of the great arteries, and Fallot's tetralogy. Emphasis has been put on preexistent gross pathology, with histological verification, and postoperative complications. Among patients with aortic valve stenosis preexistent anomalies dominated (left ventricular hypoplasia, mitral valve abnormalities, left ventricular endocardial fibroelastosis). The findings suggest that the cases represent an extreme within a spectrum and could explain the late postoperative dismal results in patients suffering from congenital left heart obstruction. In patients with atrioventricular septal defects the important pathology related predominantly to the operative procedure (injury to the atrioventricular bundle, patch dehiscence at the site of the atrioventricular node, inadequate repair of the left atrioventricular valve leaflets) and to pulmonary obstructive vascular disease. In complete transposition of the great arteries, with or without ventricular septal defects, technical problems dominated. Obstruction of the systemic and pulmonic venous pathways, atrial dysrhythmia, and tricuspid valve injury were the most serious complications following Mustard's procedure. The Rastelli-type procedure was complicated by degeneration and calcification of the porcine valve and crowding of the left ventricle. The arterial switch was complicated by abnormal origin and course of the left circumflex artery, which led to kinking and myocardial infarction. In Fallot's tetralogy surgical complications (injury to the atrioventricular bundle and the tricuspid valve) were the most important. The study discloses that the heart after surgery for congenital heart disease cannot be considered without taking preexistent pathology into account. Careful preoperative investigations are mandatory, since most anomalies could have been detected and, hence, might have changed the operative result.
Am J Cardiovasc Pathol 1988
PMID:The heart after surgery for congenital heart disease. 306 2


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