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

Spontaneous (nontraumatic, noninfectious) rupture and/or dissection of the pulmonary trunk or secondary pulmonary arteries in the setting of pulmonary hypertension is rarely considered as a cause of sudden death. Systemic-to-pulmonary vascular shunts and rheumatic mitral stenosis have been the most common predisposing factors, occurrence in association with recurrent thromboembolic hypertension rarely having been documented. Recently, we had the opportunity to study a 52-year-old white woman with catheterization-proved "primary" pulmonary hypertension who died suddenly with cardiac tamponade from rupture/dissection of the pulmonary trunk, and who had morphological evidence of extensive thromboembolic pulmonary vascular disease.
Am J Cardiovasc Pathol 1988
PMID:Fatal dissection of the pulmonary trunk. An obscure consequence of chronic pulmonary hypertension. 306 6

A spectrum of asymptomatic patients with carotid bifurcation disease exists, with varying degrees of risk for each sub-group. With Duplex scanning we studied the carotid arteries of several asymptomatic populations: volunteers at a health fair, patients referred to our vascular laboratory because of cervical bruits or associated vascular disease, and the contralateral asymptomatic vessels in those patients who had previously undergone endarterectomy. Volunteers had an extremely low incidence of carotid disease, possibly reflecting a bias of more healthy individuals attending a health fair. The contralateral asymptomatic vessels and vessels in the hospital asymptomatic group both had similar disease, with mainly fibrous or calcific plaques. Occurrence of new carotid territory symptoms was low in each hospital group. However, there were more strokes in the territory of the contralateral asymptomatic vessels, suggesting a greater risk for these patients. Symptomatic vessels tend to have plaques that are heterogeneous and echolucent. Change in plaque morphology may eventually become the best predictor of stroke risk, but longer follow-up studies of plaque progression are needed. In the meantime, the characteristics of asymptomatic populations in carotid artery studies must be carefully defined.
J Cardiovasc Surg (Torino)
PMID:The spectrum of carotid artery disease in asymptomatic patients. 306 8

Prostacyclin (PGI2) release by human aortic tissue obtained at surgery was assessed in patients (n = 23) with ischaemic heart disease undergoing coronary artery bypass grafting (group 1) patients (n = 14) undergoing surgery for aortic stenosis (group 2), patients (n = 4) undergoing surgery for aortic regurgitation (group 3), and patients (n = 8) with ischaemic heart disease taking aspirin (group 4). Although there was a highly significant correlation between (a) intimal and medial PGI2 production and (b) medial PGI2 production and aortic diameter, there was no correlation between intimal PGI2 production and aortic diameter. Aspirin intake (75-150 mg daily) was associated with a pronounced inhibition (95%) of aortic PGI2 production. This inhibition of aortic PGI2 secretion by aspirin may account for the variable efficiency of aspirin in altering the natural history of vascular disease.
Cardiovasc Res 1988 Jul
PMID:Release of prostacyclin from the human aorta. 307 12

An increase of arterial carbon dioxide (CO2) partial pressure induces an increase of cerebral blood flow by dilatation of the resistance vessels. By the Transcranial Doppler sonographic technique (TCD) blood flow velocity as a correlate of flow volume can be measured within the great basal intracranial arteries. We investigated 8 patients with an internal carotid artery occlusion or high-grade stenosis and 5 cerebrovascular diseased patients without extracranial stenosis. 12 healthy volunteers and patients without vascular disease served as the control group. Blood flow velocities in the middle cerebral arteries were evaluated before and after 5 minutes of breathing a 5% CO2 gas mixture. In a prestudy the end tidal pCO2 was monitored during this procedure. As a result of the close parallelity of pCO2 increase in the prestudy group we planned to standardize the CO2 reactivity tests without consideration of the individual pCO2 values. The CO2 inhalation provoked a flow velocity increase of at least 20% in the control subjects (47.1 +/- 17.3%). The vascular diseased without extracranial stenosis responded with 34.8 +/- 17.4% (minimum: 23.5%, n. s.). The CO2 reactivity in cases of occlusion or greater than 50% stenosis was significantly decreased (p less than 0.001) both when considering only the affected sides (12.4 +/- 7.5%, maximum: 20%) and when including the non affected sides (22.6 +/- 15.0%). It is concluded that the CO2 reactivity test is a simple and valid method to evaluate the cerebrovascular reserve capacity in any case of uncertainty about the benefits of surgical treatment of a carotid stenosis. In future this technique might become one fundamental argument beside others in selecting adequate treatment.
Thorac Cardiovasc Surg 1988 Aug
PMID:Cerebrovascular reserve capacity (CRC) in carotid artery disease: a routine test in selection for surgical treatment? 318 82

We describe a 53 year old man who died following his 3rd myocardial infarction. Before death there were scintigraphic signs of infarctions in the lung and spleen. Postmortem examination revealed an occlussive vascular disease in coronary, pulmonary, and splenic vessels. The histological findings were consistent with thromboangiitis obliterans. We suggest that thromboangiitis obliterans probably is a generalized vascular disease.
Am J Cardiovasc Pathol 1988
PMID:A case of thromboangiitis obliterans affecting coronary, pulmonary, and splenic vessels. Is thromboangiitis obliterans a generalized vascular disease? 321 9

The value of health screening among the general population has been well-documented, with testing for hypertension, diabetes, and glaucoma now commonplace. It was the purpose of our study to determine the efficacy of a screening program for peripheral vascular disease and carotid artery disease using the noninvasive laboratory diagnostic tools. In the screening for peripheral disease, there were 496 participants with a mean age of 35 (range 17 to 63) years. All participants had an ankle:brachial index (ABI) of 0.95 or greater except one (0.47). Risk factors included smoking (350), history of cardiac disease (19), family history of vascular disease (204), and pain in the legs on walking (39). The risk factors could not be correlated with any objective vascular findings (abnormal ABIs). A Doppler ultrasound device, including an inflatable ankle cuff, was used to measure the ABI of the dorsalis pedis and posterior tibial vessels. Testing was performed on a volunteer basis after the participant completed a check-off sheet of risk factors. In screening for carotid artery disease 1338 women, whose average age was 31 years, had an less than 1% incidence of cardiac disease, and 803 men, whose average age was 40 years, had a 4% incidence. Less than 1% of the group had diabetes mellitus. All patients were asymptomatic referable to the extra-cranial vascular system. Two men of the 2141 persons tested had a lesion meriting further evaluation. The role of Health Fairs may be more effective as an educational resource than a diagnostic interventional tool.(ABSTRACT TRUNCATED AT 250 WORDS)
J Cardiovasc Surg (Torino)
PMID:Is screening for vascular disease a valuable proposition? 328 41

Until the development of ultrasonic duplex scanning, the only diagnostic test that was able to study vascular disease wherever it occurred was angiography. Duplex scanning found its initial place for the evaluation of the carotid bifurcation. With improvements in technology, a range of transmitting frequencies, better transducers, and computer assisted algorithms, the application of this method has been greatly extended. We now have the capability of evaluating every major vascular bed of interest to the vascular surgeon. For the first time, we can now both screen and follow patients without resorting to angiography.
J Cardiovasc Surg (Torino)
PMID:Duplex scanning and the vascular surgeon. 329 46

Arterial switch for repair of transposition of the great arteries was performed on 53 patients since October 1983. These patients were divided into three groups: group I, 25 infants with an intact ventricular septum who had primary repair in the first month of life (2 to 34 days of age, mean 9.7 +/- 6.6); group II, 13 patients with an intact ventricular septum who had anatomic repair after a preliminary procedure (pulmonary artery banding in 13, shunt in 10, atrial septectomy in 1); and group III, 15 infants with transposition of the great arteries and ventricular septal defect. In group III, six patients had Taussig-Bing abnormality, nine had previous pulmonary artery banding, three had coarctation of the aorta repaired earlier in life, and four were less than 2 weeks old. Overall early mortality was 9.4% (5/53: group I 8%, group II 7.6%, group III 13.3%). Two late deaths occurred in group II 10 and 12 weeks postoperatively after infection and high fever. A third late death 18 weeks postoperatively was due to aspiration in an infant with Goldenhar's syndrome. Mortality and morbidity decreased significantly after an initial learning period (no deaths from July 1985 to March 1987 overall, and none in the last 15 infants operated on in group I). The surviving 45 patients are doing well. All have normal sinus rhythm. Two had transient asymptomatic arrhythmias. Left and right ventricular function assessed by echocardiogram and postoperative cardiac catheterization were within normal ranges in all but two patients, one with pulmonary artery stenosis and one (Taussig-Bing abnormality with two large ventricular septal defects) with severe pulmonary vascular disease (9.6 units) observed before anatomic repair. The right ventricular pressure at catheterization ranged from 27 to 42 mm Hg in 12 patients and was 55 mm Hg in two. There was no aortic stenosis. Aortic insufficiency was trivial in three patients and mild in one. We conclude that excellent results can be obtained with arterial switch for transposition of the great arteries with or without ventricular septal defect, especially in neonates.
J Thorac Cardiovasc Surg 1988 Jan
PMID:Arterial switch in simple and complex transposition of the great arteries. 333 33

A review of 66 patients undergoing femoral embolectomy showed that 38 (58%) obtained a good final outcome (discharge from hospital with viable limb) while 28 (42%) died or required amputation prior to discharge. The major association with poor final outcome was pre-operative life-threatening cardiac disease which occurred in 17 (61%) of those patients who later died or underwent amputation and in six (16%) of those who were discharged with viable limbs (p less than 0.001). Age, sex, source of embolus, duration of ischaemia and pre-existing vascular disease had little effect on final outcome. Surgical dissatisfaction, at the time of operation, with the result of attempted revascularisation was of major prognostic significance in terms of future amputation or death.
J Cardiovasc Surg (Torino)
PMID:Arterial embolectomy in the leg: results in a referral hospital. 355 69

The leading cause of mortality in industrialized societies is sudden cardiac death. Almost half a million people die each year in the United States from myocardial ischemia and infarction leading to ventricular fibrillation. These phenomena result from severe coronary artery disease due to atherosclerosis with acute mural thrombosis causing occlusion, which serves as the terminal event. Various studies have found evidence of fresh coronary artery mural thrombosis in 74 to 94 percent of patients undergoing autopsies shortly after death due to acute myocardial infarction. Not all thrombi are occlusive, but vasospasm associated with fresh injury to the diseased vessel may be sufficient with developing new thrombus to block blood flow. Because platelets are a major constituent of newly formed thrombi and contribute significantly to vaso-occlusive disease, it is important to understand basic aspects of their function. Such studies may lead to measures that prevent vascular disease and thrombosis. This chapter has described ultrastructural features of platelet-vessel wall interaction. Adhesion, spreading, secretion, and aggregate or thrombus formation have been emphasized. The findings of current studies indicate strong similarities between platelet-vessel wall interactions and the response of platelets to other surfaces. Also, platelet transformations observed during aggregate formation in suspension are identical to physical changes in thrombi on damaged vessels. The similarities are much more impressive than the differences. Therefore, the role of platelets in arterial thrombosis can be understood best as an extension of their hemostatic function. An advantage of this observation is that understanding basic mechanisms of platelet function in hemostasis can lead to solution of the problems presented by platelet involvement in thrombosis. The disadvantage is that agents used to prevent thrombosis can place the hemostatic mechanism in jeopardy. Finding the answer to this paradox will occupy our attention for years to come.
Cardiovasc Clin 1987
PMID:Platelet structural physiology: the ultrastructure of adhesion, secretion, and aggregation in arterial thrombosis. 360 10


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