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

This study follows up 292 carotid endarterectomy operations in 256 patients using the colour coded carotid Doppler Imager and oculoplethysmography and reports the rate of ipsilateral restenosis, contralateral progression, late (after 30 days postoperatively) neurological symptoms and mortality in life table form. The restenosis rate was 15% at 5 years. No case of restenosis presented with symptoms and none required reoperation. The contralateral progression rate from less than 50% internal carotid artery stenosis to greater than 50% was 20% over 5 years. Significantly more symptoms were associated with cases of contralateral progression (p = 0.05). The late neurological symptom rate was 14% at 5 years and was associated with widespread intra/extracranial vascular disease rather than restenosis. The late death rate was 12% at 5 years of which 40% were due to myocardial infarction. The overall postoperative death rate over 5 years was the same as an age and sex matched population. A more aggressive approach to coronary artery disease does not appear justified. The value of noninvasive tests in the post-endarterectomy situation is stressed with particular reference to documentation of contralateral progression.
J Cardiovasc Surg (Torino)
PMID:Carotid endarterectomy. Long term follow-up with specific reference to recurrent stenosis, contralateral progression, mortality and recurrent neurological episodes. 372 42

Fifty-three patients with a variety of thoracic aortic or pulmonary arterial diseases were evaluated by magnetic resonance imaging to determine the potential of this new technique for the diagnosis of thoracic vascular disease. Direct visualization of the atherosclerotic plaques and demonstration of their precise location and extent was achieved by magnetic resonance imaging. The size and extent of the aneurysms and the presence of mural thrombus were demonstrated by magnetic resonance imaging. Magnetic resonance imaging identified the intimal flap and indicated the proximal extent of thoracic aortic dissection. Magnetic resonance imaging permitted direct visualization of thrombi and aneurysm of the pulmonary arteries. In conclusion, magnetic resonance imaging appears to be a totally noninvasive and reliable technique for demonstration of various pathologic processes involving the thoracic aorta and pulmonary arteries. Vascular imaging is achieved without the need for contrast media.
J Thorac Cardiovasc Surg 1986 Dec
PMID:The potential of magnetic resonance imaging for the evaluation of thoracic arterial diseases. 378 88

A 64-year-old female treated with a Dacron aortobifemoral graft for atherosclerotic vascular disease sought medical evaluation for abdominal pain 6 months later. Studies including ultrasound, radionuclide, angiography, and CT scan suggested a diagnosis of false aneurysm. Surgical intervention subsequently confirmed the diagnosis of lymphocele.
Cardiovasc Intervent Radiol 1985
PMID:Lymphocele around aortic femoral grafts simulating a false aneurysm. 390 37

To assess the long-term hemodynamic consequences of combined heart and lung transplantation, we investigated six rhesus monkeys 2.6 to 4.6 years (mean 4.0) after operation. Total follow-up was 24.0 primate-years. Autotransplantation had been carried out in four animals and allotransplantation in two, and the hemodynamic results were compared with those in three normal monkeys of similar size. Each animal underwent simultaneous right and left heart catheterization and pulmonary arteriography. Hemodynamic measurements were made at three levels of inspired oxygen. Arterial oxygen tension was within normal limits in all animals, and pulmonary artery pressure and pulmonary vascular resistance index did not change significantly with changes in the levels of inspired oxygen. Indices of left ventricular systolic function were normal in all animals. Values for pulmonary artery pressure and pulmonary vascular resistance index were similar in the autograft and normal groups: in the allograft group, the average pressure was 30/17 mm Hg (mean 24) and the index was 5.6 units . m2--both levels significantly higher than normal (pressure was 16/10 mm Hg, mean 13, [p less than 0.001] and index was 2.5 units . m2 [p less than 0.02]). Pulmonary arteriography in the allograft group with the highest pulmonary vascular resistance index (6.1 units . m2) was compatible with pulmonary vascular disease. Pulmonary arteriograms in the remaining eight monkeys were normal. Prolonged survival following combined heart and lung transplantation is possible in primates. Autotransplantation (and probable persisting denervation of the cardiopulmonary axis) does not necessarily result in abnormal long-term hemodynamics. The elevation in pulmonary artery pressure and pulmonary vascular resistance index in the allograft group may be related to previous episodes of pulmonary rejection, infection, or drug reaction.
J Thorac Cardiovasc Surg 1985 Jan
PMID:Long-term hemodynamics following combined heart and lung transplantation in primates. 391 17

A new type of vascular ring formed by a hemitruncal pulmonary artery is described. Early reimplantation of the hemitruncal pulmonary artery resulted in resolution of the respiratory distress, protection of the pulmonary arterial bed from obstructive vascular disease, and preparation of the pulmonary artery for future surgical correction.
J Thorac Cardiovasc Surg 1985 Jul
PMID:Hemitruncal sling: a newly recognized anomaly and its surgical correction. 401 Mar 16

Between mid-1979 and December, 1983, 23 patients with various types of truncus arteriosus underwent total surgical correction at Royal Children's Hospital, Melbourne, Australia. Nineteen patients had primary total repair and four had secondary repair, three having survived banding done prior to 1978. Sixteen patients were less than 1 year of age. Repair was performed with circulatory arrest in infants and cardiopulmonary bypass with core cooling in older patients. Patients were electively ventilated preoperatively. In the postoperative period, pulmonary artery pressure was monitored very closely and any rise was treated with hyperventilation and vasodilators. Two patients under 1 month of age, who were severely acidotic and anuric preoperatively, died of low output syndrome. Among the rest of the infants there was only one death, probably because of pulmonary hypertensive crisis that might have been prevented. From our experience, we think that patients with truncus arteriosus should have total correction during infancy, preferably at 2 to 3 months of age, as it can be performed with a very low risk and also avoids the development of pulmonary vascular disease, which occurs very rapidly in these infants.
J Thorac Cardiovasc Surg 1985 Jul
PMID:Truncus arteriosus. Surgical approach. 401 Mar 21

We have developed real-time two-dimensional Doppler echocardiography, which can display color flow mapping on a two-dimensional echocardiogram. Intraoperative two-dimensional Doppler echocardiography was performed during cardiovascular operations before and after the definitive procedure in 33 patients, 14 with valvular disease, eight with congenital heart disease, and 11 with vascular disease. Its clinical usefulness was evaluated. In patients with valvular heart disease, 13 valve replacements, 10 valvuloplasties, and four untouched lesions were assessed. No paravalvular leakage and three instances of minimal physiological transvalvular leakage from St. Jude Medical valves in the mitral position were noticed. Regurgitation after valvuloplasty was graded by extent of the regurgitant flow. This grading, comparable to postoperative grading, indicated no need for an additional procedure. In congenital heart disease, preoperative diagnoses were confirmed. The effect of the corrective operation was evaluated and no significant leakage or stenosis was found. Interatrial shunt flow was shown to increase after operative balloon atrial septostomy in a patient with dextro-transposition of the great arteries. In 11 patients with dissecting aortic aneurysm, the aneurysm was totally visualized in the operative field, including the structure and flow dynamics. In two patients, the preoperative cineangiographic diagnosis regarding involvement of dissection was corrected. After the vascular procedure, sufficient flow in the major aortic branches was confirmed in all patients and minimal leakage at the suture line was noticed in four patients. In conclusion, intraoperative color flow mapping by two-dimensional Doppler echocardiography has enabled the precise diagnosis and the necessary operation to be determined before cardiopulmonary bypass. It has also allowed the effects of the operation to be assessed before chest closure.
J Thorac Cardiovasc Surg 1985 Dec
PMID:Intraoperative color flow mapping by real-time two-dimensional Doppler echocardiography for evaluation of valvular and congenital heart disease and vascular disease. 406 30

The angiographic evaluation of 38 patients younger than 40 years of age with lower-extremity arterial disease is reviewed. Although atherosclerosis was the most common diagnosis, other etiologies included thromboembolism, popliteal artery entrapment, Buerger's disease, collagen vascular disease, and arteritis. The two features of the angiographic workup that proved most helpful in establishing an accurate diagnosis were biplane aortography and runoff exams designed to demonstrate possible popliteal artery entrapment.
Cardiovasc Intervent Radiol 1985
PMID:The angiographic evaluation of lower-extremity arterial disease in the young adult. 407 47

In the presence of hypertension, the arterial and arteriolar vessel walls may undergo adaptive, destructive, and reparative changes. These different types of hypertensive alterations were studied simultaneously in the intrarenal vascular bed of two-kidney, one-clip hypertensive rats. After constriction of one renal artery, focal medial necrosis of the interlobular arteries developed in the untouched kidneys after the first 24 h. These earliest signs of vascular decompensation could be explained by short-lasting hypertensive episodes that were only detectable by continuous blood pressure recording in conscious animals. Two weeks after the experiment was started, owing to a widening of the media, a substantial increase in the wall-to-lumen ratio was observed in the interlobular arteries. At the same time, the frequency of focal medial necrosis began to fall significantly. Therefore we concluded that the structural vascular adaptation might be responsible for the disappearance of focal medial necrosis in spite of still rising blood pressure values. This assumption was confirmed by an additional experiment in previously chronically two-kidney, one-clip hypertensive rats: 24 h after removing the renal artery clip, a short, severely hypertensive period, induced by infusions of angiotensin II, caused hypertensive vascular lesions almost exclusively in the primarily clipped kidneys with a nonadapted vascular bed. Early intimal changes, which are known to lead to malignant nephrosclerosis, were not only absent in the beginning of two-kidney, one-clip hypertension, but also did not occur during the angiotensin-induced accelerated hypertension. Thus, even extremely high blood-pressure values per se may not be enough to initiate this crucial renal vascular disease.
J Cardiovasc Pharmacol 1984
PMID:Adaptation and decompensation of intrarenal small arteries in experimental hypertension. 608 13

The vast majority of patients with peripheral arterial insufficiency have degenerative lesions in large arteries; however, collateral circulation develops in smaller arteries and arterioles. Vascular disorders affecting arterioles are idiopathic Raynaud's disease and systemic sclerosis. The pathogenesis of Raynaud's phenomenon is still poorly understood. There is some evidence that systemic sclerosis is a primary disorder of small arterioles.
J Cardiovasc Pharmacol 1984
PMID:Precapillary vessels and peripheral vascular ischemic disease. 608 16


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