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PubMed2004

[Subclinical hypothyroidism and arteriosclerosis].

Overt hypothyroidism predisposes to the development of atherosclerosis. Recent data indicate that subclinical hypothyroidism is also associated with enhanced risk for arteriosclerotic cardiovascular disease, which could be attributed to multiple mechanisms such as hyperlipidemia, hypercoagulable state, direct effects on vascular smooth muscle or endothelial dysfunction. The relationship between subclinical hypothyroidism and atherosclerosis is, however, still ambiguous. The elucidation of this problem is important as subclinical hypothyroidism is a relatively common condition, and if necessary early T4 substitution therapy given to adequately selected patients could prevent the development of atherosclerosis. In the reflection of recent literature this article deals with the probable mechanisms responsible for the presumed accelerated arteriosclerosis in subclinical hypothyroidism.

Arteriosclerosis↗

PubMed2004

The effect of Liple on physical and emotional quality of life in the treatment of arteriosclerosis obliterans.

AIM: The purpose of this study was to determine the effect of treatment with prostaglandin E1, Liple, on both the physical and emotional health-related quality of life (QOL) of patients with arteriosclerosis obliterans (ASO). METHODS: Treatment with Liple was evaluated using the before and after treatment results obtained using the SF-36, a QOL questionnaire, and an assessment of symptoms by a physician. The study was designed as a non-randomized before and after treatment study without comparison groups, and the study was conducted from May 1999 to July 2001 at 473 facilities located within Japan targeting patients with ASO. No intervention other than the administration of Liple was performed, and no restrictions were placed on the dose amount or administration interval for Liple. RESULTS: The results suggest that there was a significant improvement in patients' symptoms after treatment with Liple. CONCLUSIONS: Both physical and emotional QOL also improved after administration of Liple compared to baseline, based on the results of the SF-36 and assessment of symptoms by a physician.

Adolescent↗

PubMed2005

[Perioperaive evaluation and management in vascular surgery especially for arteriosclerosis obliterans].

Perioperative cardiac event is relatively high in vascular surgery for arteriosclerosis obliterans (ASO), which is a major cause of postoperative death. ACC/AHA guideline and revised cardiac risk index (CRI) were advocated to assess risk factor stratification and to manage risk reduction. ACC/AHA guideline categorized all vascular procedures except carotid endarterectomy as high risk. Because almost all patients with ASO were aged and/or inactive, noninvasive testing was necessary in almost all patients by the stepwise bayesian strategy. Patients with revised CRI less than 1 point dominated about three fourths of all patients, whose prevalence and incidence of ischemic heart disease (IHD) were 2.5% and 1.3%, respectively. It seemed appropriate to apply noninvasive testing only for patients with revised CRI more than 2 points, and high risk indicated coronary angiography. Electrocardigrams obtained at baseline, immediately, and on the first 2 days after surgery appear to be cost-effective to diagnose IHD. Use of cardiac biomarkers was reserved for patients at high risk and those with clinical, or ECG evidence of myocardial infarction (MI). Beta-blockers or alpha-agonists were effective to reduce incidence of perioperative IHD. Although even optimal preoperative assessment and perioperative management, some patients will have perioperative MI.

Adrenergic alpha-Agonists↗

PubMed2005

[Preoperative care of microcirculatory vessels in patients with lower limb arteriosclerosis obliterans].

The paper analyses diagnosis and treatment outcomes for 20 men aged from 55 to 76 with lower limb arteriosclerosis obliterans. Based on exhaustive laboratory and instrumental diagnostic data the authors conclude that 10-days course of Vazaprostan (20 mkg per day) for patients with IIb stage of chronic lower limb arterial insufficiency yields not only improvement in tissue metabolism, but a reduction of peripheral vascular resistance as well. Thus such therapy can be used for preoperative care before reconstructive vascular interventions in order to reduce the risk of implant thrombosis in early postoperative period.

Aged↗

PubMedDate not supplied

[Ozone therapy and viscosity of blood and plasma, distance of intermittent claudication and certain biochemical plasma components in patients with occlusive arteriosclerosis of the lower limbs].

Blood and plasma viscosity, total lipids, triglycerides, total cholesterol, free fatty acids, fibrinogen, lipid-gram, and hematocrit were determined in 53 patients with occlusive arteriosclerosis in the lower limbs prior to and after ozone therapy. At the same time the distance of the intermittent claudication was measured. A significant prolongation of the distance walked painlessly, reduction in blood and plasma viscosity as well as the decrease in total cholesterol after therapy with ozone correlated with a decrease of the blood viscosity.

Aged↗

PubMed2006

Cost-effectiveness of Liple (LipoPGE1) for arteriosclerosis obliterans patients in Japan: an economic evaluation using the EQ-5D instrument.

AIM: This study was conducted to evaluate the health-related quality of life (HRQOL) and cost-effectiveness of LipoPGE(1) when added to the conventional treatment of arteriosclerosis obliterans (ASO) patients. The research design consisted of a before and after-treatment study without comparison groups. We collected data from May 1999 through July 2001 at 473 institutions located throughout Japan. The subjects were ASO patients who experienced pain at rest or had ulcers of the extremities. METHODS: The observation period was a 2-month period that commenced with the start of administration of LipoPGE1. The HRQOL score (utility value) was obtained from the EQ-5D instrument, and the incremental cost-effectiveness ratio was calculated on the basis of quality-adjusted life years (QALYs). RESULTS: The mean utility value for the 2 months after the start of the administration of LipoPGE(1) was 0.672, and it was a significantly higher (P<0.0001) than the 0.616 before administration of LipoPGE(1). The incremental cost-effectiveness ratio was 18,807 US dollar/QALY assuming that drug efficacy persisted for 1 year after the end of LipoPGE1 therapy, and 75,227 dollar/QALY assuming a duration of just 3 months. CONCLUSIONS: We concluded that when LipoPGE1 is added to the conventional treatment of ASO patients, the HRQOL of the patient improves, and it is highly cost-effective.

Adolescent↗

PubMed2006

[Overview on diagnosis, treatment and therapeutic angiogenesis for arteriosclerosis obliterans].

Arteriosclerosis of the extremities is a disease of the blood vessels characterized by hardening and/or narrowing of the arteries that supply the legs and feet. This causes a decrease in blood flow that can injure nerves and other tissues. Therapeutic angiogenesis using angiogenic growth factor is expected to be a new treatment for patients with critical limb ischemia. The first human clinical trial treating peripheral vascular disease was started in 1994 using vascular endothelial growth factor. To date, other potent angiogenic growth factors, such as hepatocyte growth factor(HGF), have been also estimated in clinical trials for peripheral arterial disease. Several results from phase 1 or 2 trials using HGF gene were encouraging. Phase 3 trials are now ongoing and their results are expected.

Arteriosclerosis Obliterans↗

PubMed1991

[Thrombosis test in vitro of 107 cases with arteriosclerosis obliterans].

Thrombosis test in vitro of 107 cases with arteriosclerosis obliterans were measured and controlled by 36 normal persons. Of 107 cases, 13 cases belonged to ischemic phase, 47 cases nutritional disturbance phase, 47 necrosis (24 cases were first degree, 9 cases second degree, 14 third degree). Types distribution were: simple blood stasis 65 cases, blood and damp stasis 34, and 8 others. 46 patients were treated systematically by TCM-WM. The result proved that the indexes of thrombosis test in vitro of patients were much higher than that of normal persons (P less than 0.001). The relevant indexes were different in varied periods, degrees and types (P less than 0.05-0.01) and between before and after treatment (P less than 0.001). Of treated 46 cases, total effective rate was 86.96%, amputation rate was 13.04%. Formation of thrombus in vitro lowered 88.03%. The authors suggested that measurement of thrombosis test might be a accurate way to reflect the course of the disease and a basis for treatment and differentiation of symptoms.

Adult↗

PubMed1991

Arteriosclerosis obliterans of the lower limbs as a model of peripheral vascular disease with hypertension.

In patients with arteriosclerosis obliterans of the lower limbs, hypertension is often characterized by a disproportionate increase in systolic pressure whereas diastolic blood pressure remains normal or even low. This hemodynamic pattern is associated with a reduction in systemic and forearm arterial compliance, whereas cardiac output and peripheral vascular resistance remains within the normal range in the absence of complications. The reduced arterial compliance is influenced not only by structural modifications of the arterial wall but also by changes in vasomotor tone. Whereas increased sodium intake and beta-blockade by propranolol reduce arterial compliance, nitrate derivatives increase arterial compliance with a resulting selective decrease in systolic pressure.

Animals↗

PubMed1991

[Immediate results of reconstructive operations in arteriosclerosis obliterans of the iliac and femoral arteries].

The work generalizes the immediate results of restoration of the main and collateral blood flow in 240 patients with arteriosclerosis obliterans of the iliac and femoral arteries. The outcomes of surgical treatment were judged according to the clinical and ultrasonic evaluation of regional hemodynamics. The results were found to be good in 84 (35.0%), satisfactory in 104 (47.5%), and poor in 42 (17.5%) patients. The results of operations on the iliac and femoral arteries are shown separately, as well as the results of surgery in their combined lesions. Thromboses of the reconstructed arteries and prostheses were encountered in 10 (4.17%), hemorrhages in 8 (3.33%), wound infection in 16 (6.67%), and venous thromboses in 4 (2.5%) patients. For the prevention of thromboses of the deep veins the author claims dosed physical exercises on a constructed training apparatus to be advisable. Amputation of the extremity was carried out in 10 (4.17%) patients because surgical correction of the blood flow proved ineffective and specific complications occurred.

Adult↗

PubMed1991

[Arteriosclerosis vascular changes as an expression of the local effect of mechanical continuous stress--observations of the femoral artery of marathon runners].

The arteries of the thigh of 126 male marathon runners at the age of 41.6 +/- 11.3 years were examined with B-Scan-ultrasound. 32 (62.1%) persons were found with arteriosclerotical plaques. All of them were older than 35 years, so the number of arteriosclerosis in this group increases to 36.4 percent (n = 88). 38 persons were younger than 35 years. Persons with plaques started training about 10.9 years later than those without plaques. Correlations of plaques and age, age of starting training, years of training and km/year were found. The numbers of riskfactors showed significant differences between both groups but the correlation of "having no risk factor" and arteriosclerotical plaques was higher than the correlations of nicotine, hypertension, hypercholesterolemia and plaques. It seems that marathon running itself is a risk factor of developing arteriosclerotical plaques in the femoral arteries particularly if the age of starting training is higher than 30 years.

Adult↗

PubMed1991

[Effect of work load on arteriosclerosis risk factors in employees of 2 Upper Silesia industries].

Investigations were undertaken to estimate various energy expenditure during professional work on incidence of hypertension, overweight, obesity, hyperuricaemia and hypercholesterolemia in workers of two enterprises in Upper Silesia. The study was carried out in 1957 individuals (1392 male, 565 female) divided into 5 groups according to the hardness of their work. Serum level of uric acid and cholesterol was determined in all investigated subjects. Incidence of hypertension, overweight and obesity was estimated. It has been stated that incidence of hypertension, hypercholesterolaemia, overweight and obesity in men and hyperuricaemia in both sexes decreased with hardness of the work. The incidence of hypertension, overweight and obesity was not related to hardness of the work in women. The authors conclude that physical activity associated with professional work can be much more in men than in women listed as a preventive measure against arteriosclerosis.

Adolescent↗

PubMed1991

[Arteriosclerosis research in the animal model and cell cultures].

Feeding animals a diet of increased cholesterol content gave rise to the feeding hypothesis, and balloon experiments were the basis of the injury hypothesis of atherogenesis. When analyzing the sequence of events in arterial walls during atherogenesis, it turned out that in spite of complex causes and courses of stenosing processes in arterial walls the final results were relatively uniform: atheromas of fibromuscular proliferates or a mixture of both develop. Calcification of the thickenings of arterial walls occurs frequently in the progression of the disease. In animal experiments, the development of arteriosclerosis can be speeded up with various experimental techniques and enables study of the action of drugs to inhibit atherogenesis, as well as therapies for restenoses which frequently occur after angioplasty or bypass operations. In studies of drug effects the limitations of animal experiments become obvious when trying to transfer results obtained in animal experiments to the situation in humans. Cultures of cells from human arteries are, therefore, necessary supplements. Mass cultures and clone cultures of arterial walls are, however, very artificial systems. Therefore, co-cultures of endothelial cells, smooth muscle cells, and adventitial tissue have been established which imitate the morphology of arterial walls. With transfilter co-cultures, it has become possible to produce fibromuscular proliferates in vitro. When oxidized LDL-particles and monocytes are added to the culture medium, lipid-containing proliferates develop.

Animals↗

PubMed1991

[Spontaneous course of peripheral, stenosing arteriosclerosis and the effect of catheter interventions].

Peripheral obliterating arteriosclerosis tends to progress. If it was previously a mainly unilateral disease, similar alterations on the opposite side are to be expected in the near future. This applies in particular to the most frequent incidence, occlusion of the femoral artery, which only rarely remains unilateral. Clinical symptoms of stenotic lesions are often found in the still-patent femoral artery, and the tendency to complete obliteration can be appraised from these lesions. The progression appears to be slower in patients in whom endogenous risk factors are present than in patients in whom smoking is regarded as the crucial factor. In the region of the pelvic arteries, the tendency to bilateral obliteration is considerably less. Stenoses of the iliac artery also have a less pronounced tendency to occlusion than do stenoses of the femoral artery. Manifestation of the disease in a different segment of the artery is far rarer and mostly develops proximal to the already existing obliteration. Occasional regressions of the stenoses probably result from the reduction of thrombotic deposits. Catheter interventions may affect the spontaneous course in various ways. It appears possible that the imminent complete obliteration can be delayed or prevented by stretching of the stenosis. After elimination of an isolated arterial occlusion, the collateral dilatation regresses. If a further obliteration is situated distal to the reopened section of the artery, an additional collateral dilation develops there. A reobliteration develops relatively frequently after catheter recanalization of the femoral artery and may have an unfavorable effect on the further course.

Angioplasty, Balloon↗

PubMed1977

[The significance of dietary fat in arteriosclerosis. An outmoded theory? (author's transl)].

The high cholesterol content of an atheroma, the frequent occurrence of myocardial infarction with high serum cholesterol, the extensive arteriosclerotic changes in diseases with high serum cholesterol (nephrosis, myxedema) and the occurrence of cholesterol deposits in the aorta in some animals fed with cholesterol are the principal arguments for the lipid theory of arteriosclerosis. But since many observations contradict this theory and the composition of the atheroma is the same as for many granulation tissues which are interpreted as a healing process, it is postulated that atheroma tissue is also to be interpreted as part of a reparative process. Such a hypothesis could explain all the well-known arteriosclerotic changes. Longterm studies in man for testing the serum cholesterol-lowering action of the "unsaturated" vegetable oils include serious errors of method and permit no confirmed conclusions.

Animals↗

PubMed1991

Aortic mural thrombus in young women: premature arteriosclerosis or separate clinical entity?

Two young women were admitted with peripheral arterial emboli secondary to aortic mural thrombi, and each underwent successful aortic thromboendarterectomy procedures. Both patients were taking oral steroidal medications, and both patients were heavy cigarette smokers. These cases and a careful review of the previous literature suggest that the development of aortic mural thrombi in young women may not always represent premature arteriosclerosis, as has been previously presumed, but may represent a separate and distinct clinical entity, at least in some patients.

Adult↗

PubMed1991

[Infrainguinal bypass surgery of occlusive arteriosclerosis of the lower extremities using polytetrafluoroethylene (PTFE) vascular prostheses].

During the past 15 years, PTFE vascular prostheses have been employed as an alternative graft material in patients with peripheral arteriosclerosis of the lower extremity and no suitable autogenous saphenous vein for employment as a bypass route. PTFE is a porous polymer of teflon which becomes incorporated into the tissue by invasion of fibroblasts into the material after implantation. The result of the operation as indicated by the patency of the prosthesis depends on the length of the bypassed occluded arterial segment, the quality of the artery where the distal anastomosis is made, the preoperative fall in pressure in the extremity, coagulopathy and the development of intimal hyperplasia. The results after short bypass operations are insignificantly different from the results after the use of autologous saphenous vein. The use of PTFE in infrainguinal bypass operations is an acceptable alternative to autogenous saphenous vein.

Aged↗

PubMed1990

[Factors associated with generalized forms of arteriosclerosis in patients with coronary disease].

We studied the lipidic metabolism and the atherogenic risk factors non related to lipidic metabolism in two groups of patients: group 1 with only coronary disease and group 2 with coronary disease and atherosclerosis in the cerebral and/or peripheric artery territories. Patients of group 2 showed a cholesterol, cLDL, and B-apoprotein titers significantly higher than group 1. Systolic and diastolic blood pressure were higher in group two. Also the incidence of diabetes mellitus in group 2 was higher than in group 1. In a stepwise discriminating analysis the diastolic arterial pressure and cholesterol titers were the parameters with a greatest predictive potential for the presence of localized or generalized ischemic disease. B-apoprotein was the lipidic parameter with the greatest predictive potential. All together these data suggest that in coronary patients, a discrete increase in plasma cholesterol can imply a risk of suffering ischemia in some other arterial territories. Diastolic blood pressure, cholesterol and diabetes mellitus are the factors with the highest predictive potential for the generalization of arteriosclerosis.

Arteriosclerosis↗