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At least 721 records · Page 40Linked to original sources
PubMed1994

[Abnormal endothelium-mediated regulation of vascular tone in arteriosclerosis].

Knowledge regarding the endothelial-derived relaxing factor (EDRF) has substantially increased over recent years. The chemical identification of EDRF as nitric oxide (NO) and the discovery of the NO-pathway started an exciting research field with new insights into the regulation of many biologic processes. Concerning regulation of the vascular tone, EDRF(NO) is one of the most potent relaxant substances known; in addition, EDRF(NO) is a potent inhibitor of platelet adhesion and aggregation and leukocyte adhesion to the vascular wall; furthermore, EDRF(NO) is probably an inhibitor of smooth muscle cell proliferation. This profile of EDRF(NO) may be an important part of the anti-arteriosclerotic function of intact endothelial cells. In animal models of hypercholesterolemia and in patients with hypercholesterolemia and/or arteriosclerosis, the EDRF(NO) mechanism is impaired or almost abolished (= endothelial dysfunction). The reason for this abnormal endothelial function is not fully understood and may be multifactorial; it has been suggested that this endothelial dysfunction is due to an accelerated breakdown of EDRF(NO) by oxidized low density lipoprotein and/or oxygen derived free radicals. In addition, there may be an increased release of vasoconstrictive substances, e.g., endothelin-1, from endothelial cells which may override the relaxant effects of EDRF (NO). This abnormal function of the endothelium (in terms of the EDRF(NO) mechanism) appears to be reversible in animal models and in patients with hypercholesterolemia, and is accomplished by normalizing plasma cholesterol levels.

Amino Acid Oxidoreductases↗
PubMed1995

Screening of patients with ischemic heart disease by transesophageal atrial pacing and the selection of surgical therapy: in patients with arteriosclerosis obliterans and aortic aneurysm.

This study evaluated (1) a screening method for ischemic heart disease (IHD) using transesophageal atrial pacing (TEP), and (2) the appropriate surgical therapy for patients with concomitant IHD which was evaluated on the basis of the coronary score (CS) by Leaman. Thirty-nine patients with arteriosclerosis obliterans of the lower extremities (ASO) and 35 with aortic aneurysm underwent TEP and coronary angiography (CAG). Coexistent IHD was diagnosed in 25 patients (64%) with ASO and in 14 (40%) with aortic aneurysm. Screening for IHD by TEP was 96% sensitive, 71% specific, and 87% accurate in patients with ASO, and 79% sensitive, 90% specific, and 86% accurate in patients with aortic aneurysm. Coronary artery bypass grafting (CABG) and peripheral arterial revascularization (PAR) were performed by one stage surgery in 3 patients with a CS of 16 or more. In 18 patients with a CS of 5.5 or less, only PAR was performed. One stage surgery was performed in 6 patients with aortic aneurysm. Four patients had a CS of 9.5 or more, and 2 patients with coexistent stenosis of the left anterior descending branch (LAD) had CS of 3.5 and 8, respectively. Repair of the aneurysm was undertaken in 5 patients with a CS of 8 or less without LAD disease. In patients with ASO showing a CS of 5.5 or less and in those with aortic aneurysm showing a CS of 8 or less (and without LAD disease), the only surgical procedure performed was either PAR or repair of the aneurysm. There were no complications attributable to IHD observed in these patients during the perioperative period.

Adult↗
PubMed1993

[Favorable in vitro effect of pentoxifylline on damaged lymphocyte migration in arteriosclerosis obliterans and systemic lupus erythematosus].

Decreased blood cell--e.g. lymphocyte--motility is seen in a number of vascular and autoimmune diseases. Pentoxifylline (Pf) shows a well-known therapeutic effect in several vascular alterations by causing the redistribution of blood cell cytoskeleton and increased microcirculation. As most literary data on Pf concern red blood cells and granulocytes authors here investigated the effect of Pf on previously decreased lymphocyte migration and chemotaxis. Results of in vitro studies suggest that Pf enhances impaired lymphocyte motility in obliterative arteriosclerosis and systemic lupus erythematosus and thus may also be introduced in the treatment of polysystemic autoimmune diseases.

Arteriosclerosis Obliterans↗
PubMed1995

[EDTA in the treatment of arteriosclerosis].

EDTA has been used since the early fifties in the treatment of arteriosclerosis. There are few serious complications connected with using therapeutic doses of EDTA, although numerous side effects can arise. Several theories exist which suggest that the drug has a positive effect on atheromatous plaque; no such effect has been proven in vivo. Many papers claim to show the positive effect of EDTA on angina pectoris and intermittent claudication, but only one double blind placebo controlled experiment has been reported. In a sample of 153 claudicatio intermittens patients, no significant improvement in the distance walked nor in the ankle/brachial-index was proven, nor did the patients themselves notice any improvement. A professional investigation of the treatment, carried out by Norwegian Health Authority in 1981, concluded by advising Norwegian physicians not to recommend this kind of treatment for their patients. Since then, no clinical documentation of the effect of the treatment has become available. It must therefore be regarded as ethically unsound practice to start such treatment, unless as part of a clinically controlled experiment.

Arteriosclerosis↗
PubMed1995

Inhibition of transplant arteriosclerosis in rat aortic grafts by low molecular weight heparin derivatives.

The effects of low molecular weight heparin derivatives with a low anticoagulant activity on transplant arteriosclerosis (TA) in a rat aortic transplant model were investigated. TA was induced by ischemia in the syngeneic transplants and primarily by immunological mechanisms in the allogeneic transplants. Treatment with the heparin derivatives, OAM 71262 or LA-heparin, was administered in a dosage of 250 micrograms/kg/hr by mini-osmotic pumps during 8 weeks. No immunosuppressive regimen was given to the recipient rats in either model. All rats were killed 8 weeks after aortic grafting. The grafts were examined for intimal and medial changes using an image analysis system. Heparin derivatives had a beneficial effect on both the intimal thickening and the medial injury in the syngeneic transplants, but not in the allogeneic grafts. In the syngeneic LA-heparin treated grafts, the thickness of the intima was less than that in the syngeneic control grafts (P < 0.05). In the syngeneic transplants, a significant increase was observed in the media after treatment with OAM 71262 (P < 0.01) as well as those with LA-heparin (P < 0.001). In the syngeneic grafts treated with both heparin derivatives, a significant reduction in the antigen expression of alpha-actin-containing smooth muscle cells in the intima, transforming growth factor-beta 1 both in the media and adventitia, and platelet-derived growth factor-beta receptors in the adventitia was observed immunohistochemically. In summary, low molecular weight heparin derivatives with low anticoagulant activity partially inhibited ischemia-induced syngeneic TA, whereas no such effect could be demonstrated in nonimmunosuppressed recipients with allogeneic grafts.

Animals↗
PubMed1994

[A case report of spontaneous renal rupture due to arteriosclerosis].

A case of spontaneous renal rupture with subcapsular hematoma was reported. The patient was a 44-year old man complaining of a sudden left flank pain without any recent history of trauma. His abdominal ultrasonography (US), computerized tomography (CT) and renal angiography demonstrated left renal rupture with subcapsular renal hematoma. Cytological examination of left upper urinary tract revealed a suspicion of a neoplasma of renal pelvis and left renal function was not recovered. Therefore, left total nephro-uretectomy was performed, and histological examination revealed hemorrhage and infarct due to the severe arteriosclerosis and intestinal nephritis without malignancy. Sixty-three cases of non-traumatic subcapsular renal hematoma reported previously in the Japanese literature are reviewed with some statistical analyses.

Adult↗
PubMed1994

[Aortoiliac arteriosclerosis treated with bypass surgery].

After introduction of the crimped Dacron bifurcation prosthesis, bypass surgery has been the preferred surgical treatment for arteriosclerosis in the aortoiliacal segment. During the years 1979-88 we performed 152 aortoiliacal/femoral bypass operations. Perioperative mortality was 2%, while 96% of patients experienced improvement from operation. Primary and secondary five-year graft patency rates were 84 and 88%. Considering the high risk in this patient group, we regard the operational mortality to be acceptable, and the long term results satisfactory. However, surgical treatment should be reserved for patients with serious occlusive disease in the aortoiliac segment. For patients with more limited lesions, endovascular procedures are a relevant alternative to surgery.

Adult↗
PubMed1994

[Femoropopliteal bypass in arteriosclerosis].

Since Kunlin's report on femoropopliteal bypass operations, this procedure, with homologous vein or various prosthesis has been the principal treatment for serious arteriosclerosis in this anatomical area. During the years 1979-88 we performed 235 femoropopliteal bypasses. Reversed autologous vein was used in 60% and the distal anastomosis placed below the knee in 75%. Perioperative, 30 days mortality was 2.1%. 93% of the operations were successful. The overall five year patency rate was 50.6%, but with significantly better results with the distal anastomosis above the knee. There was no significant difference, however, between reversed homologous vein and human umbilical vein grafts in the below knee position. At present, the indications for femoropopliteal bypass are critical ischemia and seriously incapacitating claudication.

Adult↗
PubMed1994

[Percutaneous transluminal angioplasty in the treatment of arteriosclerosis of the lower extremities].

With the introduction of balloon catheters in 1974, dilatation of arteriosclerotic stenoses has become an important treatment for this condition. During the years 1979-88, 368 such procedures were performed in 270 patients. Two patients (0.7%) died from complications. In 8%, revascularisation was unsuccessful. Long occlusions appeared especially difficult to recanalize. 81% of the patients were improved by the treatment. The long term results were best in the iliac segment with 5-year patency of 90% after dilatation of short stenoses (< 4 cm) and 65% after dilatation of longer stenoses. In the femoropopliteal segment, the 5-year patency rates were 65% and 50% respectively. Results after recanalisation of occlusions were poor. Percutaneous transluminal angioplasty is an important supplement to surgery, applying mainly to patients with limited arteriosclerosis and moderate symptoms.

Adult↗
PubMed1994

Suppression of acute rejection prevents graft arteriosclerosis after allogeneic aorta transplantation in the rat.

Rat aortic allografts develop arteriosclerotic alterations in the vascular wall that are histologically similar to those observed in chronic rejecting vascular allografts. We used cyclosporine and rapamycin (RAPA) in two different rat strain aorta transplantation models to investigate the effect of immunosuppression on posttransplant graft arteriosclerosis. High dose CsA (25 mg/kg, 3 times/week) treatment significantly inhibited intimal proliferation in the "strong" WAG-BN model (P < 0.01) as well as in the "weak" BN-WAG combination (P < 0.001), compared with untreated allogeneic controls. In the latter combination, even fewer intimal lesions were present than in WAG autotransplants, suggesting that CsA may also inhibit the arteriosclerotic response to mechanical injury. RAPA (3 mg/kg, 3 times/week) was as effective as CsA in reducing intimal lesions (P < 0.01 and P < 0.001 in the BN-WAG and WAG-BN models, respectively). Low dose CsA (5 mg/kg, 3 times/week) was only partially effective in preventing intimal lesions. Histology of the nontreated allografts showed ongoing acute rejection in the adventitial layer. The degree of cellular infiltration correlated with the severity of arteriosclerotic lesions. High dose CsA and RAPA treatment prevented adventitial infiltration in both models, while low dose CsA was only moderately effective. In conclusion, in the present study, the degree of arteriosclerotic involvement after allogeneic aorta transplantation was related to the severity of cellular adventitial infiltration. The myointimal thickening was inhibited by effective immunosuppressive treatment. These observations may imply that chronic rejection develops after ineffective immunosuppression.

Animals↗
PubMed1976

A critical review of the literature on long-term treatment of peripheral arteriosclerosis with oral anticoagulants.

Protracted administration of oral anticoagulant agents to patients presenting symptoms of peripheral arteriosclerosis is a treatment in widespread use in the Netherlands a Germany. However, a critical perusal of the available literature reveals a scarcity of objective data which might confirm the value of this treatment. It may be concluded from the data in the literature that protracted administration of anticoagulants may be useful only in case of stenosis of the superficial femoral artery. It is pointed out that a statistically correct study of this subject, with use of objective parameters, is urgently necessary.

Anticoagulants↗
PubMed1994

Partial inhibition of allograft arteriosclerosis (chronic rejection) by 15-deoxyspergualin.

15-deoxyspergualin (DSG) is an immunosuppressive drug that suppresses monocyte/macrophage function and/or T cell induction and early differentiation of B lymphocytes. It is as effective as cyclosporine in the prevention of acute rejection. We have investigated the effects of DSG on rat aortic allograft arteriosclerosis (chronic rejection). DSG was administered to the recipient rat at a dose of 0.3-10 mg/kg/day i.p. for 1-3 months, after which recipients were sacrificed. Histological changes were quantitated from paraffin sections. DSG is effective in chronic rejection in rat aortic allografts and reduces all three manifestations in the vascular wall--adventitial inflammation, media necrosis, and intimal thickening. At the dose of 1.0 mg/kg/day we demonstrated significant inhibition of adventitial inflammation from 10.6 point score units (psu) to 4.7 psu (P < 0.05), of media necrosis (P = 0.004) and of intimal thickening from 2.9 psu to 0.8 psu (P = 0.008). The therapeutic window was small in the long-term experiment. Doses of 3-10 mg/kg/day were toxic and 0.3 mg/kg/day was ineffective. In vitro smooth muscle cell proliferation was not inhibited by DSG and in the in vivo carotic denudation model DSG had no inhibitory effects either. These results suggest that DSG works via suppression of the immune/inflammatory response rather than via a direct antiproliferative effect on smooth muscle cells.

Animals↗
PubMed1993

[Risk factors of arteriosclerosis. Differential profile--various mechanisms?].

Up to the present more than 250 factors have been discussed as being risk factors for arteriosclerosis. Yet only a very few pathogenetic mechanisms have actually been proven to be causative in maintaining or complicating the disease. Experimental research in atherosclerosis reflects on a history of approximately 80 years, starting with the remarkable discovery by Windaus in 1912, who for the first time described that in atherosclerotic material 30 times more cholesterol is found as compared to healthy material. Today, due to an enormous quantity of experimental, biochemical, cellular and molecular biological data it is clear that the cholesterol of an atherosclerotic plaque is not being built at the location of deposit but rather derives from circulating plasmalipoproteins, especially from the LDL and IDL particles. Predisposition requires exceeding a threshold concentration of approximately 100 mg/dl cholesterol in plasma and its biological modification. In atherogenesis essentially five cell types are involved: the endothelium, the thrombocytes, the monocyte/macrophage system, the smooth muscle cells of the intima, and the T-lymphocytes. As a consequence of a rather complicated interaction of lipoproteins with these cells changes of the endothelium are initiated which eventually lead to lipid deposition. From early clusters, the so-called fatty streaks, and under unfavorable circumstances and unlimited growth atherosclerotic plaques may develop with the inherent danger of rupture and thrombotic occlusion. The vulnerability respectively the resistance of the arterial wall towards hypercholesterolemia is influenced by other so-called primary risk factors such as hypertension, cigarette smoking, diabetes mellitus, and hyperfibrinogenemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteriosclerosis↗
PubMed1993

Delayed arteriosclerosis progression in high risk subjects treated with mesoglycan. Evaluation of intima-media thickness.

Noninvasive ultrasonic biopsy (UB) can be used to classify arteriosclerotic lesions and their progression in the carotid and femoral bifurcation. Also the evaluation of intima-media thickness (IMT) is useful to quantify the progression of early arteriosclerosis. Two randomly selected groups of asymptomatic subjects were included in a 18 month, open study. One group was treated with oral mesoglycan (200 mg/day) and one group was followed-up as control. The two groups were comparable for age and sex distribution. The average UB score was 14.4 +/- 5 in the treatment group and 14.3 +/- 8 in the control group. After 18 months the UB score was 15.7 +/- 4 in the treatment and 16.2 +/- 6 in the control group. These differences were not significant. However the average increase in IMT in 18 months in the treatment group was 0.016 mm equivalent to 0.0106 mm per year. In the control group the average increase was 0.119 equivalent to 0.0793 per year. Therefore the increase in IMT was 7.48 times greater in the control group. These differences were significant (p < 0.05). Two drop-outs were recorded in the treatment group and 1 in the control group. In conclusion IMT measurements showed a decreased level of IMT progression in subjects under mesoglycan treatment. These results need to be confirmed by a larger randomised study.

Arteriosclerosis↗
PubMed1993

[Studies on the reduction and correction risk factors for arteriosclerosis in junior high school pupils].

Circulatory system examinations performed on first-grade pupils of junior high schools (12 years old; N = 1,204), identified 105 high-risk pupils with arteriosclerosis-promoting factors. These pupils were consulted on life-style modification, emphasizing nutrition and exercise, and encouraged to practice personal health management and self-monitoring. Reduction and correction of high risk factors were studied in these subjects, based on review of results of health examinations performed regularly up to the time of their graduation. Results are as follows: 1. Averages for obesity grade (for both sexes) in the second and the third years were significantly lower than that in the first year. Based on a general reference value > or = 20%, improvements were observed in 22.5% of males and 50.0% of females. 2. In both sexes average total cholesterol (TC) and triglyceride (TG) were lower in the second and the third years than in the first year, and a significant increase in HDL cholesterol was seen. With regard to a general reference value > or = 3.0 for AI (Atherogenic Index) calculated using TC and HDL cholesterol, improvements (reduction) were observed in 29.4%, of males and 46.2% of females. 3. While the numbers of subjects with elevated SBP, DBP, GPT, FPG and BUN were few, there were significant decreases in averages in the second and third years compared with those in the first year. Using general reference values, improvements in these risks were seen in 100% for all values except for GPT where 75.0% showed improvement. 4. Comparison of grouped distribution of summed values of examination results between the first year and the third year, showed improvements (reduction and correction of risks) in 69 pupils (65.7%), while 30 pupils (28.6%) remained in the same group with no improvement and 6 pupils (5.7%) turned for the worse, dropping one rank.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteriosclerosis↗
PubMedDate not supplied

Six year experience with wrinkled ePTFE vascular prostheses for arteriosclerosis obliterans.

From November 1986 to January 1993, 97 wrinkled ePTFE prosthetic vascular grafts were implanted in 90 peripheral arterial reconstructions for 87 patients with arteriosclerosis obliterans (ASO) (79 men and 8 women). Grafts used in this series were 54 Vitagraft and 33 Technograft. Initial results for a period of as long as 6 years are summarized here. Forty-four (45.3%) grafts were implanted anatomically, and the remaining were extra-anatomically routed. The mean age of patients in the anatomic bypass group was 64.7 years, and that of patients in the other group was 71.4 years. Twenty-three (43.3%) grafts in the extra-anatomic group were anastomosed sequentially. Mean follow-up periods for each group were 32.4 months and 30.9 months, respectively. None of nine late deaths during the follow-up period was graft related. There was one primary obstruction in the anatomic group; in the extra-anatomic groups, primary graft occlusion occurred in four grafts. In addition, one perigraft seroma and one pseudoaneurysm requiring surgical repair were seen. Cumulative event free ratio for this group was 80.8% at 72 months. These results reveal that the wrinkled ePTFE graft is clinically applicable to arterial reconstruction for ASO with satisfactory long-term patency, even in extra anatomic sequential bypasses.

Aged↗
PubMed1993

[Pathology of arteriosclerosis--an overview].

Arteriosclerosis is vascular disease characterized by thickening, hardening and remodelling of the arterial wall and classified into following three categories: atherosclerosis, Mönckeberg's medial calcific sclerosis, and arteriolosclerosis. Fibromuscular intimal thickening starts its development in the fetal age of the 6th month and continues to grow with aging. The specific topography of early atherosclerotic lesions is primarily attributed to wall shear stress, one of hemodynamic forces. The lesion will proliferate to form atherosclerosis when complicated by hyperlipidemia, hypertension, and/or other clinical risk factors. The major complications of atherosclerosis, stenosis of the arterial lumen and thrombus formation at ulcerated arterial walls, frequently cause such lethal diseases as ischemia of various pivotal organs or rupture of aneurysms.

Animals↗
PubMed1993

[Angiography in arteriosclerosis].

Advances in angiography of arteriosclerosis have been made possible by improvement of angiographic techniques, materials, such as narrow catheters and gliding guidewires, x-ray apparatus and equipments, including digital subtraction angiography (DSA), computed radiography and magnetic resonance angiography and contrast media. Improved, narrow and yet wide lumen catheters have made it possible to insert the catheter via the axillary or brachial artery. The matrix of DSA was increased to 1024 x 1024 from 512 x 512, and resolution of DSA has been greatly improved. Intravenous DSA has made examination of aneurysm or arterial stenosis or occlusion, easier without much harmful invasion. Ionic or non-ionic low osmolar contrast media has greatly reduced the irritation to the vessels.

Aged↗