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Results for “VASCULAR DISEASES”

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At least 1,297 records · Page 72Linked to original sources
PubMed2000

Immunohistochemical characterization of coronary thrombi in allograft vascular disease.

BACKGROUND: Coronary thrombosis is a frequent complication of allograft vascular disease (AVD) in cardiac transplant recipients. No data are available on thrombus composition in these hearts. METHODS: The present study aimed at characterizing thrombus components in coronary arteries from transplanted hearts with AVD, using single and double immunostain with anti-gpIIb-IIIa, anti-fibrin, and anti-endothelial antibodies. The pathologic series consists of 55 grafts survived longer than 2 months, and obtained from 55 patients deceased (n=44) or undergone repeat transplantation (n=11). RESULTS: Mural thrombi were found in multiple segments of 75 of 440 total coronary vessels (17%) (recent in 33, organizing in 28, and organized in 14), whereas occlusive thrombi were found in 19 vessels (8 recent and 11 with multichannel pattern of organization). Recent and thin mural thrombi were mostly constituted of CD41a- and CD61-positive platelets; the amount of fibrin progressively increased with the increase of thrombus size. In organizing mural thrombi, gpIIb-IIIa immunostain was still present. Fibrin was the only identifiable thrombus component in old mural thrombi embedded within the intimal lesions. Recent occlusive thrombi immunoreacted both with anti-CD41a and anti-CD61 and with anti-fibrin antibodies, whereas organized occlusive thrombi with multichannel pattern exclusively immunoreacted with anti-fibrin antibodies. Double immunostain showed that mural thrombi were stratified on de-endothelized arterial segments. CONCLUSIONS: Thrombus composition is related to both type and "age" of thrombus, with platelets as the early and major components of mural microthrombi at one end of the spectrum, and fibrin as the dominant component of occlusive thrombi at the other end.

Adult↗
PubMedDate not supplied

Diagnostic accuracy of intravenous digital subtraction angiography for peripheral vascular diseases.

Intravenous digital subtraction angiography (IV DSA) was performed on 406 regions of 241 patients with peripheral vascular diseases. The results were compared with conventional angiograms for 167 arteries. There was excellent correlation between conventional angiograms and IV DSA. The diagnostic accuracy was 95 with 97% sensitivity and 94% specificity when more than 60% stenoses were taken into consideration. DSA is a less-invasive procedure which can be performed on out-patients for screening and follow-up evaluation of peripheral vascular diseases.

Aged↗
PubMed2003

Erectile dysfunction and vascular disease. What is the connection?

Many of your male patients may be reluctant to talk about problems they are having with sexual functioning. However, it is important that you routinely and sensitively ask about erectile dysfunction in patients as young as 40, because the condition may be a sign of previously undetected vascular disease. In this article, Dr Kolodny explores the connection with vascular disease and suggests ways that primary care physicians can help patients reduce their risk of both erectile dysfunction and potential underlying disorders.

Adult↗
PubMed2004

Hypertension management in patients with vascular disease.

Hypertension (HTN), the leading cause of morbidity and mortality worldwide, is a modifiable risk factor for atherosclerosis. However, all too often, HTN is not well controlled in patients with vascular disease. Studies have demonstrated that patients whose blood pressure is controlled achieve at least a 50% reduction in cardiovascular events compared with similar patients whose blood pressure is not controlled. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recently prepared and distributed new guidelines for the management of HTN. This article will highlight the new recommendations for HTN management and how they can be applied to the patient with vascular disease.

Antihypertensive Agents↗
PubMed1995

Contrast-enhanced MR angiography for the diagnosis of intracranial vascular disease: optimal dose of gadopentetate dimeglumine.

OBJECTIVE: Although contrast-enhanced MR angiography has been shown useful in evaluating intracranial vascular lesions, particularly those with slow flow, the optimal dose of contrast material has not been found. Accordingly, we performed a study to determine the optimal dose of gadopentetate dimeglumine for contrast-enhanced MR angiography of intracranial vascular diseases. SUBJECTS AND METHODS: In this prospective study, 152 consecutive adult patients suspected of having intracranial vascular diseases had cerebral MR angiograms. Images were obtained with a three-dimensional time-of-flight sequence with magnetization transfer saturation on a 1.5-T unit. Imaging parameters (43/8 [TR/TE], 20 degrees flip angle, 64 1-mm-thick sections) were identical in each MR angiogram. One hundred twenty-two of 152 patients were randomly assigned to receive one of four doses (0, 5, 10, or 20 ml) of gadopentetate dimeglumine for MR angiography (36, 37, 38, and 11 patients, respectively). In patients who had normal major cerebral arteries on MR angiograms, degree and extent of visualization of the cerebral veins and small intracranial arteries were rated blindly on a three-point scale, and the results were compared among the four groups given different doses of contrast material. In another 30 patients who had unenhanced and enhanced MR angiograms, the presence or absence of artifactual narrowing of the internal carotid artery or major cerebral arteries (caused by signal loss due to slow or turbulent flow seen only on unenhanced images) and the visibility of arteriovenous malformation were determined. RESULTS: In nearly all patients, regardless of the dose of contrast material, the cerebral veins were well visualized on MR images. Degree and extent of visualization of the cerebral veins appeared to depend on the dose of contrast material. In the 20-ml injection group, venous overlap limited interpretation of the small and large arteries, whereas in the 5- and 10-ml groups, the signal intensity of the veins was much less intense, causing no difficulty in interpretation. However, no significant differences in visibility of the small arteries were apparent between the unenhanced and enhanced MR angiograms, even though the small vessels were better visualized in some patients who received either 5 or 10 ml of contrast material. In six of the 30 patients who had both unenhanced and enhanced MR angiograms, the unenhanced images showed artifactual narrowing of the internal carotid or middle cerebral arteries, which proved to be normal on contrast-enhanced MR angiograms. Venous sinuses or draining veins were better delineated on contrast-enhanced MR angiograms in all six patients with arteriovenous malformation. CONCLUSION: Five to 10 milliliters of gadopentetate dimeglumine appears to be an optimal dose range for contrast-enhanced cerebral MR angiography. Use of this dose can help in differentiating true stenosis of large arteries from artifactual narrowing and in depicting small arteriovenous malformation with slow flow.

Adolescent↗
PubMed2002

Contrast-enhanced magnetic resonance angiography MoBI-trak in the study of peripheral vascular disease.

PURPOSE: To evaluate the diagnostic accuracy of contrast-enhanced magnetic resonance angiography (CE-MRA) MoBI-trak of peripheral vessels in patients with peripheral vascular disease who were candidates for digital subtraction angiography (DSA). METHODS: Eleven patients underwent CE-MRA with automated table movement (MoBI-trak) using a 1.5 T superconducting magnet (Philips Gyroscan ACS NT) equipped with a Power Trak 6000 gradient. Contrast medium (Gd-DTPA) was administered in two sequential boluses-20 cm(3) at 0.6 cm(3)/sec (starting phase) and 20 cm(3) at 0.3 cm(3)/sec (maintenance phase)-using a MedRad Spectris automatic injector. DSA was the gold standard and was performed using a Philips Integris 3000, with a brilliance intensifier of 38 seconds. DSA and MRA were evaluated on printed films. RESULTS: DSA provided 213 diagnostic assessments: 144 negative, 30 stenosis <50%, 5 stenoses in the 51-70% range, 12 stenoses in the 71-99% range and 22 occlusions. CE-MRA MoBI-trak sensitivity, specificity, positive and negative predictive value and diagnostic accuracy were 94.1%, 99.2%, 98.4%, 80.0% and 97.5%, respectively. CONCLUSIONS: Our work is in accordance with the literature. Using this technique MoBI-trak has been shown to be a reliable technique for the detection of peripheral vascular disease up to the trifurcation, although it underlines the necessity for more diagnostic investigation and improvements in the technique.

Angiography, Digital Subtraction↗