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[Prevention of arterial and venous vascular diseases, especially the correlation between risk factors and arteriosclerosis].

In a epidemiological study 3840 clerks of state of North Rhein Westfalia were investigated concerning the frequency of atherosklerotic leasions of the carotid and femoral arteries in duplex scanning. 17% of all investigated showed independency to age, sex and risk factors alterations of the vessel walls. Men had twice as much plaques as women and male subjects with multiple risk factors had four times more plaques than those without.

Adult↗

Enhancement of platelet sensitivity to ADP-aggregation by isometric exercise in arteriosclerosis patients and its prevention.

A new method for assessment of platelet sensitivity to ADP-aggregation was devised. Its reproducibility and the correlations between the values obtained by this method, the optical density (O. D.) method, and the screen filtration pressure (SFP) method were assessed. In summary, this method may be said to have three main points: 1. It can be performed without centrifugation, avoiding mechanical stress to platelets, using only 0.8 ml. of blood and inexpensive equipment. 2. It may reflect different aspects of platelet function from the O. D. method and the SFP method, despite the positve significant correlations between the values obtained by these three methods. 3. It was proved to be highly reproducible and is thought to be useful clinically. By using this method, the effect of sustained isometric exercise by handgripping on platelet aggregability was assessed in coronary sclerotic and cerebral arteriosclerotic patients on placebo and EG-626, a newly synthesized cyclic AMP phosphodiesterase inhibitor. On placebo, an enhancement platelet sensitivity was observed after isometric exercise in coronary and cerebral arteriosclerotic patients but not in healthy control subjects. The enhancement was prevented by pretreatment of EG-626, administered orally 1.5 hours prior to exercise.

3',5'-Cyclic-AMP Phosphodiesterases↗

[A new transluminal angioplasty for the treatment of arteriosclerosis obliterans].

A Peripheral Simpson Atherectomy Catheter (PSAC), which permits transluminal excision and removal of diseased intima, has been tested experimentally and clinically. The device consists of a tubular housing and a cutting mechanism to excise the intima protruding into the housing. Experimentally, vascular clay model was used to estimate its efficacy. Multiple passages improved lumen size and inner smoothness, and there was some difficulty to treat curved models. Clinically, 9 lesions in 7 patients of iliofemoral atheromatous disease were treated with PSAC. Recanalization was achieved successfully except for two lesions, one a soft atheroma and the other a curved vessel. No angiographic dissections or acute arterial occlusions occurred. Despite the procedure was complicated, it seemed safe and effective. In order to improve this method, an angioplastic catheter which had a laser probe in its housing was newly designed. Nd-YAG laser was irradiated with this catheter to the atherosclerotic lesions which were induced by a high cholesterol diet in rabbit. It left smoother surface and less thermal injury than usual irradiation with contact laser probe, but it needed more energy. These results showed that PSAC can be an alternative transluminal angioplasty and the new designed laser catheter is useful, but more experiments are required to establish these procedures.

Adult↗