Disease Of Lower Extremities Research Articles

Treatment of Arterial Occlusive Disease of the Lower Extremities

Treatment of Arterial Occlusive Disease of the Lower Extremities

Vascular Diseases: A Concise Guide to Diagnosis, Management, Pathogenesis, and Prevention

Dr Sandor A. Friedman has edited a comprehensive general text on vascular diseases that are frequently seen by the general internist and surgeon. The goal of the book, as is stated in the introduction, is to review the management of major circulatory diseases and to summarize some of the newer concepts that have arisen in the pathogenesis, diagnosis, and therapy of vascular disorders. The entire spectrum of vascular disease is covered, including occlusive disease of the lower extremities, arterial aneurysms, venous thrombosis, pulmonary thromboembolism, thoracic outlet syndrome, and disorders affecting the renal, visceral, and cerebrovascular system. In addition, important topics such as diabetic neuropathy and an overview of the noninvasive and newer invasive radiological procedures are covered. Although this book is oriented toward the medical specialist, there is one chapter by Dr Anthony Imperato that covers the basic concepts and rationale behind the operative procedures used in vascular reconstructive surgery.

主題IV-13 下肢動脈疾患の外科治療

主題IV-13 下肢動脈疾患の外科治療

Prostacyclin therapy in peripheral arterial disease.

Abstract Thirty patients with advanced peripheral arterial disease of lower extremities were treated with a single or multiple courses of prostacyclin /2–10 ng/kg/min intraarterially or intravenously for about 72 hours/. The observation period ranged from 2 to 15 months. The sustained improvement, as evidenced by alleviation of rest pain and healing of ischemic ulcers, occurred in 40 per cent of patients. Severity of local symptoms and arteriographic localization of the lesions are of essential prognostic value for the efficacy of prostacyclin therapy, however, they do not comprise all of the factors which determine responsiveness to prostacyclin. Platelet activity as assessed by several in vitro and in vivo methods was suppressed during the therapy, and returned to normal shortly after termination of the infusions. These short-lasting anti-platelet as well as vasodilatory effects of prostacyclin are in contrast with persistance of the clinical improvement which occurred in a substantial number of patients.

主題I-1-17 下肢慢性閉塞性動脈疾患例の晩期再血行再建手術成績

主題I-1-17 下肢慢性閉塞性動脈疾患例の晩期再血行再建手術成績

主題III-2 下肢動脈閉塞症再手術例より見た手術術式の比較

主題III-2 下肢動脈閉塞症再手術例より見た手術術式の比較

Location of occlusive arterial disease of lower extremity. Possible importance of local factors in pathogenesis.

Arterial lesions were studied in 121 patients with ischemic lower extremities using a technique termed complete arteriography which permits the viewing of all arteries in the thigh, calf and foot in a single investigation. When atherosclerotic occlusions or plaques are present in a single artery, they are predominantly in the femoral artery; however, two or more arteries are affected in the majority of cases. Atherosclerotic lesions are common in the superficial femoral artery, but rare in the deep femoral artery. Occlusions accumulate mainly in segment III of the superficial femoral artery, while most plaques are found in segment IV. In the anterior tibial artery, the number of occlusions increases gradually in the proximo–distal direction, while the number of plaques decreases. These relations are established within the first three years of the disease. The rate at which atherosclerotic occlusions of the femoral artery spread from the initial segmental obliteration in the adductor canal to the adjacent segments proximally and distally, when expressed as a simple function of time, was virtually identical for both segments. In the uppermost segment of the artery, however, the development of occlusions is more rapid, although the final number of obliterations here is not much different. We conclude that the differences in frequency, location and rate of formation of the pathologic changes cannot be explained by the general metabolic inclination per se but must be due to the coaction of local factors.

Vascular effects of nylidrine hydrochloride during exercise.

Summary and ConclusionsBlood flow response to exercise was tested plethysmographically in 3 healthy subjects and 7 patients with non-gangrenous occlusive arterial disease of lower extremities, before and after intravenous administration of nylidrine hydrochloride, an adrenaline analog. Response in blood flow was significantly augmented after administratino of drug in all but one subject, who had severe bilateral frost bite. Since blood flow response to exercise takes place mostly in working skeletal muscles, it is concluded that the primary site of nylidrine action is in the vasculature of skeletal muscle. Nylidrine apparently enhances capacity of muscle vessels to respond to exercise.

The value of skin thermometry in peripheral vascular disease of the lower extremities.

The value of skin thermometry in peripheral vascular disease of the lower extremities.

Lumbar sympathectomy in the treatment of obliterative vascular disease of the lower extremities.

Lumbar sympathectomy in the treatment of obliterative vascular disease of the lower extremities.