1/16. Occlusive arterial diseases of the upper and lower extremities found in workers occupationally exposed to vibrating tools.hand-arm vibration syndrome (HAVS) is primarily a disorder of the fingers and hands. However, in some cases, vibration-exposed workers are observed to have also episodic blanching of the hands and feet. In latter cases, arteriographies of both the upper and lower extremities are necessary to diagnose the background arterial disorders. In this study, eight HAVS subjects with such disorders were examined by arteriography for differential diagnosis in cases of workers' accident compensation. In three HAVS cases with thromboangiitis obliterans, the arteriographic examination revealed obstructive changes in the palm and forearm as well as three below-knee lesions in the lower extremities. In five HAVS cases with arteriosclerosis obliterans, obstruction kinking or coiling, stenosis and/or tapering-off of the proper digital arteries were observed together with two below-knee lesions and three high lesions in the lower extremities. From the viewpoint of occupational health, palpation of superficial arteries of both the upper and lower extremities should be routinely performed during both pre-placement and periodic medical examinations for workers exposed to vibrating tools for early detection and/or prevention of any worsening of the background disorders.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
2/16. Cystic adventitial degeneration of the popliteal artery-the diagnostic value of duplex sonography.Cystical adventitial degeneration of the popliteal artery is a disorder which is difficult to diagnose, due to the similarity of the symptoms of people presenting with peripheral arterial occlusive disease (PAOD) or popliteal entrapment syndrome. The only thing that differs from patients suffering from PAOD is the lack of typical risk factors for arteriosclerosis. Typical diagnostic procedures like conventional angiography or magnetic resonance imaging angiography can be negative, too and therefore misleading. The only which is crucial in the diagnosis of cystic adventitial degeneration of the popliteal artery is to know the morphological background of this disorder, namely that it is a cyst of the adventitia of the artery which leads to a dynamic exercise-dependent flow inhibition. We present a 57-year old white male who had a week's history of intermittent claudication in his left calf. He was lacking of typical risk factors for arteriosclerosis and on first examination all pulses in both lower extremities were palpable and Doppler index on both legs was >1. Only duplexsonography revealed a cystic formation impressing the left popliteal artery in the hight of the rift in the popliteal joint.- - - - - - - - - - ranking = 2keywords = arteriosclerosis (Clic here for more details about this article) |
3/16. Occlusion of the left common iliac artery and consecutive thromboembolism of the left popliteal artery following anterior lumbar interbody fusion.We report on a case of occlusion of the left common iliac artery due to arteriosclerosis and consecutive thrombotic occlusion of the left popliteal artery in a 52-year-old man following anterior retroperitoneal interbody fusion of L4--S1. Initial symptoms included leg pain and numbness of the lateral shank, which were thought to be a result of lumbar nerve root irritation from surgery. diagnosis was not made until 13 days after surgery, when motor deficits were observed. angiography showed occlusion of the left common iliac artery and thromboembolism of the left popliteal artery. After thromboendarterectomy of the common iliac artery and thrombectomy of the popliteal artery, motor deficits of the left foot were resolved whereas symptoms of pain and sensory deficits continued. spine surgeons should be aware of this rare complication in cases of postoperative leg pain or of neurologic deficits in the lower extremity after anterior lumbar interbody fusions.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
4/16. Extensive arterial calcification of unknown etiology in a 29-year-old male.A 29-year-old male with generalized arterial calcification is presented. The roentgenogram showed extensive calcification bilaterally in the facial, brachial, renal, external iliac, femoral, and popliteal arteries. There was also calcification around the joints of the fingers, toes, elbows, and shoulders. The uniformity of arterial calcification in the radiograph differentiated this lesion from Monckeberg's arteriosclerosis. The serum concentration levels of calcium, phosphorus, alkaline phosphatase, and calcium regulatory hormones were normal. The patient did not have diabetes mellitus, renal disease, or connective tissue disease, thus the etiology of the calcification was not identified. However, a bone scintigram showed that the uptake of 99 mTc-methylene diphosphate was significantly increased in the calcified arteries. Therefore, increased metabolic activity was associated with the derangement leading to arterial calcification.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
5/16. A case of subclavian steal syndrome with a specific form of obstruction of the right proximal subclavian artery.We experienced a case of subclavian steal syndrome (SSS) with a specific form of obstruction of the right proximal subclavian artery. The patient was a 44-year-old man who complained of numbness of the right hand. Right carotid-subclavian artery anastomosis was performed under general anesthesia. The obstructed segment was a fibrous cord, 3.5 cm in length and 2.0 mm in diameter. Postoperatively, the patient was free from the symptom. In the Japanese literature, 73 cases of SSS were reported from 1965 to 1986, and the etiology was mentioned in 64 cases. In 28 cases the cause was aortitis syndrome (43.8%), in 22 cases arteriosclerosis (34.4%), in 13 cases congenital malformation (20.3%), and in 1 case iatrogenic lesion (1.6%). These data indicated that SSS caused by congenital malformation was not so rare as previously believed. Of 13 cases with congenital malformation, our case and 3 other cases had similar aspect in clinical features. All 4 patients were middle-aged men (aged 34, 26, 45 and 44 years) with a fibrous cord at the proximal portion of the right subclavian artery. None had any other cardiovascular anomalies.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
6/16. Adventitial cystic disease of the popliteal artery: failure of percutaneous transluminal angioplasty as a therapeutic modality.Adventitial cystic disease of the popliteal artery is an important cause of peripheral vascular insufficiency in the young and middle-aged man. The pathologic feature is a mucinous cyst located within the adventitia of the artery that expands and secondarily compromises the vessel lumen. Although physiologically quite different, this process is easily mistaken for arteriosclerosis. The clinical history of sudden claudication in a young nonsmoking man, combined with characteristic angiographic features, are important clues to the correct underlying pathology. Treatment generally consists of cyst evacuation or local bypass. This article was prompted by the failure of percutaneous transluminal angioplasty to achieve durable success in controlling this unique type of arterial disease. Subsequent surgical intervention proved satisfactory, lending support to this modality as the treatment of choice.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
7/16. research related to surgical treatment of aortic and peripheral vascular disease.The history of vascular surgery and the developments that made it possible are briefly traced. Approaches to the treatment of arterial lesions are considered in terms of the characteristic anatomic, pathologic and clinical patterns of arteriosclerosis or atherosclerosis, the basic underlying lesion in most aneurysmal and occlusive diseases of the aorta and major arteries. The importance of appreciating the various patterns and rates of progression of atherosclerosis is emphasized.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
8/16. Vascular retinopathy in migraine.After years of episodic monocular visual loss, two migraineurs suffered sudden, persisting loss of vision from retinal vascular occlusion. One was a 34-year-old woman with systemic lupus erythematosus who showed abnormalities of the cilioretinal arterial and retinal venous circulations. The other was a 62-year-old man with hypertension and arteriosclerosis who had a central retinal vein occlusion. Persisting monocular visual loss is a rare consequence of migraine. Our cases suggest a role for venous lesions. Occlusion of retinal vessels in some migraineurs may result from the synergistic effect of another vascular disorder with the migraine.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
9/16. Cold sensitivity of the hand in arterial occlusive disease.Digital blood pressure was measured using photoplethysmography in patients with cold sensitivity of the hand. In 19 patients with Buerger's disease, or arteriosclerosis obliterans (arterial occlusion group), 90 of 91 fingers with cold sensitivity showed significantly low pressures. In 17 patients with typical Raynaud's phenomena due either to primary Raynaud's disease or secondary to collagen disease (Raynaud's group), decreased digital pressure was noted in only five of 123 fingers with cold sensitivity. blood pressure measurements in the fingers after local cooling of the hand showed a more severe response to cold in the Raynaud group than in the arterial occlusion group. These results indicate that the pathophysiologic mechanism for cold sensitivity in arterial occlusive disease is different from that in Raynaud's disease. In the arterial occlusion group impaired circulation due to occlusions in the digital arteries or more proximal arteries is a necessary precondition for cold sensitivity, and an increased sympathetic response to cold is of less importance as an etiologic factor. Thus a patient with cold sensitivity of the hand and normal digital blood pressure should not be considered to have arterial occlusive disease as the underlying cause of cold sensitivity.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
10/16. Neovascular glaucoma in systemic occlusive vascular disease.A 58-year-old woman was seen with a red inflamed right eye with rubeosis iridis and neovascular glaucoma with closure of the angle. There was no evidence of the diabetes and no evidence of occlusion of the central retinal vein. physical examination was normal except for an absent carotid pulse on the right side, a carotid bruit on the left side, and absence of the pulse in all extremities. Further evaluation revealed severe arteriosclerosis involving many major branches of the aorta, including both carotid arteries. This patient had neovascular glaucoma as the only presenting sign of severely arteriosclerotic stenosis of both carotid arteries. This case demonstrates the need for emphasis on this rare but occult life-threatening cause of neovascular glaucoma. Ophthalmologists should be alert to the possible presence of carotid occlusive disease as a causative factor when cases of neovascular glaucoma are encountered.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
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