1/25. Major vascular surgery in a patient with sickle cell disease.We report a patient with homozygous sickle cell disease who underwent femoropopliteal bypass for claudication on walking 10m. Isotope studies showed a blood flow in his left femoral artery of only 0.808 ml. 100ml.min-1. The potential problems of sickle cell disease combined with peripheral vascular disease were probably reduced in this patient because he had an increased fetal haemoglobin level of 13%. Despite the femoral artery being clamped for 100 min, no sickling crisis occurred.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/25. Thermal biofeedback for claudication in diabetes: a literature review and case study.temperature biofeedback (TBFB) is designed to alter cutaneous temperature in treated extremities by providing information corresponding to minor temperature fluctuations in the context of therapeutic structure and reinforcement. Toe TBFB may improve vascular flow and walking tolerance in patients with peripheral vascular disease. This case study documents improved walking in a diabetes patient with lower extremity complications, and suggests TBFB might increase lower extremity temperature and blood flow volume pulse in uncomplicated diabetes. ankle-brachial index (ABI) and walking function were assessed in a 60-year-old woman with type 2 diabetes and intermittent claudication, before and after five sessions of TBFB applied to the ventral surface of the great toe. Toe temperature increased during feedback phases but not during baseline phases. Improvements were seen in ankle-brachial index, walking distance, walking speed, and stair climbing. This case indicates the need for extended and controlled study of TBFB for improved vascular and ambulatory function in diabetic claudication.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
3/25. diagnosis of intermittent vascular claudication in a patient with a diagnosis of sciatica.BACKGROUND AND PURPOSE: The purpose of this case report is to illustrate the importance of medical screening to rule out medical problems that may mimic musculoskeletal symptoms. CASE DESCRIPTION: This case report describes a woman who was referred with a diagnosis of sciatica but who had signs and symptoms consistent with vascular stenosis. The patient complained of bilateral lower-extremity weakness with her pain intensity at a minimal level in the region of the left sacroiliac joint and left buttock. She also reported numbness in her left leg after walking, sensations of cold and then heat during walking, and cramps in her right calf muscle. She did not report any leg pain. A medical screening questionnaire revealed an extensive family history of heart disease. Examination of the lumbar spine and nervous system was negative. A diminished dorsalis pedis pulse was noted on the left side. Stationary cycling in lumbar flexion reproduced the patient's complaints of lower-extremity weakness and temporarily abolished her dorsalis pedis pulse on the left side. OUTCOMES: She was referred back to her physician with a request to rule out vascular disease. The patient was subsequently diagnosed, by a vascular specialist, with a "high-grade circumferential stenosis of the distal-most aorta at its bifurcation." DISCUSSION: This case report points out the importance of a thorough history, a medical screening questionnaire, and a comprehensive examination during the evaluation process to rule out medical problems that might mimic musculoskeletal symptoms.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
4/25. popliteal artery entrapment syndrome: specific aspect.A case of popliteal artery entrapment syndrome (PAES) is reported. A non smoker, 63-year-old man, consulted for severe claudication of the lower limb, with a sudden onset. There was no past history of vascular disease. Neither the arteriography nor the arterial doppler led to definite diagnosis. In our case, only the C.T. scan was contributive to the diagnosis. The age, 63, at which this abnormality became symptomatic, the abrupt appearance of ischaemic symptoms and the embryologic type of the arterial stenosis were particular. The surgical management was the only therapeutic option.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
5/25. Digital angiography using hand-operated table movement for vascular disease of the pelvis and lower extremities.We developed a new technique using hand-operated table movement during digital angiography (DA) for the study of vascular disease of the pelvis and lower extremities. Digital video memory (DVM) is used in this technique to digitize, record, and display fluorographic images without subtraction in real time. This allows free table movement and the imaging of a large area with a single injection of contrast medium. Forty-five examinations for vascular disease of the pelvis and lower extremities were performed by this DA technique. Good images of an extensive area from the lower abdomen to the lower leg were obtained in a single study.- - - - - - - - - - ranking = 6keywords = vascular disease (Clic here for more details about this article) |
6/25. role of antiplatelet therapy in cardiovascular disease III: peripheral arterial disease.peripheral arterial disease (PAD) is a common manifestation of the atherosclerotic disease process, typically affecting vascular beds in the lower extremities. In its most severe form PAD may lead to limb amputation. patients with PAD are also at increased cross-risk of thrombosis at coronary and cerebrovascular sites. However, despite its prevalence and severity, PAD is underdiagnosed and undertreated. In this collection of case studies, the role of the antiplatelet agent clopidogrel in current treatment strategies for the management of PAD is highlighted.- - - - - - - - - - ranking = 4keywords = vascular disease (Clic here for more details about this article) |
7/25. Expansion of contracted visual fields following treatment with pentoxifylline in two patients with coexistent peripheral vascular disease--case reports.pentoxifylline, a hemorheologic drug reputed to reduce blood viscosity, can be used to improve the microcirculation in peripheral vascular disease. The authors report on 2 patients who were being followed up for possible glaucoma and whose visual field constriction became worse at about the same time as their peripheral vascular symptoms began to increase in severity. Following initiation of treatment with oral pentoxifylline, their peripheral vascular complaints decreased and their visual fields gradually expanded over the next several months. This dual effect seemed more than a coincidence. It may in fact indicate that the same mechanism said to aggravate the peripheral ischemia (ie, increased blood viscosity) in patients with peripheral vascular disease may also have been the basis for the visual field contraction in these 2 patients, possibly by producing retinal ischemia. The reversal of the contracted visual fields would then seem to be due to the ameliorative effect of the pentoxifylline treatment on the blood viscosity.- - - - - - - - - - ranking = 6keywords = vascular disease (Clic here for more details about this article) |
8/25. Neurogenic claudication secondary to vascular disease.Neurogenic claudication is characterized by sensory symptoms which appear during exercise or while maintaining a fixed posture. They are paraesthetic in quality, may be associated with 'march' phenomena, and patients may have bowel and bladder disturbance. The problem is most commonly secondary to lumbar canal stenosis (LCS) but rarely due to aortic disease, as shown in this case report. This report concerns a 66 year old woman who presented with symptoms of paraesthesia radiating from the buttocks to the thigh and, intermittent loss of bladder and bowel function, all associated with walking. There were no associated symptoms of vascular claudication. Clinically, there was evidence of aorto-iliac obstruction with absence of femoral pulses and a vascular index of 0.4 at both ankles. Neurological examination was normal at rest but the left ankle jerk was absent immediately after exercise. Myelogram and computerized tomographic (CT) scan were normal. An aortogram revealed a very tight irregular stenosis of the aorta at the level of the renal and mesenteric arteries. Very few lumbar vessels were seen. An aortic endarterectomy via a thoraco-abdominal approach was performed and an aortobifemoral graft inserted. The patient's symptoms resolved following this procedure. We postulate that her symptoms were caused by a 'steal' from the blood supply to the cauda equinda due to the severe athromatous disease of her upper abdominal aorta.- - - - - - - - - - ranking = 4keywords = vascular disease (Clic here for more details about this article) |
9/25. popliteal artery entrapment syndrome.popliteal artery entrapment syndrome is a rare but potentially limb threatening peripheral vascular disease occurring predominantly in young adults. We report a case of a 17-year-old boy who presented with intermittent claudication on the right side. Digital subtraction angiography revealed bilateral, focal narrowing of the popliteal arteries. magnetic resonance imaging displayed compression of the arteries by the medial head of the gastrocnemius muscles. The mechanism, presentation, imaging findings, and management of this rare disease are discussed.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
10/25. Persistent sciatic artery in a patient with extracranial internal carotid artery aneurysm and infrarenal abdominal aortic aneurysm. A case report.A rare case of a persistent sciatic artery (PSA) in a patient with aneurysms of the internal carotid artery and abdominal aorta is presented. A 70-year-old man was referred with intermittent claudication of the right lower extremity. angiography and computed tomography demonstrated that this symptom was due to occlusion of the PSA. On preoperative examinations, aneurysms of the extracranial internal carotid artery and abdominal aorta were incidentally discovered, and then surgically treated prior to the management of PSA. Systemic examinations must be performed in patients with PSA in order to scrutinize associated anomalies or vascular disease.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
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