21/63. 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 = 1keywords = vascular disease (Clic here for more details about this article) |
22/63. Complete gangrene of penis in patient with arterial vascular disease.We present a clinical case of distal penile gangrene in a patient with peripheral vaso-occlusive disease that did not correlate with the extension of the intraoperative finding and required total penectomy. Surgical intervention at the onset of wet gangrene avoids the complication of sepsis.- - - - - - - - - - ranking = 0.66666666666667keywords = vascular disease (Clic here for more details about this article) |
23/63. Early experience in the application of distal protection devices in treatment of peripheral vascular disease of the lower extremities.The objectives of this study were to reduce the risk of showering distal vessels with thromboemboli created during percutaneous interventions of the arteries in the lower extremities. Distal protection devices have been used in coronary and carotid interventions. Hence, using similar techniques, these filters and occlusion balloons were advanced past the targeted lesions and distally into femoral and popliteal arteries. Once opened, these devices allowed standard angioplasty and stent placement and captured the dislodged thromboemboli. Five cases were performed with the distal protection devices. One case used the distal occlusion balloon and four with the filter system. All five passed the lesion and were deployed. All five devices were retrieved without incident and were retrieved with substantial debris. There were no adverse events. The use of distal protection to treat high-risk or unstable lesions in the lower extremities shows great promise. Further case will be needed to evaluate the device for feasibility and safety.- - - - - - - - - - ranking = 0.66666666666667keywords = vascular disease (Clic here for more details about this article) |
24/63. Peripheral vascular disease: carotid and vertebral brachytherapy for in-stent restenosis.For years, intra-arterial brachytherapy has been a recognized method for treating recurrent stenosis after percutaneous transluminal angioplasty and stent placement. However, its use in arteries supplying the brain has not been described to date. We report a case treated with intra-arterial brachytherapy for high-grade recurrent stenoses of the high cervical internal carotid artery and the proximal vertebral artery. At 2-year follow-up, the outcome was successful.- - - - - - - - - - ranking = 0.66666666666667keywords = vascular disease (Clic here for more details about this article) |
25/63. Occult stenosis of the common carotid artery complicating mandibular reconstruction with a fibular free flap.An unsuspected severely stenosed common carotid artery that compromised a free flap for mandibular reconstruction is described. To our knowledge no one has advocated the assessment of the carotid tree before transfer of free tissue. We suggest that patients with several risk factors for peripheral vascular disease should have colour flow duplex imaging of the carotid system if transfer of free tissue is being considered.- - - - - - - - - - ranking = 0.16666666666667keywords = vascular disease (Clic here for more details about this article) |
26/63. Reactive angioendotheliomatosis in association with a well-differentiated angiosarcoma.A 55-year-old white female with a complex medical history including mixed connective tissue disease and peripheral vascular disease developed a group of red-purple papules on her proximal medial thigh that was followed, five months later, by the development of a large violaceous patch. She reported a history of radiation to this site (for melanoma) during her childhood. She was admitted to the hospital with a presumptive diagnosis of cellulitis, but failed to respond to antibiotics. A biopsy was performed and demonstrated a well-differentiated angiosarcoma arising in conjunction with reactive angioendotheliomatosis. Excision of the lesion was performed, and fifteen months of follow-up have shown no recurrence or metastasis.- - - - - - - - - - ranking = 0.16666666666667keywords = vascular disease (Clic here for more details about this article) |
27/63. 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 = 0.16666666666667keywords = vascular disease (Clic here for more details about this article) |
28/63. Cystic adventitial disease: a case report and literature review.Cystic adventitial disease (CAD) is a rare non-atherosclerotic cause of peripheral vascular disease (PVD). We describe a 54-year-old man who presented with calf claudication and catheter angiography showed the typical scallop appearances of CAD. Surgery involved resection of the diseased segment with a femoral popliteal venous bypass graft. A literature review revealed the different theories for pathogenesis, the investigation of choice being catheter angiography and the treatment excision with bypass grafting.- - - - - - - - - - ranking = 0.16666666666667keywords = vascular disease (Clic here for more details about this article) |
29/63. Abciximab-associated thrombocytopenia after previous tirofiban-related thrombocytopenia.A 62-year-old man with a history of coronary artery disease and coronary artery bypass graft, chronic heart failure, and peripheral vascular disease required percutaneous coronary intervention (PCI) after progression of shortness of breath and fatigue over 2 years. Four hours after the procedure, the patient developed hematemesis and was found to be thrombocytopenic. The thrombocytopenia was presumed to be due to the abciximab infusion the patient received during and shortly after the PCI. Further review of the patient's medical history revealed that a similar episode had occurred 11 years earlier. At that time, he was enrolled in a clinical trial comparing tirofiban and heparin in patients with unstable angina; he developed profound thrombocytopenia within 24 hours of randomization. After the study unblinding, investigators discovered that the patient received tirofiban, which was thought to be the cause of his thrombocytopenia. Both abciximab and tirofiban are glycoprotein IIb-IIIa inhibitors, and thrombocytopenia induced by this class of drugs is a serious and potentially life-threatening adverse reaction. The mechanism is not well understood but has been described as immune mediated with both ligand-mimetic agents (tirofiban and eptifibatide) and abciximab. Our patient's situation was unusual in that he developed thrombocytopenia from a ligand-mimetic agent and subsequently had a similar reaction to abciximab. To our knowledge, this case report is the first documentation of thrombocytopenia associated with both tirofiban and abciximab in a single patient, and suggests that care should be given in administering glycoprotein IIb-IIIa inhibitors of either type to patients with a history of thrombocytopenia due to one of these agents.- - - - - - - - - - ranking = 0.16666666666667keywords = vascular disease (Clic here for more details about this article) |
30/63. Combined peripheral and coronary artery percutaneous intervention in patients with significant coronary and peripheral vascular disease. case reports and review.Combined percutaneous coronary and peripheral intervention in patients with coronary and peripheral vascular disease can be time and cost saving. Despite the potential benefit, such hybrid procedures have been rarely reported. We report two cases of hybrid peripheral and coronary intervention that were performed at our institution with excellent outcomes. This is followed by a review of the literature.- - - - - - - - - - ranking = 0.83333333333333keywords = vascular disease (Clic here for more details about this article) |
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