Arterial occlusion peripheral

Vascular risk factors previous stroke, hypertension, diabetes, contralateral internal cerebral artery occlusion, peripheral vascular disease... 

Many serious health problems result from abnormally located blood clots heart attacks (clots in coronary arteries), pulmonary embolism (clots in the lungs), and peripheral arterial occlusion and deep vein thrombosis (clots in the limbs). Each year heart attacks alone afflict over a million people in the United States, and almost half of them die as a result. 

Direct Fibrinolytics Alfimeprase is a recombinant tmncated form of fibrolase, a fibrinolytic zinc metalloproteinase isolated from the venom of the Southern copperhead snake. It degrades fibrin directly and achieves thrombolysis independent of plasmin formation. This may result in faster recanalization and a decreased risk of hemorrhagic conversion. The initial data on the safety and efficacy of alfimeprase in peripheral arterial occlusion disease appeared very promising, but recent communication from the sponsor revealed that the phase III trials of the drug in peripheral arterial disease and catheter obstruction (NAPA-2 and SONOMA-2) failed to meet their primary and key secondary endpoints of revascularization. A trial for I AT in acute stroke (CARNEROS-1) is planned to begin soon. 

Lagiou, P. et al., Flavonoid classes and risk of peripheral arterial occlusive disease a case-control study in Greece, Eur. J. Clin. Nutr., 60, 214, 2006. 

Unlabeled Uses Treatment of atherosclerosis, gangrene, pain due to severe peripheral arterial occlusive disease, pulmonary hypertension... 

Unlabeled Uses Acute peripheral occlusive disease, basilar artery occlusion, cerebral infarction, deep vein thrombosis, femoropopliteal artery occlusion, mesenteric or subclavian vein occlusion, pleural effusion (parapneumonic)... 

Untreated, HIT can lead to thrombosis, venous thromboembolism, acute MI, peripheral artery occlusion, and stroke mortality rate approaches 20% to 30%... 

Ginkgo biloba has been studied for its effects on mild to moderate occlusive peripheral arterial disease. Randomized... 

Staben P, Albring M. Treatment of patients with peripheral arterial occlusive disease Fontaine stage III and IV with intravenous iloprost an open study in 900 patients. Prostaglandins Leukot Essent Fatty Acids 1996 54(5) 327-33. 

The effects of PGEi and iloprost on microcirculation have been investigated in a randomized crossover study in 36 patients with peripheral arterial occlusive disease stage III and IV according to Fontaine (6). They received PGEi and iloprost by single 3-hour intravenous infusions on two different days at doses recommended by the... 

In a retrospective analysis of 63 patients treated with arginine vasopressin for catecholamine resistant vasodila-tory shock, 30% developed ischemic skin lesions (23). Pre-existing peripheral arterial occlusive disease and septic shock were independent susceptibility factors. 

Matsuo, H. (1998) Preliminary evaluation of AS-013 (prodrug of prostaglandin E1) administration for chronic peripheral arterial occlusive diseadel. J. Angiol., 7 22-24. 

Creutzig A, Lehmacher W, Elze M. Meta-analysis of randomised controlled prostaglandin El studies in peripheral arterial occlusive disease stages III and IV. Vasa. 2004 33 137-144. 

Ouriel K, Kaul AF, Leonard MC. Clinical and economic outcomes in thrombolytic treatment of peripheral arterial occlusive disease and deep venous thrombosis. J Vase Surg. 2004 40 971-977. 

Flex A, Gaetani E, Pola R, Santoliquido A, Aloi F, Papaleo P, Dal Lago A, Pola E, Serricchio M, Tondi P, Pola P. The-174 G/C polymorphism of the interleukin-6 gene promoter is associated with peripheral artery occlusive disease. Eur J Vase Endovasc Surg 2002 24 264-268. 

I I Kirk G, McLaren M, Muir AH, et al. Decrease in P-selectin levels in patients with hypercholesterolaemia and peripheral arterial occlusive disease after lipid-lowering treatment. Vase Med 1999 4 23-26. 

Regensteiner JG, Meyer TJ, Krupski WC, et al. Hospital vs home-based exercise rehabilitation for patients with peripheral arterial occlusive disease. Angiology 1997 48 291 -300. 

Early experience with this lytic in the treatment of peripheral arterial disease has been promising with equivalent safety and efficacy to alteplase (3 1,32). Burkart et al. published their initial experience in 13 patients with arterial occlusion and five with venous thrombosis. TNK-tPAwas administered at a rate of 0,25 mg/hr with restoration of flow in all patients, The clinical success with respect to limb salvage or symptom relief was achieved in I I of 13 (85%) patients and four out of the five patients with venous thrombosis, There were no intracranial bleeding complications,... 

Duda SH, Tepe G, Luz O, et al. Peripheral artery occlusion treatment with abciximab plus urokinase versus with urokinase alone—a randomized pilot trial (the PROMPT Study). Platelet receptor antibodies in order to manage peripheral artery thrombosis, radiology 2001 221 (3) 689—696. 

Yoon HC, Miller FJ Jr, Using a peptide inhibitor of the glycoprotein llb/llla platelet receptor initial experience in patients with acute peripheral arterial occlusions. AJRAmJ Roentgenol 2002 178(3) 617—622. 

Drescher P McGuckin J, Rilling WS, Crain MR. Catheter-directed thrombolytic therapy in peripheral artery occlusions combining reteplase and abciximab, AJR Am J Roentgenol 2003 180(5) 1385-1391. 

Ouriel K, Castaneda p McNamara T, et al, Reteplase monotherapy and reteplase/abciximab combination therapy in peripheral arterial occlusive disease results from the RELAX trial. J Vase Inter/ Radiol 2004 15(3) 229-238. 

Compared to normotensives, hypertensive persons develop a marked excess of the major cardiovascular diseases. In the age group 45-74, they develop at least twice as much occlusive peripheral artery disease, about three times as much coronary disease, more than four times as much congestive [heart] failure and over seven times the incidence of brain infarction as normotensives. 

T9. Toth, L., and Koenig, W., Hypoalpha-hyperbeta-lipoproteinemia in a patient with coronary artery disease and occlusive peripheral arterial disease. Atherosclerosis 42,121-124... 

Peripheral arterial occlusion. Heparin may prevent extension of a thrombus and hasten its recanalisation it is commonly used in the acute phase following thrombosis or embolism. There is no case for treating ischaemic peripheral vascular disease with an oral anticoagulant (for prevention, see Antiplatelet drugs). 

M. Van den Berg, G. H. Boers, D. G. Franken, H. J. Blom, G. J. Van Kamp, C. Jakobs, J. A. Rauwerda, C. Kluft, and C. D. Stehouwert, Hyperhomocysteinemia and Endothelial Cell Dysfunction in Young Patients with Peripheral Arterial Occlusive Disease, European Journal of Clinical Investigations 25 (1995) 176-181. 

Abciximab is used for prevention of cardiac ischemic events in patients undergoing percutaneous coronary intervention and to prevent myocardial infarction in patients with unstable angina who do not respond to conventional treatment. It has also been used for thrombolysis in patients with peripheral arterial occlusive disease and arterial thrombosis (2). 

Ten patients with peripheral arterial occlusive disease were scheduled to undergo elective percutaneous transluminal angioplasty after a single dose of ciprofloxacin 400 mg (66). Antibiotic concentrations were significantly reduced in ischemic lesions compared with healthy adipose tissue. However, improvement of arterial blood flow in the affected limb was associated with increased cure rates of soft tissue infections. 

Joukhadar C, Klein N, Frossard M, Minar E, Stass H, Lackner E, Herrmann M, Riedmuller E, Muller M. Angioplasty increases target site concentrations of ciprofloxacin in patients with peripheral arterial occlusive disease. Clin Pharmacol Ther 2001 70(6) 532-9. 

Piridoxilate, an equimolar mixture of glyoxylic acid and pyridoxine, is marketed in a few countries (for example France) for peripheral arterial occlusive disease and functional venous disorders. 

Synthetic PGI2 has been used in arterial occlusive disease as an anti-aggregatory drug (23-28). Adverse effects are common (85%). Headache, fever, nausea, anorexia, diarrhea, pain at the infusion site, and arthralgia are the most prominent. A single study has suggested an increased risk of thromboembolism after the use of iloprost in peripheral vascular disease (29). 

The incidence of hemorrhagic complications is particularly high when high doses of streptokinase are used in the treatment of deep venous thrombosis (31). High-dose streptokinase thrombolysis for 2-3 days with an initial dose of 500 000 units followed by a maintenance dose of 3 600 000 U/day led to a 10% rate of major spontaneous bleeding complications, with a fatal outcome in four older subjects out of the total of 98 patients. The fatahty rate of bleeding caused by streptokinase amounts to 7% in patients with peripheral arterial occlusion, but is much lower in younger patients with venous thromboembolism. 

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