Arterial occlusive disease

Endo H, Inoue T, Ogasawara K, Fukuda T, Kanbara Y, Qgawa A. Quantitative assessment of cerebral hemodynamics using perfusion-weighted MRI in patients with major cerebral artery occlusive disease comparison with positron emission tomography. Stroke 2006 37 388-392. 

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. 

The basic biology of chemokines and their receptors is well covered in Chapters 2 and 3 of this book, and we will focus hereafter upon the roles of individual chemokines and receptors in atherosclerosis. The largest amount of data on the roles of chemokines in cardiovascular disease (C VD) has been obtained from in vitro studies and murine models, which will be discussed in detail. In man, genetic polymorphisms in chemokine and chemokine-receptor genes have pointed to an important role for specific chemokines in various atherosclerotic diseases including coronary artery disease and carotid artery occlusive disease. For properties see Table 1. 

Ghilardi G, Biondi ML, Turri O, Guagnellini E, Scorza R. Internal carotid artery occlusive disease and polymorphisms of fractalkine receptor CX3CR1 a genetic risk factor. Stroke 2004 35(6) 1276-1279. 

Dudman, N. P., Guo,X. W., Gordon, R. B., Dawson, P. A. and Wilcken, D. E. Human homocysteine catabolism three major pathways and their relevance to development of arterial occlusive disease. / Nutr. 126(4 Suppl) 295s-300s, 1996. 

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

First- and second-trimester abortion Cervical reopening Induction of labor Augmentation of labor Postpartum hemorrhage Ectopic pregnancy Lactation suppression In gastrointestinal disease Peptic ulceration Liver transplantation Chemotherapy-induced mucosal lesions In cardiovascular disease Congenital cardiac malformations Raynaud s syndrome Chronic obstructive pulmonary disease Adult respiratory distress syndrome Pulmonary hypertension Arterial occlusive disease Extracorporeal circulation In urology Erectile dysfunction... 

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,... 

Gruss JD, Vargas-Montano H, Bartels D, et al. Use of prostaglandins in arterial occlusion diseases. Int Angiol 1984 3 7. 

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. 

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. 

Percutaneous coronary intervention (PCI) such as coronary angioplasty and stent implantation has become a worldwide routine strategy for coronary arterial occlusive diseases. Along with the recognition that thrombus formation is very likely to be involved in acute coronary syndrome (ACS), selection of the optimal anticoagulant is becoming essential to achieve reliable anticoagulation for successful PCI. 

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. 

Martin M, Schoop W, Weitler E, Streptokinase in chronic arterial occlusive disease, JAMA I 970 211 11 69-1 173,... 

Wholey MH, Jarmolowski CR, Eles G, Levy D, Buecthel J. Endovascular stents for carotid artery occlusive disease. J Endovasc Surg 1997 4 326-338. 

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. 

Levi CR, Mitchell A, Pitt GC et al. (1996). The accuracy of magnetic resonance angiography in the assessment of extracranial carotid artery occlusive disease. Cerebrovascular Diseases 6 231-236... 

Yamauchi H, Fukuyama H, Nagahama Y et al. (1996). Evidence of misery perfusion and risk of recurrent stroke in major cerebral arterial occlusive diseases from PET. Journal of Neurology, Neurosurgery and Psychiatry 61 18-25... 

Baier, R. E., DePalma, V. A., Management of Arterial Occlusive Disease, ... 

The APT 1994 overview showed that any excess risk of intracranial bleeding with antiplatelet therapy was small, at most one or two per 1000 patients per year in trials of long-term (more t one month) treatment (8). Among patients at high ri of arterial occlusive disease, therefore, the large absolute reductions in serious vascular events produced by antiplatelet therapy (Figure 24.2) fer outweigh any absolute hazards. 

M. R. Malinow, Homocyst(e)ine and Arterial Occlusive Diseases, Journal of Internal Medicine 236 (1994) 603-617. 

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. 

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