Stenoses

Propranolol. Propranolol (Table 1), a Class II antiarrhythmic agent, is usefiil in the management of hypertrophic subaortic stenosis, especially for the treatment of exertional or other stress-induced angina by improving blood flow. The dmg can increase exercise tolerance in patients suffering from angina. Propranolol has been shown to have cardioprotective action in post-MI patients (37—39,98,99,108). 

Of the proximate derivatives of atropine, the methobromide and the methonitrate are in use for much the same purposes as atropine, but the methonitrate has received special attention for the treatment of pyloric stenosis. opoAtropine has been found by Mancini to retain the same type of action as atropine but to be less potent in peripheral and more active in central nervous action. ... 

A percutaneous catheter procedure that inflates a balloon in areas of narrowing (stenosis) in arteries. 

Srivatsa SS, Tsao P, Holmes DR et al (1997) Selective av(33 integrin blockade limits neointima hyperplasia and lumen stenosis in stented porcine coronary artery injury in Pig. Cardiovasc Res 36 408-428... 

Obstruction of the esophagus, stomach, small intestine, and colon has occurred when bulk-forming laxatives are administered without adequate fluid intake or in patients with intestinal stenosis. 

Stock et al. used P4HB scaffolds and tissue engineered the patch with a porosity of 95% and pore sizes in the range of 180-240 p,m by salt-leaching and solvent evaporation. The sheep autologous cells (endothelial, smooth muscle, and fibroblast cells) were seeded on the scaffold before implantation. Results confirmed that the cell-seeded implants induced progressive tissue regeneration with no thrombus formation, stenosis, or dilatation. 

Deletions in the elastin gene (located at 7qll.23) have been found in approximately 90% of subjects with Williams syndrome, a developmental disorder affecting connective tissue and the central nervous system. The mutations, by affecting synthesis of elastin, probably play a causative role in the supravalvular aortic stenosis often found in this condition. A number of skin diseases (eg, scleroderma) are associated with accumulation of elastin. Fragmentation or, alternatively, a decrease of elastin is found in conditions such as pulmonary emphysema, cutis laxa, and aging of the skin. 

Low level of NO involved in causation of pylorospasm in infantile hypertrophic pyloric stenosis... 

Remonda L, Held O, Schroth G. Carotid artery stenosis, occlusion, and pseudoocclusion first-pass, gadolinium-enhanced, three-dimensional MR angiography— preliminary study. Radiology 1998 209 95-102 [see comment]. 

Heiserman JE, Drayer BP, Keller PJ, Fram EK. Intracranial vascular stenosis and occlusion evaluation with three-dimensional time-of-flight MR angiography. Radiology 1992 185 667-673. 

FIGURE 4.5 A 72-year-old man with medical history remarkable for hypertension and dyslipidemia presented with posterior circulation infarct (a). CTA and posterior circulation angiography (left vertebral artery injection) performed demonstrated severe mid-basilar artery stenosis (b and c). Left vertebral artery injection demonstrated near-complete reversal of the stenosis after a drug-eluting balloon expandable stent (Cypher, Cordis Johnson Johnson) was deployed (d). 

Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N Engl J Med 1991 325 445 53. 

Mrc European carotid surgery trial interim results for symptomatic patients with severe (70-99%) or with mild (0-29%) carotid stenosis. European Carotid Surgery TriaUsts Collaborative Group. Lancet 1991 337 1235-1243. 

Aleksic M, Rueger MA, Lehnhardt EG, Sobesky J, Matoussevitch V, Neveling M, Heiss WD, Bmnkwall J, Jacobs AH. Primary stroke unit treatment followed by very early carotid endarterectomy for carotid artery stenosis after acute stroke. Cerebrovasc Dis 2006 22 276-281. 

McPherson CM, Woo D, Cohen PL, Panciob AM, Kissela BM, CarrozzeUa JA, Tomsick TA, ZuccareUo M. Early carotid endarterectomy for critical carotid artery stenosis after thrombolysis therapy in acute ischemic stroke in the middle cerebral artery. Stroke 2001 32 2075-2080. 

Gasecki AP, Eerguson GG, EUasziw M, Clagett GP, Pox AJ, Hachinski V, Barnett HJ. Early endarterectomy for severe carotid artery stenosis after a nondisabling stroke Results from the North American symptomatic carotid endarterectomy trial. J Vase Surg 1994 20 288-295. 

Blaser T, Hofmann K, Buerger T, Effenberger O, Wallesch CW, Goertler M. Risk of stroke, transient ischemic attack, and vessel occlusion before endarterectomy in patients with symptomatic severe carotid stenosis. Stroke 2002 33 1057-1062. 

Clinical trials and meta-analyses have demonstrated that early carotid endarterectomy (CEA) is the preferred treatment for most patients with severe symptomatic internal carotid artery (ICA) stenosis and selected patients with moderate disease.However, CEA is often delayed in chnical practice, or may not be appropriate in some patients due to an unfavorable risk-benefit profile. In these settings, it is reasonable to consider acute antithrombotic treatment to prevent early recurrent stroke. 

The relationship between LAA and early recurrence is likely to be largely mediated by arterial embolism from atherosclerotic plaque, although recurrent low-flow stroke may also occur due to severe vessel stenosis or occlusion. In recently symptomatic individuals with moderate-or-severe ICA stenosis, platelet-fibrin embolic signals (ES) are commonly detected in the MCA using transcranial Doppler (TCD) ultrasound and have been reported to independently predict a fivefold increase in 90-day recurrence. " ... 

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