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Arteropathies, Microcirculation and Vasculitis
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
The term ‘intimal hyperplasia’ is used to describe the intimal thickening associated with arteriosclerosis, in which smooth muscle cells, collagen and elastic re-duplication are present in the intima (Fig. 11.2). This is a feature of ageing and should not be confused with atherosclerosis. There are a variety of confusing terms used to describe this intimal thickening, such as neointima, fibromuscular hyperplasia, adaptive intimal thickening, hypertrophy and fibroplasia. It is a ubiquitous response of the vessel wall to any injury and is responsible for angioplasty related stenosis and experimental endothelial damage, and also occurs in hypertension. ‘Arteriosclerosis obliterans’ is a term applied to the occlusive arterial disease in the small- and medium-sized arteries of the lower extremities.
The cardiovascular system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Mary N Sheppard, C. Simon Herrington
The term ‘intimal hyperplasia’ is used to describe the intimal thickening associated with arteriosclerosis, in which smooth muscle cells, collagen, and elastic deposition are present in the intima (see Figure 7.3). This is also a feature of ageing and should not be confused with atherosclerosis. There are a variety of confusing terms used synonymously to describe this intimal thickening, such as neointima, fibromuscular hyperplasia, adaptive intimal thickening, hypertrophy, and fibroplasia. It is a ubiquitous response of the vessel wall to any injury and is responsible for angioplasty-related stenosis and experimental endothelial damage with instruments; it also occurs in hypertension. ‘Arteriosclerosis obliterans’ is a term applied to the occlusive arterial disease in the small- and medium-sized arteries of the lower extremities.
Atherosclerosis and Diabetes
Published in Grant N. Pierce, Robert E. Beamish, Naranjan S. Dhalla, Heart Dysfunction in Diabetes, 2019
Grant N. Pierce, Robert E. Beamish, Naranjan S. Dhalla
Hypertension in the diabetic patient accelerates atherosclerosis. Indeed, hypertension was found to be a major risk factor in arteriosclerosis obliterans in patients with diabetes mellitus.113 This may explain in part the excessive mortality figures of those subjects who have diabetes with concomitant hypertension.210 Deaths due to coronary heart disease or renal failure in the diabetic population are closely related to the presence of hypertension.208Hypertension in the diabetic population may be a more dangerous condition than when it is present in the general population. Goodkin211 found that diabetics had a higher mortality rate than nondiabetics at similar blood pressures. Other investigators have reported a higher incidence of myocardial infarction in the diabetic, hypertensive population when compared to the nondiabetic, hypertensive population.212 Experimentally, myocardial structural damage is greater when diabetes is induced in the hypertensive animal than when either disease is present alone.213–215 Similarly, evidence suggestive of greater structural damage has been reported in human hypertensive diabetics in comparison to their solely hypertensive counterparts.216 These effects have been thought to be due to vascular lesions in the cardiac microcirculation.215
Synergistic deterioration of prognosis associated with decreased grip strength and hyporesponse to erythropoiesis-stimulating agents in patients undergoing hemodialysis
Published in Renal Failure, 2022
Shizuka Kobayashi, Kentaro Tanaka, Junichi Hoshino, Shigeko Hara, Akifumi Kushiyama, Yoshihide Tanaka, Shuta Motonishi, Ken Sakai, Takashi Ozawa
All causes of death were defined as all-cause mortality. Cardiovascular disease was defined as ischemic cardiovascular events (angina, myocardial infarction, arteriosclerosis obliterans, cerebral hemorrhage, and cerebral infarction), or nonischemic heart disease events (heart failure). In the survival analysis, if a patient experienced both events, the first event took precedence. The observation period was 2 years. In our study, we observed events with a composite endpoint. However, we performed a separate multivariate analysis for all-cause mortality and cardiovascular disease. Angina pectoris and myocardial infarction were diagnosed using coronary angiography and myocardial scintigraphy, while arteriosclerosis obliterans was screened with ankle-brachial index (ABI) and diagnosed by a specialist using lower extremity ultrasound, contrast-enhanced computed tomography (CT), or magnetic resonance imaging (MRI). Cerebral hemorrhage and infarction were diagnosed based on imaging findings, such as CT and MRI.
Endothelin-1 and C Reactive Protein as Potential Biomarkers for Restenosis in Patients with Arteriosclerosis Obliterans
Published in Journal of Investigative Surgery, 2021
Ibrahim Rencüzoğulları, Tufan Çınar, Yavuz Karabağ
Arteriosclerosis obliterans (ASO), which mainly affects medium- and large-sized arteries of the lower extremities, is characterized by thickening and calcification of arterial walls due to atherosclerotic plaque formation, resulting in decreased blood supply to the effected extremity [1]. It has been shown that ASO is commonly seen in patients aged 55-75 years [2]. Multiple risk factors, including older ager, male gender, heavy smoking, diabetes, hypertension, and chronic renal failure, have been demonstrated to be associated with ASO [3]. The clinical manifestations in patients with ASO may range from intermittent claudication to the acute occlusion of the effected artery. Nowadays, percutaneous vascular interventions, including balloon angioplasty and stent implantation, have become the main treatment option to treat such patients [3]. However, studies have shown that approximately 30-50% of patients develop restenosis within 1 year after the index procedure, which raises concerns about the long-term safety and efficacy of such procedures [2,3]. Since an evidence-based treatment for restenosis has not been yet clarified, predicting restenosis by identifying its potential causes has still the utmost importance.
Ameliorative effects of the traditional Chinese medicine formula Qing-Mai-Yin on arteriosclerosis obliterans in a rabbit model
Published in Pharmaceutical Biology, 2020
Lei Zhang, Jia-Qin Yuan, Fu-Chen Song, Mei-Dong Zhu, Qi Li, Sheng-Hua Liu, Kai Zhao, Cheng Zhao
Arteriosclerosis obliterans (ASO) is one of the specific manifestations of systemic atherosclerosis (AS) in arteries, including arterial intimal thickening and stenosis or occlusion of artery lumen, resulting in deficiency of blood supply of body, and even life-threatening (You et al. 2010; Akagi et al. 2018; Halliday and Bax 2018). Epidemiological surveys have reported that currently approximately 200,000,000 patients are suffering from ASO worldwide (Halliday and Bax 2018; Zhang R et al. 2019). So far, thanks to the development of sciences and technology, the diagnosis of this disease has been improved greatly; however, the effective remedies of ASO are still limited. Currently, the available treatments for this disease mainly include surgery, such as endarterectomy, vascular bypass grafting, endovascular therapy, etc.; however, surgeries are suitable for only one third of the ASO patients, and this disease also has a high recurrence rate after simple surgery (Paumier et al. 2010; You et al. 2010). Besides, there are also some drugs for treating ASO, including vasodilatation drugs, antiplatelet drugs, thrombolytic drugs, anticoagulant drugs, etc.; however, the current drugs for ASO need long-term administration, and long-term use of these synthetic drugs would result in various bothersome side-effects, such as headache, bleeding, and serious diseases of digestive tract, etc. (You et al. 2010; Ding 2018). Consequently, discovery of more effective alternative remedies with low toxicities is beneficial for better management or treatment of this disease.