Aim: To observe the influence of mental behavior intervention in treating arteriosclerosis (AS) with lovastatin. Methods: A total of 64 patients, who had been diagnosed to have AS according to disease history, examination and by electrocardiograph, rheoencephalogram and skull CT etc. were selected. Patients with certain mental diseases and serious psychologic obstacles were excluded. The 64 patients were randomly divided into intervention group and control group, receiving lovastatin. In the intervention group, psychotherapy was accompanied with lovastatin; Eysenck personality inventory(EPQ), symptom checklist-90(SCL-90) and characteristic coping program were used as tools of evaluation. The questionnaire investigation and vascular biochemistry marker were measured before and 12 weeks after treatment respectively. Results: Differences from the results of mental scale test and vascular biochemistry marker in the two groups before the treatment had no significant meaning(P > 0.05); however, after the treatment, results of mental scale test and vascular biochemistry marker in the intervention group were significantly better than those in the control group(P < 0.05). In the intervention group, high density lipoprotein cholesterol (RDL-C) level [(1.14 ± 0.32) mmol/L] was increased as compared with that before treatment [(1.03 ± 0.20) mmol/L]; and indicated significant difference as compared with that of the control group after the treatment[ (1.10 ± 0.24) mmol/L] (P < 0.05 to 0.01). Conclusion: The intervention of psychological behavior has positively cooperative effect on the clinical treatment with lovastatin.

In 32 older patients treated as outpatients for arteriosclerotic blood flow disturbances in the Ansbach district hospital over a period of 28 days a systematic watch was kept on the depth of night sleep from 10 p.m. five times with a two hour interval during placebo or chlomethiazole treatment. The patients received four capsules of 500 mg active substance or placebo. The optimal long term action of the clomethiazole therapy appeared only after 10 days on a uniform dose. The act of falling asleep and sleeping sufficiently were favorably influenced. There were no hangover symptoms. By and large normalization of the sleep-waking rhythm could be observed.

Arteriosclerosis is a degenerative and dysmetabolic disease of the arterial walls. It is known to be the principal cause of coronary artery disease (CAD). Arteriosclerosis has an impact on the entire vascularization including the microvascularization. The retina is a nervous tissue that is supported by microvascularization. Therefore, systemic diseases that affect the nervous or the cardiovascular system are susceptible to have manifestations in the retina. Retinal signs associated to the risks to develop CAD (qualitative appreciation; diameter and appearance of arterioles) have been suggested. A quantitative approach would strengthen the interpretation of these evaluations.

The Metabolic Hyperspectral Retinal Camera (MHRC) - the experimental instrument - has the capacity to identify and quantify a variety of biomolecules specific to the retina and the optic nerve.

The purpose of this pilot study is to determine if the MHRC has the capacity to detect a specific hyperspectral signature in the retinal arterioles of subjects suffering from arteriosclerosis.

This article presents a model for the use of multisite, sonographic imaging to assess arteriosclerosis. The arteries of 100 randomly selected patients were scanned in three anatomical areas (carotid, femoral-popliteal, aorta-iliac) in conjunction with measurement of selected risk factors (smoking, cholesterol, triglycerides, high density lipoproteins, antioxidant levels). Arteries were interrogated for intimal wall hyperplasia, plaque, and ulceration. Multisite scanning (24 sites) detected the presence of pathology in all sites surveyed. The model was developed at the Cardiovascular Wellness Center in Westbury, NY.

Blood plasma cholesterol and triglycides concentration lipids composition of lipoproteins as contrasted to the amount of 17-KS and their hormonally active fractions excreted were investigated in 87 patients with myocardial infarction in their history and in 49 practically healthy individuals with no clinical manifestations of ischemic heart disease. In patients with coronary atherosclerosis exhibiting normal blood plasma lipids level, the excretion of 17-KS and of their fractions did not differ from that in healthy individuals. Patients with hyperlipoproteinemia of the IIa, IIb and IV types demonstrated a significantly reduced excretion of 17-KS, etiocholanolone, androsterone and dehydroepiandrosterone. No differences in the excretion of androgens depending upon the type of hyperlipoproteinemia were recorded. A significant negative correlation between the blood plasma cholesterol concentration and the amount of ethocholanolone excreted, the level of hypertriglyceridemin and the passage of dehydroepiandrosterone with urine was noted. In patients with hyperlipoproteinemia and a reduced androgens excretion a deranged lipids composition of lipoproteins was disclosed. A decrease in the amount of androgens leads to disruption of the synthesis and metabolism of lipoproteins and exerts a marked influence on the emergence and further development of hyperlipoproteinemia.

Cost factors are an increasingly important aspect of medical care. In the United States, more than 150,000 patients per year have limb-threatening ischaemia due to infrainguinal atherosclerosis. We studied the economic impact of this disease process and its treatment in 313 consecutive patients seen at our hospital between 1979 and 1981. Minimum follow-up was 3 years. Seventy-nine percent of our patients undergoing revascularisation attempts had limb salvage with full function at 1 year and 60% had full function at 3 years. Of the patients who died, 85% died with their limbs intact. The mean patient cost for all 289 arterial reconstructions was $26,194 +/- $876 S.E. ($23,026 +/- $1117 for 166 femoropopliteal bypasses; $30,380 +/- $1349 for 123 distal bypasses). The mean length of stay (LOS) for the reconstruction group was 50 days. In this patient population, the following adverse risk factors were present: Gangrene or necrosis in the foot (72%), age more than 70 (56%), and previous vascular surgery (21%). A significantly higher cost was associated with each of these factors (gangrene, $32,653 +/- $1534; age greater than 70, $28,089 +/- $1235; previous bypass, $29,666 +/- $1962). During the same time period, initial patient costs for 24 patients undergoing primary below-knee amputation and rehabilitation were $27,225 +/- $2896 S.E. Twenty-nine percent of the patients with below-knee amputations never walked again. The nonambulatory patients had a significant continuing expenditure for institutionalisation ($100/day) or home care ($270/week). These facts document the high cost of limb-threatening arteriosclerosis and its treatment by vascular reconstruction or primary below-knee amputation.(ABSTRACT TRUNCATED AT 250 WORDS)

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We report 72 non-diabetic patients with obliterant atherosclerosis, stadium II, (intermittent claudication). The medium age of these patients was 62 +/- 4.5 years old. They were randomly included into four groups. Three were treated with Ozone: one of them by endovenous way, other intramuscular way, and the last one by rectal way; meanwhile, in the fourth group the patients were submitted to conventional medical treatment (control group). In the three ozone-groups there weren't differences when they were compared between then. But there was a significant improvement in comparison with the control group. The claudication distance in the treadmill increased to the 2.5 km/hour. Ankle/arm pressure rates hadn't significant differences, this corroborates the ozone action on the microcirculation. The least uncomfortable, the more harmless and the more economic way was the rectal way.

BACKGROUND:

Limb ischemia is a major complication in patients who are receiving hemodialysis (HD). In this study, distinctive features and factors affecting the outcome of HD patients with limb ischemia are identified.

METHODS AND RESULTS:

One hundred and eighty consecutive symptomatic limb ischemic patients who were or were not receiving HD and who successfully underwent surgical bypass grafting (bypass, n=75) or endovascular angioplasty (percutaneous transluminal angioplasty (PTA), n=105) were retrospectively compared at our hospital. The endpoint of this study was amputation of the ischemic leg or death. Median follow up was 2.25 years. The amputation-free survival of HD patients was significantly lower than that of non-HD patients (P<0.0001). In the bypass group, the amputation-free survival of HD patients was significantly lower than that of non-HD patients (P=0.0002), even if the graft was patented or not (P=0.77). In contrast, in the PTA group, the amputation-free survival of HD patients was lower than that of non-HD patients (P=0.03), and with a significantly lower patency rate (P=0.0004). Predictors of amputation-free survival differed between HD and non-HD patients; predictors were diabetes mellitus and gender in HD patients, while they were Fontaine classification and hyperlipidemia in non-HD patients. The infectious death rate was higher in HD patients than in non-HD patients (53% vs 22%, P<0.05).

CONCLUSIONS:

This study clearly showed a poorer prognosis in HD patients than in non-HD patients especially after bypass surgery, even if the the graft was patented or not.

Objective: To evaluate the effect of mechanical debulking in treating arteriosclerosis occlusive disease of lower extremity. Methods: The clinical data of 52 arteriosclerosis occlusive disease of lower extremity cases treated with Rotarex mechanical debulking system from June 2017 to June 2020 at Department of Intervention Vascular Surgery,Peking University Third Hospital were retrospectively analyzed. There were 37 males and 15 females,aged(69.4±10.1)years(range:47 to 89 years).Lesion length was (21.6±12.9)cm(range:4 to 45 cm),occlusion length was (18.5±11.8)cm(range:4 to 45 cm).The lesion was located in iliac artery(IA) in 6 cases,femoral-popliteal artery(FPA) in 42 cases,and both IA and FPA in 4 cases. All the cases were treated with Rotarex mechanical debulking system. Residual stenosis more than 50% were treated with percutaneous transluminal angioplasty(PTA).Drug coated balloon was used in part of them,and stent was used only when it was necessary. The patient's operation, complications, postoperative target vessel restenosis and reoperation were collected. The paired sample t test and rank sum test was used for data comparison and the postoperative target vessel patency rate was analyzed by Kaplan-Meier survival curve. Results: All the 52 cases obtained technical success. Percutaneous transluminal angioplasty was used in all cases,and drug coated balloon were used in 11 cases. Twenty-six stents were implanted in 24 cases (2 cases implanted 2 stents).Nine stents were implanted in IA and 15 in FPA. The length of stents was (11.3±3.3)cm(range:6 to 23 cm).There were 3 procedure related complications: one of them was acute occlusion in an iliac lesion,and thrombectomy was applied urgently,and the result was good. And the other two were distal embolism. The thrombus were took out with guiding catheter. The hospital stay was (4.8±1.9)days. The ankle brachial index increased from 0.34±0.16 to 0.81±0.16 after treatment(t=-25.160,P<0.01).The Rutherford stages decreased from (M(IQR)) 3(1) to 1(1(Z=-6.825,P<0.01).The median followed up time was 19 months(range:6 to 42 months).Two cases stopped antiplatelet agents during follow-up and which result in acute thrombosis 2 weeks and 2 months later respectively. One of them was treated with percutaneous mechanical thrombectomy and the other one was not for gastrointestinal hemorrhage. Four cases died during follow-up,one case died of lung cancer,one died of abdominal infection,and the other 2 cases died of cardiovascular disease,and no amputation was observed. Target lesion restenosis(TLR) more than 50% occurred in 13 cases during the follow-up. All TLR were observed in FPA,and target lesion revascularization was taken in 3 of them. According to Kaplan-Meier survival curve analysis,half-year,1-year and 2-year cumulative patency rates of target vessels in this group was 94.2%,87.4% and 51.4%, respectively. And half-year and 1-year cumulative patency rates just in FPA cases was 92.9% and 84.3%, respectively. Conclusions: Percutaneous mechanical debulking using Rotarex catheter combining PTA can reduce the use of stents in femoral-popliteal artery. It is safe and effective in treating with arteriosclerosis obliterans of lower extremity.