SEARCH · PubMed Health

Results for “Collateral Circulation”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,657 records · Page 92Linked to original sources

PubMed1993

Absent neovascularization in a lower extremity free flap: a case report.

A patient with a free-tissue transfer to the lower leg underwent amputation three months post-operatively. The amputated limb and the free flap were evaluated angiographically immediately following amputation. Vascular injection of the extremity, with clamping of the pedicle, demonstrated that the area of the flap was devoid of radiopaque vessels, and communications from the surrounding tissue were absent. This clinical evidence, added to published clinical reports, suggests that the lower extremity, unlike the head and neck, does not develop collateral circulation to a free-tissue transfer. Late postoperative sacrifice of the vascular pedicle to a lower extremity free-tissue transfer should be approached cautiously, with the realization that collateral circulation is not assured.

Adult↗

PubMed1963

Liver disease and ammonia intoxication.

The relation between ammonia intoxication and liver disease is not clear. Ammonia appears to be relatively non-toxic to normal individuals, whereas some patients with liver disease appear to be exquisitely sensitive to dietary protein, ammonia-releasing substances, and ammonium salts. In an attempt to elucidate this relationship the intravenous LD(50) of ammonium chloride was determined in both normal mice and in those with liver disease produced by a variety of means. Parenchymal damage was created by acute and chronic carbon tetrachloride intoxication, a low-protein, lipotrope-deficient diet, and mouse hepatitis virus. Mice in which the portal vein had been partially ligated and those infected with Schistosoma mansoni developed portal-systemic collateral circulation. Groups of these mice were placed on high-protein diets and ammonia drinking water for periods as long as two months. A combination of both parenchymal damage and collateral circulation was induced in mice either by bile duct ligation or by a combination of schistosomiasis and acute carbon tetrachloride intoxication. When the above groups of mice with liver disease were compared with normal control mice in the same weight range, the LD(50) of ammonium chloride showed no striking change.

Ammonia↗

PubMed1989

[Revascularization of the hepatic artery. Apropos of a case].

A case of emergency revascularisation of the hepatic artery for liver necrosis following its forced ligature during corpo-caudal pancreatectomy for cancer of the pancreas in referred. Necrosis protection mechanisms, namely higher portal flow, increase in O2 extraction and collateral circulation are analysed. The therapeutic aids for preventing this serious event are presented. It is considered that peripheral expansion of the hepatic artery thrombosis prevented the installation of a valid collateral circulation, although the hypothesis of a reduction in portal flow should not be ignored.

Anastomosis, Surgical↗

PubMed1978

[Fibrinogen and fibrin structure in patients with cirrhosis of the liver (author's transl)].

The question is still open, whether a pathologic formation of fibrinogen or an insufficient stabilized fibrin are causative factors within the complex disorders in hemostasis in patients with liver cirrhosis. Thus, 45 patients with liver cirrhosis, which was proven by liver biopsy, were investigated by means of sodium-dodecyl-sulfate (SDS) polyacrylamidgel-electrophoresis in order to evaluate, whether the liver produces a pathological fibrinogen or whether the formation of fibrin from fibrinogen is defect. The fibrin stabilizing factor (factor XIII) was measured by immunological methods. In order to have a mean of the stage of the disease, 37 patients were subdivided by the extend or their porto-caval collateral circulation and further 8 patients were investigated having bleeding from esophageal varices. By the results evidence accrued that in advanced stages of liver cirrhosis and a marked porto-caval collateral circulation polymerization of fibrinogen was insufficiently, especially, the formation of alpha-chains was altered, whereas the formation of gamma-dimers, the separation of fibrinopeptides from fibrinogen, and the aggregation of fibrinmonomers were normal. This defect in fibrin structure was positive correlated with the stage of liver cirrhosis, which correlated negative with the plasma activity of factor XIII. In vitro, the defect in fibrin formation, from fibrinogen was abolished by adding factor XIII to the assay. Thus, in liver cirrhosis fibrin formation is altered because of factor XIII deficiency, but a normal fibrinogen is synthesized by the liver. In consequence, the administration of factor XIII preparations is suggested as one clinical action among others to benefit the hemostatic disorders, especially in patients with bleeding from esophageal varices.

Blood Coagulation Disorders↗

PubMed1996

Cerebral hemodynamic changes during carotid artery balloon occlusion monitored by near-infrared spectroscopy.

The cerebral oxygenation state of five patients was continuously and non-invasively monitored using near-infrared spectroscopy (NIRS) during carotid artery balloon occlusion for comparison with somatosensory evoked potential (SEP) monitoring and regional cerebral blood flow (rCBF) measurements. In patients with marked reduction of rCBF and deteriorated SEP, NIRS demonstrated a continuous decrease in oxy-hemoglobin and total hemoglobin and an increase in deoxy-hemoglobin, indicating the occurrence of severe hypoxia in the ipsilateral hemisphere because of inadequate collateral circulation. In contrast, NIRS showed only a transient (<2 min) change in these parameters in the patients who showed no remarkable changes in SEP or rCBF, suggesting that well-developed collateral circulation immediately improved cerebral hemodynamics in the ipsilateral hemisphere. These results suggest that NIRS can provide direct and valuable information on cerebral hemodynamic changes during carotid artery balloon occlusion.

Aged↗

PubMed1991

[Pathological and etiological studies on cerebral infarction in the vertebrobasilar arterial system].

25 cases of cerebral infarcts in vertebrobasilar arterial system are reported. Those were divided into 4 groups: 1. Embolism (10), the causes were NBTE, pulmonary infarct, rheumatic or congenital heart disease, coronary artery disease, respectively, and 2 unknown. 2. Thrombosis (5), the causes were arteriosclerosis, vascular malformations in the basal part of cerebrum. 3. Inflammatory infarcts (3), those were verified from tuberculosis, syphilis and aspergillosis respectively. 4. Lacunar infarcts (7), the causes were considered from hypertension. Pathologically, it was noticed that the location of embolism often situated at the terminal of basilar artery, and that if the embolism was completely obliterated, often a hemorrhagic infarction would follow. But the thrombosis in basilar artery, even the lumen was completely obliterated, any infarct would not follow, if the related collateral circulation was satisfactory. Clinically, the embolism in basilar artery often showed sudden onset, and that the symptoms of brain stem would aggravate quickly, but the thrombosis in basilar artery, if the collateral circulation was satisfactory, and symptom of brain stem might not follow.

Adult↗

PubMed2006

Common bile duct wall thickening due to intramural varices diagnosed by colour Doppler ultrasound.

Cases of common bile duct (CBD) wall thickening due to varicose dilation of intramural veins consequential to portal vein thrombosis (PVT) are rare and present a considerable differential diagnostic problem, as they can mimic cholangiocarcinoma. In such cases, colour Doppler ultrasound (CD US) is a very valuable diagnostic method. There are only a few reports in literature on CD US findings of collateral circulation in a thickened CBD wall following PVT. A patient with obstructive jaundice, a tumour of the pancreatic head, CBD wall thickening, and pre-existing PVT is presented. CD US demonstrated collateral circulation of the thrombosed portal vein in the thickened wall of the common bile duct, thus ruling out a mass in the CBD. Obstructive jaundice seldom occurs with choledocal varices. In this patient, the bile duct obstruction was due to the carcinoma of the pancreatic head.

Common Bile Duct↗

PubMed1991

[Late coronary reperfusion. A possible etiology of post-infarction angina].

Late recanalisation of the infarct Related Artery is possible and may cause post-infarction angina. This was observed in 7 male patients who had complete occlusions of an artery with collateral circulation in the immediate post-infarction period. After a symptom-free period of 17 months, angina recurred and repeat angiography showed recanalisation of the occluded artery with regression of the collateral circulation resulting in myocardial ischemia. Myocardial revascularisation was then required.

Adult↗

PubMedDate not supplied

Gluteal necrosis and paraplegia following postoperative bilateral internal iliac artery occlusion.

Complications associated with occlusion of the internal iliac arteries are seen less commonly than those following occlusion of the external iliac arteries, because the pelvis has a good collateral circulation. This paper describes a case of severe gluteal necrosis, paraplegia and acute renal failure following an aorto-bifemoral bypass, which we believe was caused by bilateral iliac artery and pelvic collateral circulation occlusion.

Acute Kidney Injury↗

PubMed2004

Effects of pretreatment with a xanthine oxidase inhibitor on free radical levels during carotid endarterectomy.

OBJECTIVE: Free radicals contribute to the tissue damage caused by ischaemia-reperfusion. The aim of the present study was to investigate whether preoperative antioxidant therapy (allopurinol) affects free radical levels in cerebral venous blood in connection with surgery for carotid artery stenosis. MATERIALS AND METHODS: Twenty-five patients were randomised into the study. Thirteen were controls and 12 were pretreated with allopurinol the day before surgery. Before, during and after surgery, blood samples were drawn from the ipsilateral jugular vein. Radical levels were measured using the spin trap technique ex vivo using OXANOH as the spin trap. Multivariate statistics were used with Principal Component Analysis and Partial Least Square regression analysis. RESULTS: Radical levels increased with diabetes, high leukocyte count, high creatinine and a high degree of contralateral stenosis. Radical levels decreased with high age, blood pressure, collateral circulation as well as operation for left-side carotid artery stenosis. After pretreatment with allopurinol, several of the relationships noted in the control group were eliminated, i.e. leukocyte count, side of operation, Betapred pretreatment and collateral circulation. CONCLUSIONS: Radical levels can be determined in connection with surgery for carotid artery stenosis using an ex vivo spin trap method. With preoperative antioxidant therapy the relationships between enhanced radical levels and clinical data, as seen in control subjects, disappeared. This might indicate a beneficial effect of preoperative pretreatment with antioxidants.

Aged↗

PubMed2006

[Primary percutaneous coronary intervention in patients with acute myocardial infarction induced by left main artery occlusion or severe stenosis].

OBJECTIVE: The effects of primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) induced by left main (LM) artery occlusion were analyzed retrospectively in this study. METHODS: A total of 1343 consecutive AMI patients who underwent primary PCI between January 1995 and December 2004 were retrospectively studied. RESULTS: LM occlusion or severe stenosis were found in 11 patients [all male, mean age (56.4 +/- 9.2) years (range 43-70 years)], cardiogenic shock was overt in 6 patients. Primary PCI were performed under the assistance of intra-aortic balloon pump (IABP) in these patients [8 stent implantation, 3 balloon dilation and 2 necessitating emergency CABG after balloon dilation]. In-hospital mortality was 45.5% (5/11). Three-month follow-up were made in all survivals (6/11). Analysis showed good collateral circulation flow from right coronary artery to left coronary artery was existed in all survival cases before PCI. CONCLUSION: Prognosis of AMI patients with LM artery obstruction or severe stenosis was poor. Patients with pre-existed collateral circulation before primary PCI and IABP had a better clinical outcomes.

Adult↗

PubMedDate not supplied

Clinical applications of cardiovascular angiogenesis.

Angiogenesis is fundamental to both normal physiologic (wound healing) and pathologic (cancer) processes. Manipulation of divergent angiogenic signals promises effective therapy of atherosclerotic cardiovascular disease. Positive proangiogenic strategies promise collateral circulation to ischemic territories, while negative antiangiogenic strategies starve the fibromuscular proliferation within the atherosclerotic lesion. Indeed, recent phase 1 trials suggest that delivering DNA or recombinant protein to the site of vascular occlusion may stimulate physiologically significant collateral circulation in chronically ischemic myocardium. While symptomatic and functional improvement has been documented, toxicity profiles and effects on long-term patient survival are still unclear. The purposes of this article are as follows: (1) to review the pathophysiologic basis for pro- and antiangiogenic strategies in the treatment of cardiovascular disease, (2) to examine the clinical trials of proangiogenic gene or recombinant protein delivery into ischemic beds, and conversely, (3) to explore antiangiogenic strategies in the prevention and treatment of intimal neovascularization and smooth muscle proliferation within the vessel wall.

Cardiovascular System↗

PubMed1982

Anterior left ventricular wall circulation in patients with coronary artery disease.

The human anterior left ventricular circulation was investigated at rest and during submaximal atrial pacing by measuring the great cardiac venous blood flow by the constant infusion thermodilution method. Forty-seven patients with angina pectoris participated in the study and were grouped stepwise according to degree of arteriosclerosis in the left anterior descending coronary artery (LAD), from normal to occluded vessel. Special attention was paid to patients with earlier infarcts and to collateral circulation. Blood flow to the myocardium was slightly but significantly reduced only among patients with a subtotal stenosis of the LAD without demonstrable collateral circulation, and only during atrial pacing. This conforms with an increased coronary arteriolar resistance in these patients. Myocardial oxygen extraction was, however, increased in all groups of patients with LAD stenosis from 50% to occlusion, except in patients with an earlier anterior wall myocardial infarction. This suggests a disproportion between oxygen demand and blood flow leading to increased extraction in patients without infarcts and a shunting of blood through scarred myocardium with a low oxygen demand in those with a previous necrosis, and is confirmed by a decreased ratio between myocardial flow and cardiac work. Patients with an increased oxygen extraction may benefit from coronary bypass surgery to the LAD area while those without may not.

Angina Pectoris↗

PubMedDate not supplied

[Predictive value of ultrasonography in portal hypertension].

Portal hypertension is a common pathology in childhood and one of its most common causes is cavernomatosis of the portal vein. This obstruction causes hemodynamic changes which lead to splenomegaly and collateral circulation. Esophageal varices are one of the most important sequelae, which endanger the patient's life because of a bleeding tendency. Ecosonography helps to detect the thickening of the lesser omentum vis a vis the aortic diameter, caused by the collateral circulation. We studied 15 children presenting with portal hypertension resulting from portal vein cavernomatosis; we performed an upper GI endoscopy and abdominal ecosonography. The endoscopy revealed grade II esophageal varices in 20% of cases, the remaining 80% had grade III and grade IV. Ecosonography revealed an increased lesser omentum/aorta ratio in children with portal hypertension, compared to controls (p < 0.001). Our results suggest that the lesser omentum/aorta ratio has diagnostic value in pediatric portal hypertension.

Aorta, Abdominal↗

PubMed1989

[Transverse sinus thrombosis accompanied by intracerebellar hemorrhage: a case report].

This case report deals with transverse sinus thrombosis accompanied by intracerebellar hemorrhage. A 33-year-old woman had sudden onset of headache, vomiting, and disturbance of consciousness. Computed Tomography (CT) scan showed left intracerebellar hematoma, while vertebral angiography revealed no visualization of the transverse sinus and cerebellar cortical veins on the left side. Evacuation of the intracerebellar hematoma along with decompression of the posterior fossa was carried out. Findings of the histopathological examination of the operation specimen showed the cortical veins to be filled with fresh thrombus and softened cerebellar parenchyma mixed with many small clots. Until now, cases such as hemorrhagic infarction in the cerebellum, due to transverse sinus thrombosis have not yet been reported. It is considered that there is much more collateral circulation in the infratentorial region rather than in the supratentorial region. This indicates that cerebellum hemorrhagic infarction rarely occurs due to transverse sinus thrombosis. In our case, the inflammation of the cortical veins (thrombophlebitis) was thought to have disturbed the collateral circulation in the cerebellum.

Adult↗

PubMedDate not supplied

Occlusion of unilateral carotid artery in Down syndrome.

The association between moyamoya phenomena and Down syndrome (DS) is reported in the literature. This paper reports a case of DS, which at age 9 presented right hemiparesis, secondary to the occlusion of the left internal carotid artery; cerebral angiography (CAG) showed a collateral circulation that mimicks the moyamoya phenomenon. Clinical recovery was almost complete; a second CAG after 15 months showed a persistent occlusion of the left internal carotid artery and an opacification of the left middle cerebral artery from abnormal vessels; but the collateral circulation is not enhanced. This case proves that in DS cerebrovascular occlusions may present moyamoya-like phenomena. These differ however from the true moyamoya disease in a number of aspects: the arterial occlusion is unilateral, the evolution is favorable and revascularization does not occur through the peculiar abnormal vessels of the moyamoya syndrome.

Angiography↗

PubMed2003

Aplasia of the internal carotid artery.

BACKGROUND: The majority of previous reports on this rare agenesis of the internal carotid artery (ICA) have been limited to reporting upon its association with other congenital anomalies case by case. In order to collectively summarize this congenital anomaly of ICA, we have reviewed nine cases of ICA aplasia and their associated abnormalities. METHODS: Nine cases of ICA aplasia were reviewed. The diagnosis of aplasia or agenesis of the ICA was based on angiographic findings and the presence of an absent or hypoplastic bony carotid canal by temporal bone computed tomography (TBCT). Their presumable embryological aetiologies, initial presenting symptoms, unusual collateral circulations, as demonstrated by angiographies, and various associated anomalies are reviewed. FINDINGS: The initial presentations were; subarachnoid haemorrhage in three patients, headache in one patient and ischemic symptoms and signs in three patients. The remaining two cases were found incidentally during angiography for other diseases. Collateral circulations to the middle cerebral artery ipsilateral to the ICA aplasia were via posterior communicating artery (P-com) or anterior communicating artery (A-com). On TBCT, all cases but one demonstrated agenesis of the bony carotid canal and the remaining case showed a hypoplastic canal. Cerebral aneurysms were found in six patients, four with A-com aneurysm, one with a basilar bifurcation aneurysm, and one with both a right P-com and a left cavernous ICA aneurysm; two incidentally found cases had no aneurysm. Other associated abnormalities were found in four cases; one case of hypoplasia of the common carotid artery (CCA) with an arachnoid cyst at the temporal pole, one case of abnormal origin of the right CCA from the aorta and the right subclavian artery from the descending aorta, one case of congenital temporomandibular joint (TMJ) ankylosis, and one case of nasopharyngeal angiofibroma with atresia of the upper basilar artery. Except for the atresia of the upper basilar artery, all such abnormalities were found on the same side as the ICA aplasia. INTERPRETATION: Agenesis or aplasia of ICA may be entirely harmless. However, associated conditions such as cerebral aneurysm or abnormal collateral channels should alert clinicians to the possibility of deterioration to life-threatening conditions, such as subarachnoid haemorrhage or irreversible ischemia. Other associated anomalies are commonly depicted on the same side as the ICA aplasia and may also give rise to issues of clinical importance.

Adolescent↗

PubMed2006

Effects of repeated praziquantel treatment on schistosomiasis mekongi morbidity as detected by ultrasonography.

Schistosomiasis mekongi is endemic in the Mekong River basin; about 80,000 people are at risk of infection in Cambodia. We conducted ultrasonographic studies of patients with schistosomiasis mekongi in Kratie province, Cambodia, focusing especially on the relationship between the frequency of praziquantel treatment and findings of ultrasonographic imaging. The frequency of praziquantel treatment in the period from 1995 to 2002 was classified into four groups: 1-2, 3-4, 5-6, and 7-8 times. Ultrasonographic images were examined to determine the presence of thickening of the portal vein wall and formation of meandering collateral circulation of the splenic vein. We selected these parameters because they are unaffected by interobserver bias. The results showed that thickening of the portal vein wall may have potential to improve with frequent praziquantel treatment. On the other hand, established hard splenomegaly and meandering collateral circulation of the splenic vein, improved very little with praziquantel treatment.

Adolescent↗