Therapy of atherosclerotic arteriopathy of lower limbs. Aspects and results. 1985

M Tesi, and G F Bronchi, and A Carini, and M Karavassili

As far as therapy is concerned, atherosclerotic arteriopathy may be divided into acute and chronic forms. In acute embolic forms, therapy should be surgical. Only in cases of peripheral embolism or polyembolism, and in rare cases for which vascular surgery cannot be adopted, can thrombolysis be carried out with UK. In acute thrombotic forms, therapy should be medical, because a thrombus of recent formation is rich in fibrin and may be lyzed by UK. Total recanalization takes place in 61% of cases treated, partial recanalization in 23%. Subsequently perviousness is maintained by adequate antithrombotic therapy. In chronic arteriopathy, the thrombus is lacking or almost lacking in fibrin and thrombolytic therapy is not indicated. Special therapeutic combinations are used containing platelet inhibitors (ticlopidine), antifibrin drugs (subcutaneous heparin), minor fibrinolytic agents (mesoglycan) and hemorheological drugs (pentoxyphylline). This therapy seems to give good results, as showed by the low percentage in amputation calculated on 2,565 patients treated and kept under observation for 5 years. Finally let us consider chronic progressive arteriopathy. This term indicates a very advanced stage, characterized by a gradual irreversible change for the worse leading towards gangrene. As a last resort, before amputating, a thrombolytic therapy with UK was tried to see if with strong fibrinolysis continued for 3 days amputation might be avoided. In a pilot study carried out on 12 patients, the angiographic data showed only partial lysis in small arteries or arterial branches. Clinical data showed reduction or disappearance of pain at rest in 80% of cases. In 70% of cases gangrene disappeared if it was initial and superficial, it was delimited if already in progress.

UI MeSH Term Description Entries
D007279 Injections, Subcutaneous Forceful administration under the skin of liquid medication, nutrient, or other fluid through a hollow needle piercing the skin. Subcutaneous Injections,Injection, Subcutaneous,Subcutaneous Injection
D007866 Leg The inferior part of the lower extremity between the KNEE and the ANKLE. Legs
D010431 Pentoxifylline A METHYLXANTHINE derivative that inhibits phosphodiesterase and affects blood rheology. It improves blood flow by increasing erythrocyte and leukocyte flexibility. It also inhibits platelet aggregation. Pentoxifylline modulates immunologic activity by stimulating cytokine production. Agapurin,BL-191,Oxpentifylline,Pentoxil,Torental,Trental,BL 191,BL191
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D002986 Clinical Trials as Topic Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries. Clinical Trial as Topic
D006025 Glycosaminoglycans Heteropolysaccharides which contain an N-acetylated hexosamine in a characteristic repeating disaccharide unit. The repeating structure of each disaccharide involves alternate 1,4- and 1,3-linkages consisting of either N-acetylglucosamine (see ACETYLGLUCOSAMINE) or N-acetylgalactosamine (see ACETYLGALACTOSAMINE). Glycosaminoglycan,Mucopolysaccharides
D006493 Heparin A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. Heparinic Acid,alpha-Heparin,Heparin Sodium,Liquaemin,Sodium Heparin,Unfractionated Heparin,Heparin, Sodium,Heparin, Unfractionated,alpha Heparin
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute
D001161 Arteriosclerosis Thickening and loss of elasticity of the walls of ARTERIES of all sizes. There are many forms classified by the types of lesions and arteries involved, such as ATHEROSCLEROSIS with fatty lesions in the ARTERIAL INTIMA of medium and large muscular arteries. Arterioscleroses

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