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The diagnosis of arteriosclerosis obliterans of the lower extremities can be made by the history alone or by the physical examination alone in the most patients. It is very important to evaluate the hemodynamic study in determination of indication for operation and operative procedures. The two major symptoms, each of which diagnostic, are intermittent claudication and ischemic rest pain. Intermittent claudication is pain or fatigue that occurs in a muscle or muscle group on repititive use. The anatomical level of claudication is significant. When aorto-iliac artery is obstructed, pain may occur first in the hip or thighs. Pain occurs in the calf in the occlusion of the femoral artery and foot pain indicates the occlusion of distal popliteal artery. Ischemic rest pain indicates an advanced stage of the disease. Fontaine classification is usually used as the stage of ischemia on the extremity. There are many laboratory evaluations of circulatory insufficiency in the diagnosis of arteriosclerotic obliterans. Measurement of segmental blood pressure is most valuable and useful among various measurements. We can get critical informations of circulatory insufficiency in the leg using segmental blood pressure. In order to differentiate from arteriosclerotic obliterans there are thromboanyitis obliterans aortitis syndrome, popliteal arterial entrapment syndrome, spinal canal stenosis, and diabetic arterial occlusive disease.
Janet is 60-years-old and has a family history of heart disease. She has had high blood pressure for her entire adult life. She is overweight and doesn't do much physical activity. Over the last year, she noticed that her legs hurt when she walked through the grocery store. She just assumed it was because she was out of shape and overweight so she ignored it. But lately, her legs were aching even if she wasn't active so she decided to see her doctor. After her doctor performed a physical exam, the doctor told her that he believed she had arteriosclerosis and wanted to do more tests.
To understand arteriosclerosis, it might help to think about the plumbing in your bathroom sink. Have you ever had a bathroom sink that isn't draining well It fills up with water as you brush your teeth and it takes several minutes to drain. The pipes below your sink have buildup that has made the pipes narrower. The water is draining slowly because of this narrowing. The same concept is happening in the arteries of those with arteriosclerosis.
Symptoms of arteriosclerosis depend on which arteries are affected. If your coronary arteries have arteriosclerosis, you will experience chest pain with physical activity. If the arteries in your legs are affected, you will have pain in your legs with activity. This is called claudication which means that there is not enough oxygen getting to your muscles.
PVD, also known as arteriosclerosis obliterans, is primarily the result of atherosclerosis. The atheroma consists of a core of cholesterol joined to proteins with a fibrous intravascular covering. The atherosclerotic process may gradually progress to complete occlusion of medium-sized and large arteries. The disease typically is segmental, with significant variation from patient to patient.
Objective. To investigate the relationship between angiotensin II (Ang II), vascular endothelial growth factor (VEGF), and arteriosclerosis obliterans (ASO). Methods. 60 ASO patients diagnosed and treated from October 2019 to December 2021 were selected for the observation group while 30 healthy physical examiners were for the control group. The general information (gender, age, history of smoking, diabetes, and hypertension) and arterial blood pressure (systolic and diastolic blood pressure) of the two groups were collected, and parameters like disease site and duration, Fontaine stage, and ankle-brachial index (ABI) of ASO patients have been evaluated. Ang II, VEGF, uric acid (UA), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), and total cholesterol (TC) were also detected for the two groups. The variations in UA, LDL, HDL, TG, and TC among two groups along with levels of Ang II and VEGF in ASO patients in accordance to conditions like the general situation, disease duration, disease site, Fontaine stage, and ABI risk level have been studied to establish a correlation between Ang II and VEGF and ASO. Results. (1) The proportion of males with a history of smoking, diabetes, and hypertension was higher () among ASO patients in comparison to the control group. The diastolic blood pressure, LDL, TC, Ang II, and VEGF levels were found to be higher () whereas HDL was low (). (2) The level of Ang II in male patients with ASO was significantly higher than that in female ASO patients (). In ASO patients, the levels of Ang II and VEGF increased not only with age () but also with progression in Fontaine stages II, III, and IV (). (3) Logistic regression analysis revealed Ang II and VEGF as risk factors for ASO. (4) An AUC (area under the ROC (receiver operator characteristic) curve) for Ang II and VEGF for the diagnosis of ASO was 0.764 (good) and 0.854 (very good), respectively, while their combined AUC in diagnosing ASO was 0.901 (excellent). The AUC of Ang II and VEGF together in diagnosing ASO was greater than that of Ang II and VEGF alone along with higher specificity as well (all ). Conclusion. Ang II and VEGF were correlated with the occurrence and development of ASO. The AUC analysis demonstrates that Ang II and VEGF were highly discriminative of ASO.
Graphical Abstract. Central illustration: lower extremity arteriosclerosis obliterans as a prognostic factor for the occurrence of major cardiovascular and cerebrovascular adverse events.
The migration of CD4+ T cells plays an important role in arteriosclerosis obliterans (ASO). However, the molecular mechanisms involved in CD4+ T cell migration are still unclear. The current study is aimed to determine the expression change of miR-142-3p in CD4+ T cells from patients with ASO and investigate its role in CD4+ T cell migration as well the potential mechanisms involved. We identified by qRT-PCR and in situ hybridization that the expression of miR-142-3p in CD4+ T cells was significantly down-regulated in patients with ASO. Chemokine (C-X-C motif) ligand 12 (CXCL12), a common inflammatory chemokine under the ASO condition, was able to down-regulate the expression of miR-142-3p in cultured CD4+ T cells. Up-regulation of miR-142-3p by lentivirus-mediated gene transfer had a strong inhibitory effect on CD4+ T cell migration both in cultured human cells in vitro and in mouse aortas and spleens in vivo. RAC1 and ROCK2 were identified to be the direct target genes in human CD4+ T cells, which are further confirmed by dual luciferase assay. MiR-142-3p had strong regulatory effects on actin cytoskeleton as shown by the actin staining in CD4+ T cells. The results suggest that the expression of miR-142-3p is down-regulated in CD4+ T cells from patients with ASO. The down-regulation of miR-142-3p could increase the migration of CD4+ T cells to the vascular walls by regulation of actin cytoskeleton via its target genes, RAC1 and ROCK2.
Human arteriosclerosis obliterans (ASO) is histologically typified by atherosclerotic thickening, loss of elasticity, and medial calcification of the arterial walls. However, the expression profiles of miRNAs in CD4+ T cells of patients with ASO are still unknown. Results of the miRNA array in our laboratory have identified that miR-142-3p is down-regulated in patients with ASO compared with that in healthy donors. The current study is thus designed to determine the potential role of miR-142-3p in CD4+ T cell migration and the mechanisms involved.
Peripheral vascular disease; PVD; PAD; Arteriosclerosis obliterans; Blockage of leg arteries; Claudication; Intermittent claudication; Vaso-occlusive disease of the legs; Arterial insufficiency of the legs; Recurrent leg pain and cramping; Calf pain with exercise
This study set out to analyze the difference of heat shock protein 27 (HSP27) and its phosphorylation in patients with lower extremity arteriosclerosis obliterans (LEASO) at different stages. This research also examined their clinical significance in this disease.
Arteriosclerosis obliterans is an occlusive arterial disease most prominently affecting the abdominal aorta and the small- and medium-sized arteries of the lower extremities, which may lead to absent dorsalis pedis, posterior tibial, and/or popliteal artery pulses.:842 59ce067264