Adventitial Cystic Disease
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Adventitial Cystic Disease
Adventitial cystic disease (also known as cystic adventitial disease) is a rare type of non-atherosclerotic peripheral artery disease. It can present as claudication, critical limb ischemia or acute limb ischemia. The most commonly affected vessel is the popliteal artery. The cause is unknown. __TOC__ Diagnosis The definitive diagnosis comes from pathological evaluation of the affected vessel, however adventitial cystic disease can be suspected based on imaging of the affected vessel using CT scan, MRI or angiography. If suspected at the time of angiography, intravascular ultrasound Intravascular ultrasound (IVUS) or intravascular echocardiography is a medical imaging methodology using a specially designed catheter with a miniaturized ultrasound probe attached to the distal end of the catheter. The proximal end of the cath ... is of use in making the diagnosis. Treatment Definitive treatment is resection with or without reconstruction of the affected vessel. Symptoms can ...
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Atherosclerosis
Atherosclerosis is a pattern of the disease arteriosclerosis in which the wall of the artery develops abnormalities, called lesions. These lesions may lead to narrowing due to the buildup of atheroma, atheromatous plaque. At onset there are usually no symptoms, but if they develop, symptoms generally begin around middle age. When severe, it can result in coronary artery disease, stroke, peripheral artery disease, or kidney problems, depending on which Artery, arteries are affected. The exact cause is not known and is proposed to be multifactorial. Risk factors include dyslipidemia, abnormal cholesterol levels, elevated levels of inflammatory markers, high blood pressure, diabetes, smoking, obesity, family history, genetic, and an unhealthy diet. Atheroma, Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. The narrowing of Artery, arteries limits the flow of oxygen-rich blood to parts of the body. Diagnosis is based upon a physical exam, ele ...
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Peripheral Artery Disease
Peripheral artery disease (PAD) is an abnormal narrowing of arteries other than those that supply the heart or brain. When narrowing occurs in the heart, it is called coronary artery disease, and in the brain, it is called cerebrovascular disease. Peripheral artery disease most commonly affects the legs, but other arteries may also be involved – such as those of the arms, neck, or kidneys. The classic symptom is leg pain when walking which resolves with rest, known as intermittent claudication. Other symptoms include skin ulcers, bluish skin, cold skin, or abnormal nail and hair growth in the affected leg. Complications may include an infection or tissue death which may require amputation; coronary artery disease, or stroke. Up to 50% of people with PAD do not have symptoms. The greatest risk factor for PAD is cigarette smoking. Other risk factors include diabetes, high blood pressure, kidney problems, and high blood cholesterol. The most common underlying mechanism of peri ...
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Claudication
Claudication is a medical term usually referring to impairment in walking, or pain, discomfort, numbness, or tiredness in the legs that occurs during walking or standing and is relieved by rest. The perceived level of pain from claudication can be mild to extremely severe. Claudication is most common in the calves but it can also affect the feet, thighs, hips, buttocks, or arms. The word ''claudication'' comes from the Latin ''claudicare'' meaning 'to limp'. Claudication that appears after a short amount of walking may sometimes be described by US medical professionals by the number of typical city street blocks that the patient can walk before the onset of claudication. Thus, "one-block claudication" appears after walking one block, "two-block claudication" appears after walking two blocks, etc. The term ''block'' would be understood more exactly locally but is on the order of 100 metres. Types Intermittent vascular Intermittent vascular (or arterial) claudication (Latin: ' ...
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Critical Limb Ischemia
Chronic limb threatening ischemia (CLTI), also known as critical limb ischemia (CLI), is an advanced stage of peripheral artery disease (PAD). It is defined as ischemic rest pain, arterial insufficiency ulcers, and gangrene. The latter two conditions are jointly referred to as tissue loss, reflecting the development of surface damage to the limb tissue due to the most severe stage of ischemia. Compared to the other manifestation of PAD, intermittent claudication, CLI has a negative prognosis within a year after the initial diagnosis, with 1-year amputation rates of approximately 12% and mortality of 50% at 5 years and 70% at 10 years. CLI was conceived to identify patients at high-risk for major amputation, but the increasing prevalence of diabetes mellitus has led to a broader conception of limb threat that includes the risk of amputation associated with severely infected and non-healing wounds. Signs and symptoms Critical limb ischemia includes rest pain and tissue los ...
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Acute Limb Ischemia
Acute limb ischaemia (ALI) occurs when there is a sudden lack of blood flow to a limb. Acute limb ischaemia is caused by embolism or thrombosis, or rarely by dissection or trauma. Thrombosis is usually caused by peripheral vascular disease (atherosclerotic disease that leads to blood vessel blockage), while an embolism is usually of cardiac origin. In the United States, ALI is estimated to occur in 14 out of every 100,000 people per year. With proper surgical care, acute limb ischaemia is a highly treatable condition; however, delayed treatment (beyond 6 to 12 hours) can result in permanent disability, amputation, and/or death. In contrast to acute limb ischemia, chronic limb threatening ischemia results from peripheral artery disease that develops over time. While limbs in both acute and chronic limb ischemia may be pulseless, a chronically ischemic limb is typically warm and pink due to a well-developed collateral artery network and does not need emergency intervention to avoi ...
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Popliteal Artery
The popliteal artery is a deeply placed continuation of the femoral artery opening in the distal portion of the adductor magnus muscle. It courses through the popliteal fossa and ends at the lower border of the popliteus muscle, where it branches into the anterior tibial artery, anterior and Posterior tibial artery, posterior tibial arteries. The deepest (most anterior) structure in the fossa, the popliteal artery runs close to the joint capsule of the knee as it spans the Intercondylar fossa of femur, intercondylar fossa. Five genicular branches of the popliteal artery supply the capsule and ligaments of the knee joint. The genicular arteries are the superior lateral, superior medial, middle, inferior lateral, and inferior medial genicular arteries. They participate in the formation of the periarticular genicular anastomosis, a network of vessels surrounding the knee that provides collateral circulation capable of maintaining blood supply to the leg during full knee flexion, which ...
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CT Scan
A computed tomography scan (CT scan; formerly called computed axial tomography scan or CAT scan) is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers or radiology technologists. CT scanners use a rotating X-ray tube and a row of detectors placed in a gantry (medical), gantry to measure X-ray Attenuation#Radiography, attenuations by different tissues inside the body. The multiple X-ray measurements taken from different angles are then processed on a computer using tomographic reconstruction algorithms to produce Tomography, tomographic (cross-sectional) images (virtual "slices") of a body. CT scans can be used in patients with metallic implants or pacemakers, for whom magnetic resonance imaging (MRI) is Contraindication, contraindicated. Since its development in the 1970s, CT scanning has proven to be a versatile imaging technique. While CT is most prominently used in medical diagnosis, ...
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Angiography
Angiography or arteriography is a medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body, with particular interest in the arteries, veins, and the heart chambers. Modern angiography is performed by injecting a radio-opaque contrast agent into the blood vessel and imaging using X-ray based techniques such as fluoroscopy. The word itself comes from the Greek words ἀγγεῖον ''angeion'' 'vessel' and γράφειν ''graphein'' 'to write, record'. The film or image of the blood vessels is called an ''angiograph'', or more commonly an ''angiogram''. Though the word can describe both an arteriogram and a venogram, in everyday usage the terms angiogram and arteriogram are often used synonymously, whereas the term venogram is used more precisely. The term angiography has been applied to radionuclide angiography and newer vascular imaging techniques such as CO2 angiography, CT angiography and MR angiography. The term ''isotope a ...
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Intravascular Ultrasound
Intravascular ultrasound (IVUS) or intravascular echocardiography is a medical imaging methodology using a specially designed catheter with a miniaturized ultrasound probe attached to the distal end of the catheter. The proximal end of the catheter is attached to computerized ultrasound equipment. It allows the application of ultrasound technology, such as piezoelectric transducer or CMUT, to see from inside blood vessels out through the surrounding blood column, visualizing the endothelium (inner wall) of blood vessels. The arteries of the heart (the coronary arteries) are the most frequent imaging target for IVUS. IVUS is used in the coronary arteries to determine the amount of atheromatous plaque built up at any particular point in the epicardial coronary artery. Intravascular ultrasound provides a unique method to study the regression or progression of atherosclerotic lesions in vivo. The progressive accumulation of plaque within the artery wall over decades ...
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