ABSTRACT
We have recognized marked effectiveness for intermittent claudication with low-density lipoprotein (LDL) apheresis in two cases of arteriosclerosis obliterans (ASO). The Case 1 was a 73-year-old man with intermittent claudication of both lower extremities (Fontaine class II), digital subtraction angiography (DSA) revealed complete obstruction of the left common iliac artery, formation of a collateral to the peripheral portion of the left common iliac artery, and diffuse stenosis of the peripheral portion of the right common iliac artery. Ten sessions of LDL apheresis (LDL-A) improved the walking distance from 100 m before to 600 m after LDL-A treatment. The Case 2 was a 61-year-old man with intermittent claudication of the left lower extremity (walking distance: 200 m) began at 59 years. DSA revealed diffuse stenosis of the peripheral portion of the left popliteal artery. Ten sessions of LDL-A improved the walking distance from 200 m before to 800 m after LDL-A. At one month after the end of LDL-A treatment, DSA revealed formation of collateral to the peripheral portion of the left popliteal artery. Our findings suggest that LDL-A combined with drug treatment is safe and useful for the treatment of ASO, especially walking distance improved with short term treatment.
Subject(s)
Arteriosclerosis Obliterans/therapy , Blood Component Removal , Intermittent Claudication/therapy , Lipoproteins, LDL/blood , Aged , Arteriosclerosis Obliterans/blood , Humans , Intermittent Claudication/blood , Lower Extremity/blood supply , Lower Extremity/diagnostic imaging , Male , Middle Aged , Radiography , Treatment OutcomeABSTRACT
It is unusual for coronary vasospasm to develop following angioplasty of a coronary vascular lesion that is located elsewhere. We experienced a rare case of shock with vasospasm of the right coronary artery in a patient following balloon angioplasty performed for stent restenosis of the left anterior descending artery.
Subject(s)
Angioplasty, Balloon, Coronary/adverse effects , Coronary Restenosis/therapy , Coronary Vasospasm/etiology , Aged , Angina Pectoris/etiology , Angioplasty, Balloon, Coronary/instrumentation , Antihypertensive Agents/therapeutic use , Cardiac Pacing, Artificial , Coronary Angiography , Coronary Restenosis/diagnostic imaging , Coronary Vasospasm/diagnostic imaging , Coronary Vasospasm/therapy , Electrocardiography , Female , Humans , Shock/etiology , Stents , Treatment Outcome , Vasodilator Agents/therapeutic useABSTRACT
A volumetric analysis by 3-dimensional intravascular ultrasound revealed that lipid-lowering therapy with pravastatin significantly reduced coronary plaque volume. The changes in plaque volume were inversely correlated with the changes in plasma levels of high-density lipoprotein cholesterol but not with changes in levels of total cholesterol or low-density lipoprotein cholesterol.
