As coronary stenosis severity increased, graft flow increased, pulsatility index decreased, and proportion of patients with systolic reverse flow increased. In mild coronary artery stenosis, the chance of flow competition between the native coronary artery and the bypass graft increased.
fibrin results in an inflammatory process that effectively damages the capillaries of a capsule, increasing the permeability of the vascular wall and producing bleeding from dilated microvessels beneath the fibrous capsule. In some cases, erosion of microvessels may cause massive hemoptysis. Despite the calcification of the capsule, it seems that a small degree of elasticity exists, which is the reason hematomas usually expand over a long period of time.These lesions are difficult to differentiate from soft-tissue sarcomas or other malignancies because many of them also reveal hemorrhagic and cystic changes on radiology. [2][3][4] The best diagnostic tools are computed tomography and magnetic resonance imaging, including guided fine-needle biopsy.
A flow-mediated endothelium-dependent vasodilation and endothelium-independent nitroglycerin-induced vasodilation were carried out in 70 patients and 15 age-matched adults without any atherosclerotic risk factors to clarify vascular responsiveness in patients with atherosclerotic peripheral vascular disease. The percent change in flow-mediated vasodilation was significantly lower in patients than in controls (5.4 +/- 0.7% vs 12.8 +/- 2.2%, P < .001). Moreover, the percent change in nitroglycerin-induced vasodilation measured after sublingual administration of nitroglycerin was lower in patients than in controls (5.8 +/- 0.6% vs 10.2 +/- 1.5%, P < .01). On multiple regression analysis, none of the determinant factors showed a significant correlation with flow-mediated vasodilation. In contrast, Fontaine classification was found to be a significant predictor for nitroglycerin-induced vasodilation (r = -0.307, P < .05). There is a significant positive correlation between nitroglycerin-induced vasodilation and ankle-brachial pressure index in the patients. The data showed that vasoditation function were markedly impaired in end-stage patients with peripheral vascular disease.
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