Diseases of the Aorta and Arterial Tree in the Elderly

  • Donald J. Breslin
  • Nicholas P. Tsapatsaris
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 76)


Diseases of the aorta and arterial tree in the elderly are common and most often are complications of atherosclerosis. These conditions frequently are potent markers of severe coronary artery disease and should prompt careful cardiac evaluation. When a single pathologic disease is present, clinical manifestations are diverse and depend on the particular expression of atherosclerosis—aneurysm formation, stenosis, and occlusion or embolism—and on its specific anatomic location thoracic aorta and its cervical and intracranial branches or abdominal aorta and its visceral and extremity branches.


Renal Artery Abdominal Aortic Aneurysm Aortic Dissection Abdominal Aortic Aneurysm Peripheral Vascular Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Schlatmann TJ and Becker AE. Histologic changes in the normal aging aorta: Implications for dissecting aortic aneurysm. Am J Cardiol 39:13–20, 1977.PubMedGoogle Scholar
  2. 2.
    Silbert S, Lippmann HI, and Gordon E. Mönckeberg’s arteriosclerosis. JAMA 151:1176–1179, 1953.Google Scholar
  3. 3.
    Heptinstall RH, Porter KA, and Barkley H. Giant-cell (temporal) arteritis. J Path Bact 67:507–519, 1954.PubMedGoogle Scholar
  4. 4.
    Parker F; Healey LA, Wilske KR, and Odland GF. Light and electron microscopic studies on human temporal arteries with special reference to alterations related to senescence, atherosclerosis and giant cell arteritis. Am J Path 79:57–80, 1975.PubMedGoogle Scholar
  5. 5.
    Schatz IJ, Fairbairn JF II, and Juergens JL. Abdominal aortic aneurysms: A reappraisal. Circulation 26:200–205, 1962.PubMedGoogle Scholar
  6. 6.
    Gore I and Hirst AE Jr. Arteriosclerotic aneurysms of the abdominal aorta: A review. Prog Cardiovasc Dis 16:113–150, 1973.PubMedGoogle Scholar
  7. 7.
    Sumner DS, Hokanson DE, and Strandness DE Jr. Stress-strain characteristics and collagen-elastin content of abdominal aortic aneurysms. Surg Gynecol Obstet 130:459–466, 1970.PubMedGoogle Scholar
  8. 8.
    Sumner DS. Hemodynamics and pathophysiology of arterial disease. In RB Rutherford (ed), Vascular Surgery, 2d ed. Philadelphia: W. B. Saunders, 1984, pp 19–44.Google Scholar
  9. 9.
    Rutherford RB. Arterial aneurysms: Overview. In RB Rutherford (ed), Vascular Surgery, 2nd ed. Philadelphia: W. B. Saunders, 1984, pp 745–754.Google Scholar
  10. 10.
    Brewster DC, Retana A, Waltman AC, and Darling RC. Angiography in the management of aneurysms of the abdominal aorta: Its value and safety. N Engl J Med 292:822–825, 1975.PubMedGoogle Scholar
  11. 11.
    DeBakey ME, Crawford ES, Cooley DA, et al. Aneurysm of abdominal aorta: Analysis of results of graft replacement therapy one to eleven years after operation. Ann Surg 160:622–639, 1964.PubMedGoogle Scholar
  12. 12.
    Bernstein EF, Fisher JC, and Varco RL. Is excision the optimum treatment for all abdominal aortic aneurysms? Surgery 61:83–93, 1967.PubMedGoogle Scholar
  13. 13.
    Young AE, Sandberg GW, and Couch NP. The reduction of mortality of abdominal aortic aneurysm resection. Am J Surg 134:585–590, 1977.PubMedGoogle Scholar
  14. 14.
    Sommerville RL, Allen EV, and Edwards JE. Bland and infected arteriosclerotic abdominal aortic aneurysms: A clinicopathologic study. Medicine 38:207–221, 1959.PubMedGoogle Scholar
  15. 15.
    Darling RC, Messina CR, Morrison G, and Brewster DC. Autopsy study of unoperated abdominal aortic aneurysms (AAA): The case for early resection (abstract). Circulation 54:11–11, 1976.Google Scholar
  16. 16.
    Rutherford RB. Infrarenal aortic aneurysms. In RB Rutherford (ed), Vascular Surgery, 2nd ed. Philadelphia: W. B. Saunders, 1984, pp 755–771.Google Scholar
  17. 17.
    Szilagyi DE, Elliott JP, and Smith RF. Clinical fate of the patient with asymptomatic abdominal aortic aneurysm and unfit for surgical treatment. Arch Surg 104:600–606, 1972.PubMedGoogle Scholar
  18. 18.
    Bernstein EF, Dilley RB, Goldberger LE, et al. Growth rates of small abdominal aortic aneurysms. Surgery 80:765–773, 1976.PubMedGoogle Scholar
  19. 19.
    Henry LG, Doust B, Korns ME, and Bernhard VM. Abdominal aortic aneurysm and retroperitoneal fibrosis: Ultrasonographic diagnosis and treatment. Arch Surg 113:1456–1460, 1978.PubMedGoogle Scholar
  20. 20.
    Ferguson MJ and Arden MJ. Gastrointestinal hemorrhage secondary to rupture of aorta. Arch Intern Med 117:133–140, 1966.PubMedGoogle Scholar
  21. 21.
    Baker WH, Sharzer LA, and Ehrenhaft JL. Aortocaval fistula as a complication of abdominal aortic aneurysms. Surgery 72:933–938, 1972.PubMedGoogle Scholar
  22. 22.
    Hertzer NR. Fatal myocardial infarction following abdominal aortic aneurysm resection: Three hundred forty-three patients followed 6–11 years postoperatively. Ann Surg 192:667–673, 1980.PubMedGoogle Scholar
  23. 23.
    Young JR, Humphries AW, deWolfe VG, and LeFevre FA, Complications of abdominal aortic surgery. Part II. Intestinal ischemia. Arch Surg 86:65–73, 1963.Google Scholar
  24. 24.
    Hertzer NR, Beven EG, Young JR, et al. Coronary artery disease in peripheral vascular patients: Classification of 1,000 coronary angiograms and results of surgical management. Ann Surg 199:223–233, 1984.PubMedGoogle Scholar
  25. 25.
    Kidd JN, ReulGJ Jr, Cooley DA, et al. Surgical treatment of aneurysms of the ascending aorta. Circulation 54:111–118–122, 1976.Google Scholar
  26. 26.
    Crawford ES. Thoraco-abdominal and abdominal aortic aneurysms involving renal, superior mesenteric, and celiac arteries. Ann Surg 179:763–772, 1974.PubMedGoogle Scholar
  27. 27.
    Crawford ES and Rubio PA. Reappraisal of adjuncts to avoid ischemia in the treatment of aneurysms of descending thoracic aorta. J Thorac Cardiovasc Surg 66:693–704, 1973.PubMedGoogle Scholar
  28. 28.
    Joyce JW, Fairbairn JF III, Kincaid OW, and Juergens JL. Aneurysms of the thoracic aorta: A clinical study with special reference to prognosis. Circulation 29:176–181, 1964.PubMedGoogle Scholar
  29. 29.
    Pressler V and McNamara JJ. Thoracic aortic aneurysm: Natural history and treatment. J Thorac Cardiovasc Surg 79:489–498, 1980.PubMedGoogle Scholar
  30. 30.
    McNamara JJ and Pressler VM. Natural history of arteriosclerotic thoracic aortic aneurysms. Ann Thorac Surg 26:468–473, 1978.PubMedGoogle Scholar
  31. 31.
    DeBakey ME and Noon GP. Aneurysms of the thoracic aorta. Mod Conc Cardiovasc Dis 44:53–58, 1975.Google Scholar
  32. 32.
    Pond GD and Hillman B. Evaluation of aneurysms by computed tomography. Surgery 89:216–223, 1981.PubMedGoogle Scholar
  33. 33.
    Wychulis AR, Spittell JA Jr and Wallace RB. Popliteal aneurysms. Surgery 68:942–952, 1970.PubMedGoogle Scholar
  34. 34.
    Evans WE and Vermilion BD. Popliteal aneurysms. In JJ Bergan and JST Yao (eds). Aneurysms: Diagnosis and Treatment. New York, Grune & Stratton, Inc, 1982, pp 487–492.Google Scholar
  35. 35.
    Gifford RW Jr, Hines EA Jr and Janas JM. An analysis and follow-up study of one hundred popliteal aneurysms. Surgery 33:284–293, 1953.PubMedGoogle Scholar
  36. 36.
    Vermilion BD, Kimmins SA, Pace WG and Evans WE. A review of one hundred forty-seven popliteal aneurysms with long-term follow-up. Surgery 90:1009–1014, 1981.PubMedGoogle Scholar
  37. 37.
    Wheat MW Jr. Acute dissecting aneurysms of the aorta: diagnosis and treatment-1979. Am Heart J 99:373–387, 1980.PubMedGoogle Scholar
  38. 38.
    DeBakey ME, Cooley DA, and Creech O Jr. Surgical considerations of dissecting aneurysm of the aorta. Ann Surg 142:586–612, 1955.Google Scholar
  39. 39.
    Wheat MW Jr, Palmer RF, Bartley TD, and Seelman RC. Treatment of dissecting aneurysms of the aorta without surgery. J Thorac Cardiovasc Surg 50:364–373, 1965.PubMedGoogle Scholar
  40. 40.
    Schlatmann TJM and Becker AE. Pathogenesis of dissecting aneurysm of aorta. Am J Cardiol 39:21–26, 1977.PubMedGoogle Scholar
  41. 41.
    Larson EW and Edwards WD. Risk factors for aortic dissection: a necropsy study of 161 cases. Am J Cardiol 53:849–855, 1984.PubMedGoogle Scholar
  42. 42.
    Hirst AE Jr, Johns VJ Jr and Kime SW. Dissecting aneurysm of the aorta: a review of 505 cases. Medicine 37:217–279, 1958.PubMedGoogle Scholar
  43. 43.
    Earnest FIV, Muhm JR, and Sheedy PF II. Roentgenographic findings in thoracic aortic dissection. Mayo Clin Proc 54:43–50, 1979.PubMedGoogle Scholar
  44. 44.
    Oudkerk M, Overbosch E, and Dee P. CT recognition of acute aortic dissection. AJR 141:671–676, 1983.PubMedGoogle Scholar
  45. 45.
    Thorsen MK, San Dretto MA, Lawson TL et al. Dissecting aortic aneurysms: Accuracy of computed tomographic diagnosis. Radiology 148:773–777, 1983.PubMedGoogle Scholar
  46. 46.
    Roudaut R, Billes MA, Besse P, and Dallocchio M. Sensibility and specificity of two-dimensional echocardiography in the diagnosis of aortic dissection (Abstract). J Am Coll Cardiol 3:492, 1984.Google Scholar
  47. 47.
    Prokop EK, Palmer RF, and Wheat MW Jr. Hydrodynamic forces in dissecting aneurysms. Circ Res 27:121–127, 1970.PubMedGoogle Scholar
  48. 48.
    Doroghazi RM, Slater EE, DeSanctis RW, et al. Long-term survival of patients with treated aortic dissection. J Am Coll Cardiol 3:1026–1034, 1984.PubMedGoogle Scholar
  49. 49.
    Osmundson PJ and Bernatz PE. Occlusive disease of abdominal visceral arteries. In JL Juergens, JA Spittell, and JF Fairbairn II (eds), Peripheral Vascular Diseases, 5th ed. Philadelphia: W. B. Saunders, 1980, pp 295–325.Google Scholar
  50. 50.
    Derrick JR, Pollard HS, and Moore RM. The pattern of arteriosclerotic narrowing of the celiac and superior mesenteric arteries. Ann Surg 149:684–689, 1959.PubMedGoogle Scholar
  51. 51.
    Reiner L. Mesenteric arterial insufficiency and abdominal angina. Arch Intern Med 114:765–772, 1964.PubMedGoogle Scholar
  52. 52.
    Hollier LH, Bernatz PE, Pairolero PC, et al. Surgical management of chronic intestinal ischemia: A reappraisal. Surgery 90:940–946, 1981.PubMedGoogle Scholar
  53. 53.
    Shaw RS and Maynard EP III. Acute and chronic thrombosis of the mesenteric arteries associated with malabsorption: A report of two cases successfully treated by thromboendarterectomy. N Engl J Med 258:874–878, 1958.PubMedGoogle Scholar
  54. 54.
    Bercher J, Bartholomew LG, Cain JC, and Adson MA. Syndrome of intestinal arterial insufficiency (“abdominal angina”). Arch Intern Med 117:632–638, 1966.Google Scholar
  55. 55.
    Watt JK, Watson WC, and Haase S. Chronic intestinal ischaemia. Br Med J 3:199–202, 1967.PubMedGoogle Scholar
  56. 56.
    Palmer WL. Clinical features of mesenteric artery insufficiency. J Tenn Med Assoc 59:152–160, 1966.PubMedGoogle Scholar
  57. 57.
    Fry WJ and Kraft RO. Visceral angina. Surg Gynecol Obstet 117:417–424, 1963.PubMedGoogle Scholar
  58. 58.
    Bergan JJ and Yao JST. Chronic intestinal ischemia. In RB Rutherford (ed), Vascular Surgery, 2nd ed. Philadelphia: W. B. Saunders, 1984, pp 964–971.Google Scholar
  59. 59.
    Siegelman SS, Sprayregen S, and Boley SJ. Angiographic diagnosis of mesenteric arterial vasoconstriction. Radiology 112:533–542, 1974.PubMedGoogle Scholar
  60. 60.
    Stoney RJ and Wylie EJ. Recognition and surgical management of visceral ischemic syndromes. Ann Surg 164:714–722, 1966.PubMedGoogle Scholar
  61. 61.
    Zelenock GB, Graham LM, Whitehouse WM Jr, et al. Splanchnic arteriosclerotic disease and intestinal angina. Arch Surg 115:497–501, 1980.PubMedGoogle Scholar
  62. 62.
    Baur GM, Millay DJ, Taylor LM Jr, and Porter JM. Treatment of chronic visceral ischemia. Am J Surg 148:138–144, 1984.PubMedGoogle Scholar
  63. 63.
    Pierce GE and Brockenbrough EC. The spectrum of mesenteric infarction. Am J Surg 119:233–239, 1970.PubMedGoogle Scholar
  64. 64.
    Ende N. Infarction of the bowel in cardiac failure. N Engl J Med 258:879–881, 1958.PubMedGoogle Scholar
  65. 65.
    Butt LG and Cheek RC. Nonocclusive mesenteric vascular disease: Clinical and experimental observations. Ann Surg 169:704–711, 1969.Google Scholar
  66. 66.
    Ottinger LW and Austen WG. A study of 136 patients with mesenteric infarction. Surg Gynecol Obstet 124:251–261, 1967.PubMedGoogle Scholar
  67. 67.
    Bergan JJ and Yao JST. Acute intestinal ischemia. In RB Rutherford (ed), Vascular Surgery, 2nd ed. Philadelphia: W. B. Saunders, 1984, pp 948–963.Google Scholar
  68. 68.
    Bynum TE and Jacobson ED. Blood flow and gastrointestinal diseases. Digestion 4:109–116, 1971.PubMedGoogle Scholar
  69. 69.
    Bergan JJ, Dean RH, Conn J Jr, and Yao JST. Revascularization in treatment of mesenteric infarction. Ann Surg 182:430–438, 1975.PubMedGoogle Scholar
  70. 70.
    Laufman H, Nora PF, and Mittelpunkt Al. Mesenteric blood vessels: Advances in surgery and physiology. Arch Surg 88:1021–1044, 1964.PubMedGoogle Scholar
  71. 71.
    Price WE, Rohrer GV, and Jacobson ED. Mesenteric vascular diseases. Editorial. Gastroenterology 57:599–604, 1969.PubMedGoogle Scholar
  72. 72.
    Bergan JJ. Recognition and treatment of superior mesenteric artery embolization. Geriatrics 24:118–125, 1969.PubMedGoogle Scholar
  73. 73.
    Boley SJ, Feinstein FR, Sammartano R, et al. New concepts in the management of emboli of the superior mesenteric artery. Surg Gynecol Obstet 153:561–569, 1981.PubMedGoogle Scholar
  74. 74.
    Grim CE, Luft FC, Yune HY, et al. Percutaneous transluminal dilatation in the treatment of renal vascular hypertension. Ann Intern Med 95:439–442, 1981.PubMedGoogle Scholar
  75. 75.
    Goldblatt H, Lynch J, Hanzal RF, and Summerville WW. Studies on experimental hypertension: Production of persistent elevation of systolic blood pressure by means of renal ischemia. J Exp Med 59:347–379, 1934.PubMedGoogle Scholar
  76. 76.
    Smith HW. Unilateral nephrectomy in hypertensive disease. J Urol 76:685–701, 1956.PubMedGoogle Scholar
  77. 77.
    Holley KE, Hunt JC, Brown AL Jr, et al. Renal artery stenosis: A clinical-pathologic study in normotensive and hypertensive patients. Am J Med 37:14–22, 1964.PubMedGoogle Scholar
  78. 78.
    Dustan HP, Humphries AW, deWolfe VG, and Page IH. Normal arterial pressure in patients with renal arterial stenosis. JAMA 187:1028–1029, 1964.PubMedGoogle Scholar
  79. 79.
    Connor TB, Thomas WC Jr, Haddock L, and Howard JE. Unilateral renal disease as a cause of hypertension: Its detection by ureteral catheterization studies. Ann Intern Med 52:544–559, 1960.PubMedGoogle Scholar
  80. 80.
    Stamey TA, Nudelman IJ, Good PH, et al. Functional characteristics of renovascular hypertension. Medicine 40:347–394, 1961.PubMedGoogle Scholar
  81. 81.
    Marks LS, Maxwell MH, Varady PD, et al. Renovascular hypertension: Does the renal vein renin ratio predict operative results? J Urol 115:365–368, 1976.PubMedGoogle Scholar
  82. 82.
    Mackay A, Boyle P, Brown JJ, et al. The decision on surgery in renal artery stenosis. Q J Med 207:363–381, 1983.Google Scholar
  83. 83.
    Skeggs LT, Dorer FE, Kahn JR, et al. The biochemistry of the renin-angiotensin system and its role in hypertension. Am J Med 60:737–748, 1976.PubMedGoogle Scholar
  84. 84.
    Rosenthal JT, Libertino JA, Zinman LN, et al. Predictability of surgical cure of renovascular hypertension. Ann Surg 193:448–452, 1981.PubMedGoogle Scholar
  85. 85.
    Genest J, Cartier P, Roy P, et al. Renovascular hypertension. In J Genest, O Kuchel, P Hamet, and M Cantin (eds), Hypertension: Physiopathology and Treatment, 2nd ed. New York: McGraw-Hill, 1983, pp 1007–1034.Google Scholar
  86. 86.
    Foster JH, Maxwell MH, Franklin SS, et al. Renovascular occlusive disease: Results of operative treatment. JAMA 231:1043–1048, 1975.PubMedGoogle Scholar
  87. 87.
    Foster JH, Dean RH, Pinkerton JA, and Rhamy RK. Ten years experience with the surgical management of renovascular hypertension. Ann Surg 177:755–766, 1973.PubMedGoogle Scholar
  88. 88.
    Simon N, Franklin SS, Bleifer KH, and Maxwell MH. Clinical characteristics of renovascular hypertension. JAMA 220:1209–1218, 1972.PubMedGoogle Scholar
  89. 89.
    Stanley JC and Fry WJ. Surgical treatment of renovascular hypertension. Arch Surg 112:1291–129. 1977.PubMedGoogle Scholar
  90. 90.
    Perloff D, Sokolow M, Wylie EJ, and Palubinskas AJ. Renal vascular hypertension: Further experiences. Am Heart J 74:614–631, 1967.PubMedGoogle Scholar
  91. 91.
    Moser RJ Jr and Caldwell JR. Abdominal murmurs: An aid in the diagnosis of renal artery disease in hypertension. Ann Intern Med 56:471–483, 1962.PubMedGoogle Scholar
  92. 92.
    Havey RJ, Krumlovsky F, delGreco F, and Martin HG. Screening for renovascular hypertension: Is renal digital-subtraction angiography the preferred noninvasive test? JAMA 254:388–393, 1985.PubMedGoogle Scholar
  93. 93.
    Buonocore E, Meaney TF, Borkowski GP, et al. Digital subtraction angiography of the abdominal aorta and renal arteries: Comparison with conventional aortography. Radiology 139:281–286, 1981.PubMedGoogle Scholar
  94. 94.
    Kaufman JJ. Renovascular hypertension: The UCLA experience. J Urol 121:139–144, 1979.PubMedGoogle Scholar
  95. 95.
    Arlart I, Rosenthal J, Adam WE, et al. Predictive value of radionuclide methods in the diagnosis of unilateral renovascular hypertension. Cardiovasc Radiol 2:115–125, 1979.PubMedGoogle Scholar
  96. 96.
    Dean RH, Burko H, Wilson JP, et al. Deceptive patterns of renal artery stenosis. Surgery 76:872–881, 1974.PubMedGoogle Scholar
  97. 97.
    Sheps SG, Osmundson PJ, Hunt JC, et al. Hypertension and renal artery stenosis: Serial observations on 54 patients treated medically. Clin Pharmacol Ther 6:700–709, 1965.PubMedGoogle Scholar
  98. 98.
    Hricik DE, Browning PJ, Kopelman R, et al. Captopril-induced functional renal insufficiency in patients with bilateral renal-artery stenoses or renal-artery stenosis in a solitary kidney. N Engl J Med 308:373–376, 1983.PubMedGoogle Scholar
  99. 99.
    Meaney TF, Dustan HP, and McCormack L. Natural history of renal arterial disease. Radiology 91:881–887, 1968.PubMedGoogle Scholar
  100. 100.
    Wollenweber J, Sheps SG, and Davis GD. Clinical course of atherosclerotic renovascular disease: Review. Am J Cardiol 21:60–71, 1968.Google Scholar
  101. 101.
    Libertino JA, Zinman L, Breslin DJ, et al. Renal artery revascularization: Restoration of renal function. JAMA 244:1340–1342, 1980.PubMedGoogle Scholar
  102. 102.
    Ying CY, Tifft CP, Gavras H, and Chobanian AV. Renal revascularization in the azotemic hypertensive patient resistant to therapy. N Engl J Med 311:1070–1075, 1984.PubMedGoogle Scholar
  103. 103.
    Stoney RJ. Transaortic renal endarterectomy. In RB Rutherford (ed), Vascular Surgery, 2nd ed. Philadelphia: W. B. Saunders, 1984, pp 1130–1135.Google Scholar
  104. 104.
    Franklin SS, Young JD Jr, Maxwell MH, et al. Operative morbidity and mortality in renovascular disease. JAMA 231:1148–1153, 1975.PubMedGoogle Scholar
  105. 105.
    Stanley JC and Graham LM. Renal artery fibrodysplasia and renovascular hypertension. In RB Rutherford (ed), Vascular Surgery, 2nd ed. Philadelphia: W. B. Saunders. 1984. pp 1145–1162.Google Scholar
  106. 106.
    Libertino JA and Selman FJ Jr. Alternatives to aortorenal revascularization. J Cardiovasc Surg 23:318–322, 1982.Google Scholar
  107. 107.
    Hypertension Detection and Follow-up Program Cooperative Group. Five-year findings of the hypertension detection and follow-up program. III. Reduction in stroke incidence among persons with high blood pressure. JAMA 247:633–638, 1982.Google Scholar
  108. 108.
    Carter AB. Strokes: Natural history and prognosis. Proc Roy Soc Med 56:483–486, 1963.PubMedGoogle Scholar
  109. 109.
    David NJ and Heyman A. Factors influencing the prognosis of cerebral thrombosis and infarction due to atherosclerosis. J Chron Dis 11:394–404, 1960.PubMedGoogle Scholar
  110. 110.
    Dyken ML, Wolf PA, Barnett HJM, et al. Risk factors in stroke: A statement for physicians by the subcommittee on risk factors and stroke of the stroke council. Stroke 15:1105–1161, 1984.Google Scholar
  111. 111.
    Kirkendall WM and Hammond JJ. Hypertension in the elderly. Arch Intern Med 140:1155–1161, 1980.PubMedGoogle Scholar
  112. 112.
    Kannel WB, Dawber TR, Sorlie P, and Wolf PA. Components of blood pressure and risk of atherothrombotic brain infarction: The Framingham study. Stroke 7:327–331, 1976.PubMedGoogle Scholar
  113. 113.
    Kannel WB, Wolf PA, McGee DL, et al. Systolic blood pressure, arterial rigidity, and risk of stroke: The Framingham study. JAMA 245:1225–1229, 1981.PubMedGoogle Scholar
  114. 114.
    Soltero I, Liu K, Cooper R, et al. Trends in mortality from cerebrovascular diseases in the United States, 1960 to 1975. Stroke 9:549–558, 1978.PubMedGoogle Scholar
  115. 115.
    Cressman MD and Gifford RW Jr. Hypertension and stroke. J Am Coll Cardiol 1:521–527, 1983.PubMedGoogle Scholar
  116. 116.
    The Management Committee. The Australian therapeutic trial in mild hypertension. Lancet 1:1261–1267, 1980.Google Scholar
  117. 117.
    Veterans Administration Cooperative Study Group on Antihypertensive Agents. Effect of treatment on morbidity in hypertension: Results in patients with diastolic blood pressures averaging 115 through 125 mm Hg. JAMA 202:1028–1034, 1967.Google Scholar
  118. 118.
    Black DG, Heagerty AM, Bing RF, et al. Effects of treatment for hypertension on cerebral haemorrhage and infarction. Br Med J 289:156–159, 1984.Google Scholar
  119. 119.
    Whisnant JP, Fitzgibbons JP, Kurland LT, and Sayre GP. Natural history of stroke in Rochester, Minnesota, 1945 through 1954. Stroke 2:11–22, 1971.Google Scholar
  120. 120.
    Cerebral Embolism Task Force. Cardiogenic brain embolism. Arch Neurol 43:71–84, 1986.Google Scholar
  121. 121.
    Good DC, Frank S, Verhulst S, and Sharma B. Cardiac abnormalities in stroke patients with negative arteriograms. Stroke 17:6–11, 1986.PubMedGoogle Scholar
  122. 122.
    Adams HP Jr, Kassell NF, and Mazuz H. The patient with transient ischemic attacks: Is this the time for a new therapeutic approach? Stroke 15:371–375, 1984.PubMedGoogle Scholar
  123. 123.
    Fisher CM, Gore I, Okabe N, and White PD. Atherosclerosis of the carotid and vertebral arteries-Extracranial and intracranial. J Neuropath Exp Neurol 24:455–476, 1965.Google Scholar
  124. 124.
    Martin MJ, Whisnant JP, and Sayre GP. Occlusive vascular disease in the extracranial cerebral circulation. Arch Neurol 3:530–538, 1960.PubMedGoogle Scholar
  125. 125.
    Fields WS and Lemak NA. Joint study of extracranial arterial occlusion. X. Internal carotid artery occlusion. JAMA 235:2734–2738, 1976.PubMedGoogle Scholar
  126. 126.
    Javid H, Ostermiller WE Jr, Hengesh JW, et al. Natural history of carotid bifurcation atheroma. Surgery 67:80–86, 1970.PubMedGoogle Scholar
  127. 127.
    Roederer GO, Langlois YE, Jager KA, et al. The natural history of carotid arterial disease in asymptomatic patients with cervical bruits. Stroke 15:605–613, 1984.PubMedGoogle Scholar
  128. 128.
    Chambers BR and Norris JW. The case against surgery for asymptomatic carotid stenosis. Stroke 15:964–967, 1984.PubMedGoogle Scholar
  129. 129.
    Podore PC, DeWeese JA, May AG, and Rob CG. Asymptomatic contralateral carotid artery stenosis: A five-year follow-up study following carotid endarterectomy. Surgery 88:748–752, 1980.PubMedGoogle Scholar
  130. 130.
    Committee on Cerebrovascular Diseases. A classification and outline of cerebrovascular diseases II. Stroke 6:564–616, 1975.Google Scholar
  131. 131.
    Sandok BA, Furlan AJ, Whisnant JP, and Sundt TM Jr. Guidelines for the management of transient ischemic attacks. Mayo Clin Proc 53:665–674, 1978.PubMedGoogle Scholar
  132. 132.
    Millikan CH. Cerebral circulation. JAMA 239:1313–1315, 1978.PubMedGoogle Scholar
  133. 133.
    Millikan CH. The pathogenesis of transient focal cerebral ischemia. Circulation 32:438–450, 1965.PubMedGoogle Scholar
  134. 134.
    Marshall J and Wilkinson IMS. The prognosis of carotid transient ischaemic attacks in patients with normal angiograms. Brain 94:395–402, 1971.PubMedGoogle Scholar
  135. 135.
    Kendell RE and Marshall J. Role of hypotension in the genesis of transient focal cerebral ischaemic attacks. Br Med J 2:344–348, 1963.PubMedGoogle Scholar
  136. 136.
    Reed RL, Siekert RG, and Merideth J. Rarity of transient focal cerebral ischemia in cardiac dysrhythmia. JAMA 223:893–895, 1973.PubMedGoogle Scholar
  137. 137.
    Pessin MS, Duncan GW, Mohr JP, and Poskanzer DC. Clinical and angiographic features of carotid transient ischemic attacks. N Engl J Med 296:358–362, 1977.PubMedGoogle Scholar
  138. 138.
    Whisnant JP. The role of the neurologist in the decline of stroke. Ann Neurol 14:1–7, 1983.PubMedGoogle Scholar
  139. 139.
    Easton JD and Sherman DG. Carotid endarterectomy. Editorial. Mayo Clin Proc 58:205–207, 1983.PubMedGoogle Scholar
  140. 140.
    Whisnant JP, Matsumoto N, and Elveback LR. Transient cerebral ischemic attacks in a community: Rochester, Minnesota, 1955 through 1969. Mayo Clin Proc 48:194–198, 1973.PubMedGoogle Scholar
  141. 141.
    Matsumoto N, Whisnant JP, Kurland LT, and Okazaki H. Natural history of stroke in Rochester, Minnesota, 1955 through 1969: An extension of a previous study, 1945 through 1954. Stroke 4:20–29, 1973.PubMedGoogle Scholar
  142. 142.
    David TE, Humphries AW, Young JR, and Bevin EG. A correlation of neck bruits and arteriosclerotic carotid arteries. Arch Surg 107:729–731, 1973.PubMedGoogle Scholar
  143. 143.
    Wolf PA, Kannel WB, Sorlie P, and McNamara P. Asymptomatic carotid bruit and risk of stroke: The Framingham study. JAMA 245:1442–1445, 1981.Google Scholar
  144. 144.
    Hollenhorst RW. Significance of bright plaques in the retinal arterioles. JAMA 178:23–29, 1961.PubMedGoogle Scholar
  145. 145.
    Russell RWR. The source of retinal emboli. Lancet 2:789–792, 1968.PubMedGoogle Scholar
  146. 146.
    Pfaffenbach DD and Hollenhorst RW. Morbidity and survivorship of patients with embolic cholesterol crystals in the ocular fundus. Am J Ophthalmol 75:66–72, 1973.PubMedGoogle Scholar
  147. 147.
    Savino PJ, Glaser JS, and Cassady J. Retinal stroke: Is the patient at risk? Arch Ophthalmol 95:1185–1189, 1977.PubMedGoogle Scholar
  148. 148.
    Yao JST and Bergan JJ. Application of ultrasound to arterial and venous diagnosis. Surg Clin North Am 54:23–38, 1974.PubMedGoogle Scholar
  149. 149.
    Cebul RD and Ginsberg MD. Noninvasive neurologic tests for carotid artery disease. Ann Intern Med 97:867–872, 1982.PubMedGoogle Scholar
  150. 150.
    Johnson JM, Kennelly MM, Decesare D, et al. Natural history of asymptomatic carotid plaque. Arch Surg 120:1010–1012, 1985.PubMedGoogle Scholar
  151. 151.
    Fish PJ, Kakkar VV, Corrigan T, and Nicolaides AN. Arteriography using ultrasound. Lancet 1:1269–1270, 1972.PubMedGoogle Scholar
  152. 152.
    Keagy BA, Pharr WF, Thomas D, and Bowes DE. Comparison of oculoplethysmography/carotid phonoangiography with duplex scan/spectral analysis in the detection of carotid artery stenosis. Stroke 13:43–45, 1982.PubMedGoogle Scholar
  153. 153.
    Gee W, Oller DW, Amundsen DG, and Goodreau JJ. The asymptomatic carotid bruit and the ocular pneumoplethysmography. Arch Surg 112:1381–1388, 1977.PubMedGoogle Scholar
  154. 154.
    Kartchner MM, McRae LP, Crain V, and Whitaker B. Oculoplethysmography: An adjunct to arteriography in the diagnosis of extracranial carotid occlusive disease. Am J Surg 132:728–732, 1976.PubMedGoogle Scholar
  155. 155.
    Weisberg LA and Nice CN. Intracranial tumors simulating the presentation of cerebrovascular syndromes: Early detection with cerebral computed tomography (CCT). Am J Med 63:517–524, 1977.PubMedGoogle Scholar
  156. 156.
    Barnett HJM. Progress towards stroke prevention: Robert Wartenberg lecture. Neurology 30:1212–1225, 1980.PubMedGoogle Scholar
  157. 157.
    Millikan CH and McDowell FH. Treatment of progressing stroke. Prog Cardiovasc Dis 22:397–414, 1980.PubMedGoogle Scholar
  158. 158.
    McDowell FH, Millikan CH, and Goldstein M. Treatment of impending stroke. Editorial. Stroke 11:1–3, 1980.Google Scholar
  159. 159.
    Barnett HJM, Plum F, and Walton JN. Carotid endarterectomy: An expression of concern. Editorial. Stroke 15:941–943, 1984.Google Scholar
  160. 160.
    Thompson JE, Patman RD, and Talkington CM. Asymptomatic carotid bruit: Long term outcome of patients having endarterectomy compared with unoperated controls. Ann Surg 188:308–316, 1978.PubMedGoogle Scholar
  161. 161.
    Mohr JP. Asymptomatic carotid artery disease. Stroke 13:431–433, 1982.PubMedGoogle Scholar
  162. 162.
    Javid H, Ostermiller WE, Hengesh JW, et al. Carotid endarterectomy for asymptomatic patients. Arch Surg 102:389–391, 1971.PubMedGoogle Scholar
  163. 163.
    The Canadian Cooperative Study Group. A randomized trial of aspirin and sulfinpyrazone in threatened stroke. N Engl J Med 299:53–59, 1978.Google Scholar
  164. 164.
    Bousser MG, Eschwege E, Haguenau M, et al. “AICLA” controlled trial of aspirin and dipyridamole in the secondary prevention of athero-thrombotic cerebral ischemia. Stroke 14:5–14, 1983.PubMedGoogle Scholar
  165. 165.
    Bengtsson BA and Malmvall BE. The epidemiology of giant cell arteritis including temporal arteritis and polymyalgia rheumatica: Incidences of different clinical presentations and eye complications. Arthritis Rheum 24:899–904, 1981.PubMedGoogle Scholar
  166. 166.
    Huston KA, Hunder GG, Lie JT, et al. Temporal arteritis: A 25-year epidemiologic, clinical, and pathologic study. Ann Intern Med 88:162–167, 1978.PubMedGoogle Scholar
  167. 167.
    Hauser WA, Ferguson RH, Holley KE, and Kurland LT. Temporal arteritis in Rochester, Minnesota, 1951 to 1967. Mayo Clin Proc 46:597–602, 1971.PubMedGoogle Scholar
  168. 168.
    Malmvall BE, Bengtsson BA, Alestig K, et al. The clinical picture of giant cell arteritis: Temporal arteritis, polymyalgia rheumatica, and fever of unknown origin. Postgrad Med 67:141–148, 1980.PubMedGoogle Scholar
  169. 169.
    Bengtsson BA and Malmvall BE. Prognosis of giant cell arteritis including temporal arteritis and polymyalgia rheumatica: A follow-up study on ninety patients treated with corticosteroids. Acta Med Scand 209:337–345, 1981.PubMedGoogle Scholar
  170. 170.
    Jonasson F, Cullen JF, and Elton RA. Temporal arteritis: A 14-year epidemiological, clinical and prognostic study. Scott Med J 24:111–117, 1979.PubMedGoogle Scholar
  171. 171.
    Säve-Söderbergh J, Malmvall BE, Andersson R, and Bengtsson BA. Giant cell arteritis as a cause of death: Report of nine cases. JAMA 255:493–496, 1986.PubMedGoogle Scholar
  172. 172.
    Barrier J, Potel G, Renaut-Hovasse H, et al. The use of Doppler flow studies in the diagnosis of giant cell arteritis: Selection of temporal artery biopsy site is facilitated. JAMA 248:2158–2159, 1982.PubMedGoogle Scholar
  173. 173.
    Sewell JR, Allison DJ, Tarin D, and Hughes GR. Combined temporal arteriography and selective biopsy in suspected giant cell arteritis. Ann Rheum Dis 39:124–128, 1980.PubMedGoogle Scholar
  174. 174.
    Healey LA and Wilske KR. The Systemic Manifestations of Temporal Arteritis. New York: Grune & Stratton, 1978.Google Scholar
  175. 175.
    Bengtsson BA and Malmvall BE. An alternate-day corticosteroid regimen and maintenance therapy of giant cell arteritis. Acta Med Scand 209:347–350, 1981.PubMedGoogle Scholar
  176. 176.
    Hunder GG, Sheps SG, Allen GL, and Joyce JW. Daily and alternate-day corticosteroid regimens in treatment of giant cell arteritis: Comparison in a prospective study. Ann Intern Med 82:613–618, 1975.PubMedGoogle Scholar
  177. 177.
    Fernandez-Herlihy L. Duration of corticosteroid therapy in giant cell arteritis. J Rheumatol 7:361–364, 1980.PubMedGoogle Scholar
  178. 178.
    Haimovici H. Patterns of arteriosclerotic lesions of the lower extremity. Arch Surg 95:918–933, 1967.PubMedGoogle Scholar
  179. 179.
    Lindbom A. Arteriosclerosis and arterial thrombosis in the lower limb: Roentgenological study. Acta Radiol Suppl 80:1–80, 1950.PubMedGoogle Scholar
  180. 180.
    Mayor GE. The pattern of occlusion in atheroma of the lower limb arteries: The correlation of clinical and arteriographic findings. Br J Surg 43:352–364, 1956.Google Scholar
  181. 181.
    Kempczinski RF. The differential diagnosis of intermittent claudication. Pract Cardiol 7:53–61, 1981.Google Scholar
  182. 182.
    Kempczinski RF and Bernhard VM. The management of chronic ischemia of the lower extremities: Introduction and general considerations. In RB Rutherford (ed), Vascular Surgery, 2nd ed. Philadelphia: W. B. Saunders, 1984, pp 547–558.Google Scholar
  183. 183.
    Spittell JA Jr. Recognition and management of chronic atherosclerotic occlusive peripheral arterial disease. Mod Conc Cardiovasc Dis 50:19–23, 1981.Google Scholar
  184. 184.
    Barnes RW. Hemodynamics for the vascular surgeon. Arch Surg 115:216–223, 1980.PubMedGoogle Scholar
  185. 185.
    Raines JK, Darling RC, Buth J, et al. Vascular laboratory criteria for the management of peripheral vascular disease of the lower extremities. Surgery 79:21–29, 1976.PubMedGoogle Scholar
  186. 186.
    Strandness DE Jr. The use and abuse of the vascular laboratory. Surg Clin North Am 59:707–717, 1979.PubMedGoogle Scholar
  187. 187.
    Fairbairn JF II. Clinical manifestations of peripheral vascular disease. In JL Juergens, JA Spittell Jr, and JF Fairbairn II (eds), Peripheral Vascular Diseases. Philadelphia: W. B. Saunders, 1980, pp 3–49.Google Scholar
  188. 188.
    Imparato AM, Kim G-E, Davidson T, and Crowley JG. Intermittent claudication: Its natural course. Surgery 78:795–799, 1975.PubMedGoogle Scholar
  189. 189.
    Juergens JL, Barker NW, and Hines EA. Arteriosclerosis obliterans: Review of 520 cases with special reference to pathogenic and prognostic factors. Circulation 21:188–195, 1960.PubMedGoogle Scholar
  190. 190.
    Schersten T. Indications and methods of exercise training of patients with intermittent claudication. Pract Cardiol 8:45–59, 1982.Google Scholar
  191. 191.
    Lipid Research Clinics Program. The Lipid Research Clinics coronary primary prevention trial results. I. Reduction in incidence of coronary heart disease. JAMA 251:351–364, 1984.Google Scholar
  192. 192.
    Duffield RGM, Lewis B, Miller NE, et al. Treatment of hyperlipidaemia retards progression of symptomatic femoral atherosclerosis: A randomised controlled trial. Lancet 2:639–642, 1983.PubMedGoogle Scholar
  193. 193.
    LoGerfo FW and Coffman JD. Vascular and microvascular disease of the foot in diabetes: Implications for foot care. N Engl J Med 311:1615–1619, 1984.PubMedGoogle Scholar
  194. 194.
    Maddison FE. Arteriography for lower extremity ischemia. In RB Rutherford (ed), Vascular Surgery, 2nd ed. Philadelphia: W. B. Saunders, 1984, pp 559–563.Google Scholar
  195. 195.
    Health and Public Policy Committee, American College of Physicians. Percutaneous transluminal angioplasty. Ann Intern Med 99:864–869, 1983.Google Scholar
  196. 196.
    Greenfield A J. Femoral, popliteal, and tibial arteries: Percutaneous transluminal angioplasty. AJR 135:927–935, 1980.PubMedGoogle Scholar
  197. 197.
    Martin EC, Frankuchen EI, Karlson KB, et al. Angioplasty for femoral artery occlusion: Comparison with surgery. AJR 137:915–919, 1981.PubMedGoogle Scholar
  198. 198.
    Hertzer NR, Young JR, Kramer JR, et al. Routine coronary angiography prior to elective aortic reconstruction: Results of selective myocardial revascularization in patients with peripheral vascular disease. Arch Surg 114:1336–1344, 1979.PubMedGoogle Scholar
  199. 199.
    Cutler BS, Wheeler HB, Paraskos JA, and Cardullo PA. Assessment of operative risk with electrocardiographic exercise testing in patients with peripheral vascular surgery. Am J Surg 137:484–490, 1979.PubMedGoogle Scholar
  200. 200.
    Boucher CA, Brewster DC, Darling RC, et al. Determination of cardiac risk by dipyridamolethallium imaging before peripheral vascular surgery. N Engl J Med 312:389–394, 1985.PubMedGoogle Scholar
  201. 201.
    Rutherford RB. Lumbar sympathectomy: Indications and technique. In RB Rutherford (ed), Vascular Surgery, 2nd ed. Philadelphia: W. B. Saunders, 1984, pp 651–660.Google Scholar
  202. 202.
    Martin M. Thrombolytic therapy in arterial thromboembolism. Prog Cardiovasc Dis 21:351–374, 1979.PubMedGoogle Scholar
  203. 203.
    Totty WG, Gilula LA, McClennan BL, et al. Low-dose intravascular fibrinolytic therapy. Radiology 143:59–69, 1982.PubMedGoogle Scholar
  204. 204.
    McNamara TO and Fischer JR. Thrombolysis of peripheral arterial and graft occlusions: Improved results using high-dose urokinase. AJR 144:769–775, 1985.Google Scholar
  205. 205.
    Kazmier FJ, Sheps SG, Bernatz PE, and Sayre GP. Livedo reticularis and digital infarcts: A syndrome due to cholesterol emboli arising from atheromatous abdominal aortic aneurysms. Vase Dis 3:12–24, 1966.Google Scholar
  206. 206.
    Wagner RB and Martin AS. Peripheral atheroembolism: Confirmation of a clinical concept, with a case report and review of the literature. Surgery 73:353–359, 1973.PubMedGoogle Scholar
  207. 207.
    Rosansky SJ and Deschamps E.G. Multiple cholesterol emboli syndrome after angiography. Am J Med Sci 288:45–48, 1984.PubMedGoogle Scholar
  208. 208.
    Drost H, Buis B, Haan D, and Hillers JA. Cholesterol embolism as a complication of left heart catheterisation: Report of seven cases. Br Heart J 52:339–342, 1984.PubMedGoogle Scholar
  209. 209.
    Karmody AM, Powers SR, Monaco VJ, and Leather RP. “Blue toe” syndrome: An indication for limb salvage surgery. Arch Surg 111:1263–1268, 1976.PubMedGoogle Scholar
  210. 210.
    Smith MC, Ghose MK, and Henry AR. The clinical spectrum of renal cholesterol embolization. Am J Med 71:174–180, 1981.PubMedGoogle Scholar
  211. 211.
    Kassirer JP. Atheroembolic renal disease. N Engl J Med 280:812–818, 1969.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1987

Authors and Affiliations

  • Donald J. Breslin
  • Nicholas P. Tsapatsaris

There are no affiliations available

Personalised recommendations