Mechanisms of Vascular Disease: A Textbook for Vascular Surgeons

Cover......Page 1
Half-title......Page 3
Title......Page 5
Copyright......Page 6
Contents......Page 7
Contributors......Page 9
ANGIOGENESIS......Page 13
The role of sphingosine-1-phosphate......Page 14
Regulation of angiogenesis: a balance of angiostatic versus proangiogenic factors......Page 15
Synthesis of endothelins......Page 16
Endothelins in disease......Page 17
Integrins......Page 18
The procoagulant activity of the deranged endothelium......Page 19
REFERENCES......Page 20
STRUCTURE......Page 26
CONTRACTILE FUNCTION......Page 27
VASCULAR SMOOTH MUSCLE PROLIFERATION......Page 28
HOW ARE VSMCS STUDIED?......Page 29
ARE THERE DIFFERENT SUBTYPES OF VSMCS?......Page 30
ANGIOGENESIS AND ARTERIOGENESIS......Page 31
REFERENCES......Page 32
LAPLACE’S LAW OF WALL TENSION......Page 34
SHEAR THINNING FLUID......Page 36
POISEUILLE FLOW......Page 37
YOUNG’S MODULUS AND PULSATILE FLOW......Page 38
MASS CONSERVATION......Page 39
SHEAR STRESS AND PRESSURE......Page 40
FORCES ON A SINGLE TUBE GRAFT SYSTEM......Page 42
Case 1 – the cylindrical graft......Page 43
REFERENCES......Page 44
EVOLUTION OF OUR UNDERSTANDING OF HAEMOSTASIS......Page 46
Introduction......Page 47
Co-factors and transport molecules (factors V, VIII, protein S and von Willebrand factor)......Page 48
Fibrinogen......Page 49
ENDOTHELIAL CELLS AND COAGULATION......Page 50
THE PRESENT MODEL OF HAEMOSTASIS......Page 51
HISTORICAL REFERENCES......Page 53
Antithrombin-III deficiency......Page 54
Protein S deficiency......Page 55
Malignancy......Page 56
HOMOCYSTEINE......Page 57
PREVALENCE AND RISK OF HOMOCYSTEINE AND VENOUS DISEASE......Page 58
PREVALENCE AND RISK OF THROMBOPHILIA DEFECTS AND ARTERIAL DISEASE......Page 59
PREVALENCE AND RISK OF HYPERHOMOCYSTEINAEMIA IN ARTERIAL DISEASE......Page 61
THE PREVALENCE AND RISK OF HYPERFIBRINOGENAEMIA IN VASCULAR DISEASE......Page 62
SCREENING......Page 63
HEPARIN......Page 64
Aspirin and dipyridamole......Page 66
Ticlodipine and clopidigrel......Page 68
Thrombin inhibitors......Page 69
OVERVIEW......Page 70
REFERENCES......Page 71
Platelet activation......Page 80
PLATELET DISORDERS......Page 82
Autoimmune thrombocytopenic purpura (AITP)......Page 83
Von Willebrand’s disease (vWD)......Page 84
Thrombocytosis and essential thrombocythaemia......Page 85
Platelets in plaque development and thrombus generation......Page 86
Aspirin......Page 87
Aspirin use in the treatment of cardiovascular disease......Page 88
Dipyridamole......Page 89
Inhibitors of platelet-.brinogen binding......Page 90
Cilostazol......Page 91
REFERENCES......Page 92
Fatty streaks......Page 97
Plaque or atheroma......Page 98
HYPERCHOLESTEROLAEMIA AND OXIDIZED-LDL......Page 99
Biomechanical stress-induced cell death......Page 100
INFECTIONS AND HEAT SHOCK PROTEINS......Page 102
Infections and HSP expression......Page 103
Infections, sHSP and innate immunity......Page 104
Major histocompatibility complex (MHC) class II antigen and T cells......Page 105
Beta2-glycoprotein Ib as a candidate antigen......Page 106
CD40/CD40L......Page 107
REFERENCES......Page 108
Coronary circulation......Page 115
The endothelium......Page 117
The lipid core......Page 118
The cap of the plaque......Page 119
Macrophages and collagen degradation......Page 120
The vessel lumen......Page 123
THE ROLE OF INFECTIOUS AGENTS IN PLAQUE RUPTURE......Page 125
HMG CO-A REDUCTASE INHIBITORS......Page 126
Synthetic MMP inhibitors......Page 127
ABBREVIATIONS......Page 128
REFERENCES......Page 129
BACKGROUND......Page 139
Modification of atherogenic lipoproteins......Page 140
Fibric acid derivatives......Page 142
Fish oils......Page 143
Elevation of HDL cholesterol......Page 144
Glycaemic control......Page 146
Hypertension......Page 145
ANTIPLATELET THERAPY......Page 147
HORMONE REPLACEMENT THERAPY......Page 148
DIET......Page 149
OTHER EMERGING THERAPIES......Page 150
MONITORING THERAPY......Page 151
REFERENCES......Page 152
Vasculogenesis......Page 161
Neovessel maturation......Page 162
Arteriogenesis......Page 163
Delivery of molecular activators of vascular growth......Page 164
Arteriogenic activators......Page 165
REFERENCES......Page 166
RAYNAUD’S PHENOMENON......Page 170
Endothelium-independent mechanisms......Page 171
Treatment......Page 174
Systemic lupus erythematosus (SLE)......Page 175
Treatment......Page 176
Giant cell arteritis......Page 177
Takayasu’s arteritis (TA)......Page 178
Polyarteritis nodosa (PAN)......Page 179
Segmental pressure measurements......Page 180
Radiography......Page 181
REFERENCES......Page 182
Arterial remodelling......Page 185
Intimal hyperplasia......Page 186
Growth factors/cytokines......Page 189
Coagulation cascade/fibrinolytic path......Page 190
Matrix metalloproteinases......Page 191
PREVENTION VS. REVERSAL OF RESTENOSIS......Page 192
REFERENCES......Page 193
Intermediate onset narrowing......Page 203
A simple problem, a simple solution?......Page 204
Systemic treatments for restenosis......Page 205
Systemic toxicity, topical delivery......Page 206
Genetic manipulation......Page 207
Remodelling......Page 208
Brachytherapy......Page 209
Drug-eluting stents......Page 211
Novel and future methods for the prevention and treatment of in-stent restenosis......Page 213
Open surgical considerations in restenosis prevention and treatment......Page 214
CONCLUSIONS......Page 215
REFERENCES......Page 216
Smoking......Page 223
Plasma lipid levels......Page 224
HISTOLOGY......Page 225
BIOMECHANICAL EFFECTS......Page 226
GENETICS......Page 227
ABNORMAL PROTEOLYSIS......Page 229
INFLAMMATION AND THE IMMUNE RESPONSE......Page 230
OXIDATIVE STRESS......Page 231
REFERENCES......Page 232
AORTIC ANEURYSMS IN THE ABSENCE OF ATHEROSCLEROSIS......Page 238
PATHOLOGICAL PARADIGMS FOR THE FORMATION OF ABDOMINAL AORTIC ANEURYSMS......Page 239
PROTEOLYSIS AND THE FORMATION OF ANEURYSMS......Page 240
INFLAMMATION......Page 241
SMOOTH MUSCLE CELL FUNCTION AND APOPTOSIS......Page 242
GENETIC VARIATION AND EXPANSIVE ARTERIAL REMODELLING IN MAN......Page 243
REFERENCES......Page 244
Pathophysiology......Page 247
Beta-blockade......Page 248
Non steroidal anti-in.ammatories......Page 249
Anti-chlamydial therapy......Page 250
REFERENCES......Page 251
CAUSES OF SIRS......Page 255
PHYSIOLOGY OF INFLAMMATION......Page 256
THE GENERAL OVERVIEW......Page 257
THE ANTI-INFLAMMATORY RESPONSE TO SIRS......Page 258
ROLE OF CYTOKINES......Page 259
ANTI-INFLAMMATORY CYTOKINES......Page 260
Nitric oxide......Page 261
Priming......Page 262
COAGULATION......Page 263
VASOACTIVE AGENTS......Page 264
MODULATION OF THE INFLAMMATORY RESPONSE......Page 265
REFERENCES......Page 266
Reactive oxygen species......Page 271
Nitric oxide......Page 273
Cytokines......Page 274
Neutrophils and endothelial interactions......Page 275
Proteases and metalloproteinases......Page 277
REFERENCES......Page 278
Anatomy/physiology......Page 287
Aetiology/pathophysiology......Page 288
Clinical presentation......Page 289
Investigation......Page 291
Treatment......Page 292
Aetiology......Page 295
Clinical presentation......Page 296
Outcome......Page 297
REFERENCES......Page 299
Conduction......Page 303
Descending control......Page 304
SPONTANEOUS ECTOPIC DISCHARGE......Page 305
WIND-UP......Page 306
IMMEDIATE EARLY GENE EXPRESSION......Page 307
Stimulus independent pain......Page 308
IDIOPATHIC......Page 309
MULTIPLE SCLEROSIS......Page 310
REFERENCES......Page 311
Phantom limb pain (PLP)......Page 314
Supraspinal factors......Page 315
Perioperative lumbar epidural blockade......Page 316
Calcitonin......Page 317
Selective serotonin reuptake inhibitors......Page 318
Psychological therapy......Page 319
REFERENCES......Page 320
PHARMACOLOGICAL TREATMENT......Page 323
Efficacy......Page 324
Adverse effects......Page 325
Recommendations for clinical use of antidepressants as analgesics......Page 326
Gabapentin......Page 327
Lamotrigine......Page 328
Mexiletine......Page 329
Clonidine......Page 330
Topical application of local anaesthetics......Page 331
Transcutaneous electrical nerve stimulation (TENS)......Page 332
Cognitive-behavioural therapy......Page 333
REFERENCES......Page 334
Haemostasis......Page 341
Neutrophils......Page 342
Macrophages......Page 344
Proliferative phase......Page 345
Collagen and extracellular matrix production......Page 346
Epithelialization......Page 347
Remodelling......Page 348
Biochemical differences in the molecular environments of healing and chronic wounds......Page 349
Biological differences in the response of chronic wound cells to growth factors......Page 351
Molecular basis of chronic non-healing wounds......Page 352
Future concepts for the treatment of chronic wounds......Page 353
REFERENCES......Page 355
PHYSIOLOGY......Page 358
MUSCLE PUMP FAILURE......Page 360
RECURRENT VARICOSE VEINS......Page 361
REFERENCES......Page 362
Venous abnormality......Page 363
Influence of venous disease on the wound healing process......Page 365
ASSESSMENT OF VENOUS FUNCTION......Page 367
Compression therapy......Page 368
Prevention of venous ulcer recurrence......Page 369
REFERENCES......Page 371
Neuropathy......Page 373
Contracture......Page 374
Callus......Page 375
Sepsis......Page 376
Ulceration......Page 377
Charcot’s arthropathy (diabetic neuropathic arthropathy)......Page 378
Multidisciplinary treatment......Page 379
REFERENCES......Page 381
CLASSIFICATION OF LYMPHOEDEMA......Page 382
THE GENETICS OF LYMPHOEDEMA AND LYMPHANGIOGENESIS......Page 383
Lymphoedema-distichiasis......Page 385
Noonan’s syndrome......Page 386
PATHOPHYSIOLOGY OF LYMPH FORMATION......Page 387
Inflammation......Page 388
Lymph formation and propulsion......Page 389
Lymphatic channels......Page 390
REFERENCES......Page 391
Healing of prosthetic grafts......Page 397
Graft permeability......Page 398
The compliance hypothesis of graft failure......Page 399
Knitted dacron......Page 400
PTFE grafts......Page 401
Polyurethane grafts......Page 403
Biological vascular grafts......Page 404
Modifications to improve patency......Page 405
ENDOTHELIAL CELL SEEDING......Page 406
Non-degradable polymer and cell seeding......Page 407
Tissue-engineered autologous grafts......Page 408
REFERENCES......Page 409
PATHOGENESIS OF GRAFT INFECTIONS......Page 415
Laboratory investigations......Page 416
Prevention......Page 417
REFERENCES......Page 419
Index......Page 425