| Marvels, mysteries, and misconceptions of vascular compensation to peripheral artery occlusion. | |
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MedLine Citation:
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PMID: 20141596 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Peripheral arterial disease is a major health problem and there is a significant need to develop therapies to prevent its progression to claudication and critical limb ischemia. Promising results in rodent models of arterial occlusion have generally failed to predict clinical success and led to questions of their relevance. While sub-optimal models may have contributed to the lack of progress, we suggest that advancement has also been hindered by misconceptions of the human capacity for compensation and the specific vessels which are of primary importance. We present and summarize new and existing data from humans, Ossabaw miniature pigs, and rodents which provide compelling evidence that natural compensation to occlusion of a major artery (i) may completely restore perfusion, (ii) occurs in specific pre-existing small arteries, rather than the distal vasculature, via mechanisms involving flow-mediated dilation and remodeling (iii) is impaired by cardiovascular risk factors which suppress the flow-mediated mechanisms and (iv) can be restored by reversal of endothelial dysfunction. We propose that restoration of the capacity for flow-mediated dilation and remodeling in small arteries represents a largely unexplored potential therapeutic opportunity to enhance compensation for major arterial occlusion and prevent the progression to critical limb ischemia in the peripheral circulation. |
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Authors:
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Matthew A Ziegler; Matthew R Distasi; Randall G Bills; Steven J Miller; Mouhamad Alloosh; Michael P Murphy; A George Akingba; Michael Sturek; Michael C Dalsing; Joseph L Unthank |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Microcirculation (New York, N.Y. : 1994) Volume: 17 ISSN: 1549-8719 ISO Abbreviation: Microcirculation Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-02-09 Completed Date: 2010-06-17 Revised Date: 2012-02-08 |
Medline Journal Info:
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Nlm Unique ID: 9434935 Medline TA: Microcirculation Country: England |
Other Details:
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Languages: eng Pagination: 3-20 Citation Subset: IM |
Affiliation:
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Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Arterial Occlusive Diseases / pathology, physiopathology* Collateral Circulation / physiology* Disease Models, Animal Extremities / blood supply Hemodynamics Humans Ligation Mice Peripheral Vascular Diseases / pathology, physiopathology* Rats Swine Swine, Miniature Vasodilation / physiology |
| Grant Support | |
ID/Acronym/Agency:
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HL062552/HL/NHLBI NIH HHS; HL092012/HL/NHLBI NIH HHS; HL42898/HL/NHLBI NIH HHS; R01 HL042898-13/HL/NHLBI NIH HHS; R01 HL062552-09A2/HL/NHLBI NIH HHS; R01 HL092012-01A2/HL/NHLBI NIH HHS; R01 HL092012-04/HL/NHLBI NIH HHS; R24 RR013223-04/RR/NCRR NIH HHS; RR013223/RR/NCRR NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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