Skip to main content

Diseases of the Aorta and Arterial Tree in the Elderly

  • Chapter
Cardiovascular Disease in the Elderly

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 76))

  • 45 Accesses

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  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.

    PubMed  CAS  Google Scholar 

  2. Silbert S, Lippmann HI, and Gordon E. Mönckeberg’s arteriosclerosis. JAMA 151:1176–1179, 1953.

    CAS  Google Scholar 

  3. Heptinstall RH, Porter KA, and Barkley H. Giant-cell (temporal) arteritis. J Path Bact 67:507–519, 1954.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  5. Schatz IJ, Fairbairn JF II, and Juergens JL. Abdominal aortic aneurysms: A reappraisal. Circulation 26:200–205, 1962.

    PubMed  CAS  Google Scholar 

  6. Gore I and Hirst AE Jr. Arteriosclerotic aneurysms of the abdominal aorta: A review. Prog Cardiovasc Dis 16:113–150, 1973.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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. Rutherford RB. Arterial aneurysms: Overview. In RB Rutherford (ed), Vascular Surgery, 2nd ed. Philadelphia: W. B. Saunders, 1984, pp 745–754.

    Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  12. Bernstein EF, Fisher JC, and Varco RL. Is excision the optimum treatment for all abdominal aortic aneurysms? Surgery 61:83–93, 1967.

    PubMed  CAS  Google Scholar 

  13. Young AE, Sandberg GW, and Couch NP. The reduction of mortality of abdominal aortic aneurysm resection. Am J Surg 134:585–590, 1977.

    PubMed  CAS  Google Scholar 

  14. Sommerville RL, Allen EV, and Edwards JE. Bland and infected arteriosclerotic abdominal aortic aneurysms: A clinicopathologic study. Medicine 38:207–221, 1959.

    PubMed  CAS  Google Scholar 

  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. Rutherford RB. Infrarenal aortic aneurysms. In RB Rutherford (ed), Vascular Surgery, 2nd ed. Philadelphia: W. B. Saunders, 1984, pp 755–771.

    Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  18. Bernstein EF, Dilley RB, Goldberger LE, et al. Growth rates of small abdominal aortic aneurysms. Surgery 80:765–773, 1976.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  20. Ferguson MJ and Arden MJ. Gastrointestinal hemorrhage secondary to rupture of aorta. Arch Intern Med 117:133–140, 1966.

    PubMed  CAS  Google Scholar 

  21. Baker WH, Sharzer LA, and Ehrenhaft JL. Aortocaval fistula as a complication of abdominal aortic aneurysms. Surgery 72:933–938, 1972.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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. 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.

    PubMed  CAS  Google Scholar 

  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. Crawford ES. Thoraco-abdominal and abdominal aortic aneurysms involving renal, superior mesenteric, and celiac arteries. Ann Surg 179:763–772, 1974.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  29. Pressler V and McNamara JJ. Thoracic aortic aneurysm: Natural history and treatment. J Thorac Cardiovasc Surg 79:489–498, 1980.

    PubMed  CAS  Google Scholar 

  30. McNamara JJ and Pressler VM. Natural history of arteriosclerotic thoracic aortic aneurysms. Ann Thorac Surg 26:468–473, 1978.

    PubMed  CAS  Google Scholar 

  31. DeBakey ME and Noon GP. Aneurysms of the thoracic aorta. Mod Conc Cardiovasc Dis 44:53–58, 1975.

    CAS  Google Scholar 

  32. Pond GD and Hillman B. Evaluation of aneurysms by computed tomography. Surgery 89:216–223, 1981.

    PubMed  CAS  Google Scholar 

  33. Wychulis AR, Spittell JA Jr and Wallace RB. Popliteal aneurysms. Surgery 68:942–952, 1970.

    PubMed  CAS  Google Scholar 

  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. 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.

    PubMed  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  37. Wheat MW Jr. Acute dissecting aneurysms of the aorta: diagnosis and treatment-1979. Am Heart J 99:373–387, 1980.

    PubMed  Google Scholar 

  38. DeBakey ME, Cooley DA, and Creech O Jr. Surgical considerations of dissecting aneurysm of the aorta. Ann Surg 142:586–612, 1955.

    CAS  Google Scholar 

  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.

    PubMed  Google Scholar 

  40. Schlatmann TJM and Becker AE. Pathogenesis of dissecting aneurysm of aorta. Am J Cardiol 39:21–26, 1977.

    PubMed  CAS  Google Scholar 

  41. Larson EW and Edwards WD. Risk factors for aortic dissection: a necropsy study of 161 cases. Am J Cardiol 53:849–855, 1984.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  Google Scholar 

  43. Earnest FIV, Muhm JR, and Sheedy PF II. Roentgenographic findings in thoracic aortic dissection. Mayo Clin Proc 54:43–50, 1979.

    PubMed  Google Scholar 

  44. Oudkerk M, Overbosch E, and Dee P. CT recognition of acute aortic dissection. AJR 141:671–676, 1983.

    PubMed  CAS  Google Scholar 

  45. Thorsen MK, San Dretto MA, Lawson TL et al. Dissecting aortic aneurysms: Accuracy of computed tomographic diagnosis. Radiology 148:773–777, 1983.

    PubMed  CAS  Google Scholar 

  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. Prokop EK, Palmer RF, and Wheat MW Jr. Hydrodynamic forces in dissecting aneurysms. Circ Res 27:121–127, 1970.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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. 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.

    PubMed  CAS  Google Scholar 

  51. Reiner L. Mesenteric arterial insufficiency and abdominal angina. Arch Intern Med 114:765–772, 1964.

    PubMed  CAS  Google Scholar 

  52. Hollier LH, Bernatz PE, Pairolero PC, et al. Surgical management of chronic intestinal ischemia: A reappraisal. Surgery 90:940–946, 1981.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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. Watt JK, Watson WC, and Haase S. Chronic intestinal ischaemia. Br Med J 3:199–202, 1967.

    PubMed  CAS  Google Scholar 

  56. Palmer WL. Clinical features of mesenteric artery insufficiency. J Tenn Med Assoc 59:152–160, 1966.

    PubMed  CAS  Google Scholar 

  57. Fry WJ and Kraft RO. Visceral angina. Surg Gynecol Obstet 117:417–424, 1963.

    PubMed  CAS  Google Scholar 

  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. Siegelman SS, Sprayregen S, and Boley SJ. Angiographic diagnosis of mesenteric arterial vasoconstriction. Radiology 112:533–542, 1974.

    PubMed  CAS  Google Scholar 

  60. Stoney RJ and Wylie EJ. Recognition and surgical management of visceral ischemic syndromes. Ann Surg 164:714–722, 1966.

    PubMed  CAS  Google Scholar 

  61. Zelenock GB, Graham LM, Whitehouse WM Jr, et al. Splanchnic arteriosclerotic disease and intestinal angina. Arch Surg 115:497–501, 1980.

    PubMed  CAS  Google Scholar 

  62. Baur GM, Millay DJ, Taylor LM Jr, and Porter JM. Treatment of chronic visceral ischemia. Am J Surg 148:138–144, 1984.

    PubMed  CAS  Google Scholar 

  63. Pierce GE and Brockenbrough EC. The spectrum of mesenteric infarction. Am J Surg 119:233–239, 1970.

    PubMed  CAS  Google Scholar 

  64. Ende N. Infarction of the bowel in cardiac failure. N Engl J Med 258:879–881, 1958.

    PubMed  CAS  Google Scholar 

  65. Butt LG and Cheek RC. Nonocclusive mesenteric vascular disease: Clinical and experimental observations. Ann Surg 169:704–711, 1969.

    Google Scholar 

  66. Ottinger LW and Austen WG. A study of 136 patients with mesenteric infarction. Surg Gynecol Obstet 124:251–261, 1967.

    PubMed  CAS  Google Scholar 

  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. Bynum TE and Jacobson ED. Blood flow and gastrointestinal diseases. Digestion 4:109–116, 1971.

    PubMed  CAS  Google Scholar 

  69. Bergan JJ, Dean RH, Conn J Jr, and Yao JST. Revascularization in treatment of mesenteric infarction. Ann Surg 182:430–438, 1975.

    PubMed  CAS  Google Scholar 

  70. Laufman H, Nora PF, and Mittelpunkt Al. Mesenteric blood vessels: Advances in surgery and physiology. Arch Surg 88:1021–1044, 1964.

    PubMed  CAS  Google Scholar 

  71. Price WE, Rohrer GV, and Jacobson ED. Mesenteric vascular diseases. Editorial. Gastroenterology 57:599–604, 1969.

    PubMed  CAS  Google Scholar 

  72. Bergan JJ. Recognition and treatment of superior mesenteric artery embolization. Geriatrics 24:118–125, 1969.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  76. Smith HW. Unilateral nephrectomy in hypertensive disease. J Urol 76:685–701, 1956.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  78. Dustan HP, Humphries AW, deWolfe VG, and Page IH. Normal arterial pressure in patients with renal arterial stenosis. JAMA 187:1028–1029, 1964.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  80. Stamey TA, Nudelman IJ, Good PH, et al. Functional characteristics of renovascular hypertension. Medicine 40:347–394, 1961.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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. 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.

    PubMed  CAS  Google Scholar 

  84. Rosenthal JT, Libertino JA, Zinman LN, et al. Predictability of surgical cure of renovascular hypertension. Ann Surg 193:448–452, 1981.

    PubMed  CAS  Google Scholar 

  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. Foster JH, Maxwell MH, Franklin SS, et al. Renovascular occlusive disease: Results of operative treatment. JAMA 231:1043–1048, 1975.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  88. Simon N, Franklin SS, Bleifer KH, and Maxwell MH. Clinical characteristics of renovascular hypertension. JAMA 220:1209–1218, 1972.

    PubMed  CAS  Google Scholar 

  89. Stanley JC and Fry WJ. Surgical treatment of renovascular hypertension. Arch Surg 112:1291–129. 1977.

    PubMed  CAS  Google Scholar 

  90. Perloff D, Sokolow M, Wylie EJ, and Palubinskas AJ. Renal vascular hypertension: Further experiences. Am Heart J 74:614–631, 1967.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  94. Kaufman JJ. Renovascular hypertension: The UCLA experience. J Urol 121:139–144, 1979.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  96. Dean RH, Burko H, Wilson JP, et al. Deceptive patterns of renal artery stenosis. Surgery 76:872–881, 1974.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  99. Meaney TF, Dustan HP, and McCormack L. Natural history of renal arterial disease. Radiology 91:881–887, 1968.

    PubMed  CAS  Google Scholar 

  100. Wollenweber J, Sheps SG, and Davis GD. Clinical course of atherosclerotic renovascular disease: Review. Am J Cardiol 21:60–71, 1968.

    CAS  Google Scholar 

  101. Libertino JA, Zinman L, Breslin DJ, et al. Renal artery revascularization: Restoration of renal function. JAMA 244:1340–1342, 1980.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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. Franklin SS, Young JD Jr, Maxwell MH, et al. Operative morbidity and mortality in renovascular disease. JAMA 231:1148–1153, 1975.

    PubMed  CAS  Google Scholar 

  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. Libertino JA and Selman FJ Jr. Alternatives to aortorenal revascularization. J Cardiovasc Surg 23:318–322, 1982.

    CAS  Google Scholar 

  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. Carter AB. Strokes: Natural history and prognosis. Proc Roy Soc Med 56:483–486, 1963.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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. Kirkendall WM and Hammond JJ. Hypertension in the elderly. Arch Intern Med 140:1155–1161, 1980.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  115. Cressman MD and Gifford RW Jr. Hypertension and stroke. J Am Coll Cardiol 1:521–527, 1983.

    PubMed  CAS  Google Scholar 

  116. The Management Committee. The Australian therapeutic trial in mild hypertension. Lancet 1:1261–1267, 1980.

    Google Scholar 

  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. 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.

    CAS  Google Scholar 

  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.

    CAS  Google Scholar 

  120. Cerebral Embolism Task Force. Cardiogenic brain embolism. Arch Neurol 43:71–84, 1986.

    Google Scholar 

  121. Good DC, Frank S, Verhulst S, and Sharma B. Cardiac abnormalities in stroke patients with negative arteriograms. Stroke 17:6–11, 1986.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  Google Scholar 

  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. Martin MJ, Whisnant JP, and Sayre GP. Occlusive vascular disease in the extracranial cerebral circulation. Arch Neurol 3:530–538, 1960.

    PubMed  CAS  Google Scholar 

  125. Fields WS and Lemak NA. Joint study of extracranial arterial occlusion. X. Internal carotid artery occlusion. JAMA 235:2734–2738, 1976.

    PubMed  CAS  Google Scholar 

  126. Javid H, Ostermiller WE Jr, Hengesh JW, et al. Natural history of carotid bifurcation atheroma. Surgery 67:80–86, 1970.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  128. Chambers BR and Norris JW. The case against surgery for asymptomatic carotid stenosis. Stroke 15:964–967, 1984.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  130. Committee on Cerebrovascular Diseases. A classification and outline of cerebrovascular diseases II. Stroke 6:564–616, 1975.

    Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  132. Millikan CH. Cerebral circulation. JAMA 239:1313–1315, 1978.

    PubMed  CAS  Google Scholar 

  133. Millikan CH. The pathogenesis of transient focal cerebral ischemia. Circulation 32:438–450, 1965.

    PubMed  CAS  Google Scholar 

  134. Marshall J and Wilkinson IMS. The prognosis of carotid transient ischaemic attacks in patients with normal angiograms. Brain 94:395–402, 1971.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  136. Reed RL, Siekert RG, and Merideth J. Rarity of transient focal cerebral ischemia in cardiac dysrhythmia. JAMA 223:893–895, 1973.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  138. Whisnant JP. The role of the neurologist in the decline of stroke. Ann Neurol 14:1–7, 1983.

    PubMed  CAS  Google Scholar 

  139. Easton JD and Sherman DG. Carotid endarterectomy. Editorial. Mayo Clin Proc 58:205–207, 1983.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    CAS  Google Scholar 

  144. Hollenhorst RW. Significance of bright plaques in the retinal arterioles. JAMA 178:23–29, 1961.

    PubMed  CAS  Google Scholar 

  145. Russell RWR. The source of retinal emboli. Lancet 2:789–792, 1968.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  147. Savino PJ, Glaser JS, and Cassady J. Retinal stroke: Is the patient at risk? Arch Ophthalmol 95:1185–1189, 1977.

    PubMed  CAS  Google Scholar 

  148. Yao JST and Bergan JJ. Application of ultrasound to arterial and venous diagnosis. Surg Clin North Am 54:23–38, 1974.

    PubMed  CAS  Google Scholar 

  149. Cebul RD and Ginsberg MD. Noninvasive neurologic tests for carotid artery disease. Ann Intern Med 97:867–872, 1982.

    PubMed  CAS  Google Scholar 

  150. Johnson JM, Kennelly MM, Decesare D, et al. Natural history of asymptomatic carotid plaque. Arch Surg 120:1010–1012, 1985.

    PubMed  CAS  Google Scholar 

  151. Fish PJ, Kakkar VV, Corrigan T, and Nicolaides AN. Arteriography using ultrasound. Lancet 1:1269–1270, 1972.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  153. Gee W, Oller DW, Amundsen DG, and Goodreau JJ. The asymptomatic carotid bruit and the ocular pneumoplethysmography. Arch Surg 112:1381–1388, 1977.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  156. Barnett HJM. Progress towards stroke prevention: Robert Wartenberg lecture. Neurology 30:1212–1225, 1980.

    PubMed  CAS  Google Scholar 

  157. Millikan CH and McDowell FH. Treatment of progressing stroke. Prog Cardiovasc Dis 22:397–414, 1980.

    PubMed  CAS  Google Scholar 

  158. McDowell FH, Millikan CH, and Goldstein M. Treatment of impending stroke. Editorial. Stroke 11:1–3, 1980.

    CAS  Google Scholar 

  159. Barnett HJM, Plum F, and Walton JN. Carotid endarterectomy: An expression of concern. Editorial. Stroke 15:941–943, 1984.

    CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  161. Mohr JP. Asymptomatic carotid artery disease. Stroke 13:431–433, 1982.

    PubMed  CAS  Google Scholar 

  162. Javid H, Ostermiller WE, Hengesh JW, et al. Carotid endarterectomy for asymptomatic patients. Arch Surg 102:389–391, 1971.

    PubMed  CAS  Google Scholar 

  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. 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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  174. Healey LA and Wilske KR. The Systemic Manifestations of Temporal Arteritis. New York: Grune & Stratton, 1978.

    Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  177. Fernandez-Herlihy L. Duration of corticosteroid therapy in giant cell arteritis. J Rheumatol 7:361–364, 1980.

    PubMed  CAS  Google Scholar 

  178. Haimovici H. Patterns of arteriosclerotic lesions of the lower extremity. Arch Surg 95:918–933, 1967.

    PubMed  CAS  Google Scholar 

  179. Lindbom A. Arteriosclerosis and arterial thrombosis in the lower limb: Roentgenological study. Acta Radiol Suppl 80:1–80, 1950.

    PubMed  CAS  Google Scholar 

  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. Kempczinski RF. The differential diagnosis of intermittent claudication. Pract Cardiol 7:53–61, 1981.

    Google Scholar 

  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. Spittell JA Jr. Recognition and management of chronic atherosclerotic occlusive peripheral arterial disease. Mod Conc Cardiovasc Dis 50:19–23, 1981.

    Google Scholar 

  184. Barnes RW. Hemodynamics for the vascular surgeon. Arch Surg 115:216–223, 1980.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  186. Strandness DE Jr. The use and abuse of the vascular laboratory. Surg Clin North Am 59:707–717, 1979.

    PubMed  Google Scholar 

  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. Imparato AM, Kim G-E, Davidson T, and Crowley JG. Intermittent claudication: Its natural course. Surgery 78:795–799, 1975.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  190. Schersten T. Indications and methods of exercise training of patients with intermittent claudication. Pract Cardiol 8:45–59, 1982.

    Google Scholar 

  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. 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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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. Health and Public Policy Committee, American College of Physicians. Percutaneous transluminal angioplasty. Ann Intern Med 99:864–869, 1983.

    Google Scholar 

  196. Greenfield A J. Femoral, popliteal, and tibial arteries: Percutaneous transluminal angioplasty. AJR 135:927–935, 1980.

    PubMed  CAS  Google Scholar 

  197. Martin EC, Frankuchen EI, Karlson KB, et al. Angioplasty for femoral artery occlusion: Comparison with surgery. AJR 137:915–919, 1981.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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. Martin M. Thrombolytic therapy in arterial thromboembolism. Prog Cardiovasc Dis 21:351–374, 1979.

    PubMed  CAS  Google Scholar 

  203. Totty WG, Gilula LA, McClennan BL, et al. Low-dose intravascular fibrinolytic therapy. Radiology 143:59–69, 1982.

    PubMed  CAS  Google Scholar 

  204. McNamara TO and Fischer JR. Thrombolysis of peripheral arterial and graft occlusions: Improved results using high-dose urokinase. AJR 144:769–775, 1985.

    CAS  Google Scholar 

  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.

    CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  207. Rosansky SJ and Deschamps E.G. Multiple cholesterol emboli syndrome after angiography. Am J Med Sci 288:45–48, 1984.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  210. Smith MC, Ghose MK, and Henry AR. The clinical spectrum of renal cholesterol embolization. Am J Med 71:174–180, 1981.

    PubMed  CAS  Google Scholar 

  211. Kassirer JP. Atheroembolic renal disease. N Engl J Med 280:812–818, 1969.

    PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1987 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Breslin, D.J., Tsapatsaris, N.P. (1987). Diseases of the Aorta and Arterial Tree in the Elderly. In: Messerli, F.H. (eds) Cardiovascular Disease in the Elderly. Developments in Cardiovascular Medicine, vol 76. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-9925-4_13

Download citation

  • DOI: https://doi.org/10.1007/978-1-4684-9925-4_13

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4684-9927-8

  • Online ISBN: 978-1-4684-9925-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics