The Correlation Between Pulse Pressure And Arterial Thrombus Formation Of Lower Extremity

Objective：With people's living standards significantly improved inrecent years, China's dietary patterns and eating habits changed with the greatchanges, furthermore, the aging of the population and the reduction ofinfectious diseases leads to the rising incidence a variety of vascular diseases,And the vascular diseases has increasingly become the primary disease of thethreat to human physical and mental health,and even life. Some thrombusformation of important parts of arteriosclerosis obliterans are the main clinicalsymptoms of the most common one of the initiating factor.Arteriosclerosis obliterans, we all know, is a degenerative disease,is thebasic pathological processes of the large artery, cells, fibrous matrix, lipid, andtissue fragments abnormal deposited in the arterial intima or in the middle ofproliferative processpathological changes. In peripheral vascular disorders,almost most of artery stenosis,occlusive or aneurysmal disease caused, byarteriosclerosis. Atherosclerotic lesions, systemic disorders, occurs in somelarge and medium-sized arteries, such as the lower segment of the abdominalaorta, iliac artery, femoral artery and popliteal artery, etc., the upper extremityarteries rarely involved.Thickening of the lesion arteries, hardening,atheromatous plaque and calcification, can be lead to thrombosis.Thrombosiscaused vascular occlusion, the main pathology of these diseases characteristicsis degeneration and necrosis due to prolonged ischemia and hypoxia in localtissue,and the limb will be ischemic symptoms. Limb have Pulselessness,Pallor, pain, Paralysis intermittent claudication, toe or foot ulcers or necrosisand other clinical manifestations. Therefore, early on the clear diagnosis ofpositioning of thrombosis parts and the proper use of thrombolytic agents is ofgreat significance to alleviate the local symptoms,and to save the lives ofpatients.According to the World epidemiological investigation, regardless of China and Western countries, arteriosclerosis obliterans and arterialthromboembolic disease has become a first reason for death and disability. inthe MONICA project, latest statistics show that there are about17millionpeople with died of various cardiovascular and cerebrovascularthromboembolic disease each year worldwide[1]. An Australian populationcensus results show that65to69-year-old man lower limb arteriosclerosisobliterans in the incidence rate of10.6%, while75to79years lower extremityatherosclerotic occlusive disease incidence as high as23.3%. At present, it hasbeen reported in patients of atherosclerotic lesions that the morbidity rate ofsimply coronary artery, cerebral artery and peripheral arterial diseaseaccounted for29.9%,24.7%,19.2%, and the remaining26.2%of patientsmerged the two to three vascular lesions at the same time. In our country thereis no epidemiological data related to peripheral arterial occlusive disease,people generally believe that its incidence may be lower than Westerncountries. The imaging diagnosis of lower extremity arterial occlusive disease,including lower extremity arterial DSA, color Doppler ultrasound, CTA andMRA, Various methods have advantages and disadvantages [2-4].Angiography (DSA) is the "gold standard" for diagnosis of lower extremityarteriosclerosis obliterans (aso), it can be not only accurately show the lowerextremity arteriosclerosis obliterans the location, extent, and side vice cycle,hemodynamic changesofvascular stenosis/occlusion, but also real-time givethe appropriate treatment according to the inspection process observed.we canachieve the dual purpose of diagnosis and treatment,be described as killingtwo birds with one stone. The disadvantage of DSA is invasive andcomplicated operateing, pain and expensive, therefore it is not as thepreferred means of checkingTo analyze hemodynamic changes leading arterial pulse pressure inpatients with arterial thrombosis of lower extremity, discuss the relationshipbetween Pulse pressure and its degree of pulse pressure and arterial thrombusformation of lower extremity. Methods：To analyze the diagnosis results of177patients with lowerextremity ischemia symptoms in No.2hospital of Hebei Medical Universityfrom January2010to January2010. And, all the patients underwentfemoral artery thrombectomy or lower extremity artery angiography,Intra-arterial thrombolysis and balloon expandable or stent placement.Results:In177patients, there was a significant difference between thearterial pulse pressure Average value in groups of the patients ofarteriosclerosis and thrombosis and the arterial pulse pressure Average valueof patients of simple arteriosclerosis obliterans.the pulse pressure in patientswith rterial sclerosis occlusion and thrombosis was significantly higher thanthat of patients with simple arteriosclerosis obliterans, arterial pulse pressurehas an important role in the thrombotic.177patients was divided into threegroups. The incidence of arterial thrombosis was25.42%in the group a (>70mmHg); the group b (60~69mmHg) in patients with arterial thrombosisoccurred at a rate of13.56%; the patients with arterial thrombosis in the groupc (<60mmHg)6.78%in the all people, between groups are not all the same,i.e. the different degrees of arterial had a different effect on arterialthrombosis.Comparing with any two groups from the three groups, there weresignificant differences.With arterial pressure of patients with arteriosclerosisobliterans increases, the risk of thrombosis oincreased significantly in thearterial lesions. In thrombosis group, between the size of pulse pressuredifference and the length of thrombus there is not significantcorrelation.Gender may be a confounding factor in arterial thrombosis, thepatients in accordance with all subjects divided into two groups,pulsepressure>70mmHg, and pulse pressure <70mmHg. Gender as a stratificationfactor, by removing the confounding factors of gender, we will discuss that thepulse pressure is related with arterial thrombosis or not.the results show theboth of them are still statistically significant. Removeing the confoundingfactors of gender, we can find that pulse pressure is highly correlated witharterial occlusive thrombosis. Conclusion：The formation in patients with atherosclerosis formation hasa closely relatedarterial with Pulse pressure, and the degree of arterial Pulsepressure difference is directly related to the arterial thrombosis.Theatherosclerosis-related factors-gender, when the pulse pressure was toohigh,it is no longer related with formation of arterial thrombosis.And afterarterial thrombosis,the length of arterial thrombus does not exist significantcorrelation with arterial pressure difference.This pathogenesis should behighly attended,and we improve the patient's awareness. In177cases ofpatients, between the group of artery thrombosis and the non-thrombosisgroup, there were significant differences in the fluctuations weight ratio.Withincreasing fluctuations of arterial blood flow, the risk of arterial thrombosisinformation is also increased.