Naked Science Forum
Life Sciences => Physiology & Medicine => Topic started by: JimBob on 14/12/2006 04:47:20
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Michael, you quack, this is for you since I know you will try to weezle out of it somehow [;D] but I do have a serious question if someone else is inclined to give me a straight answer or if you are in a good mood, Michael.
HOW on this green earth can the right Iliac artery be 95-97% blocked and not passing enough blood to give a pulse in the Femoral Sheath and there be no other periferal artery disease in either leg? I now have a stint and a pulse and a closed wound where the Femoral artery was sew back together after it bleed 3 pints of blood into the spaces between the muscles in my abdomen and legs but I also feel better than I have in 3 or 4 years.
I had radiation therapy after a radical prostectamy for cancer and a continued PSA elevation. Could this be a cause of the blockage?
My vascular surgeon just says "It happens" but that is like saying "Yes, there are mice - even voles." It is not very satisfying for looking to my future medical health.
It is good to be back and I just had to get one in on you, Michael. [:X]
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Dear JimBob
Arterial disease is thought to begin with injury to the endothelium, which is the smooth surface that lines arteries and is known as the tunica intima. This permeabilises the vessel wall to fats, like cholesterol, and also encourages the binding of platelets, which are small cell fragments designed to plug holes in blood vessels. When platelets bind they activate and discharge, amongst other things, growth factors including PDGF.
These factors recruit other inflammatory cells to the site of the injury and also stimulate the growth and cell division of muscle cells from the blood vessel wall. Macrophages, which are specialised white blood cells, also move in and begin engulf some of the inflammatory debris from the injury site.
The result of these changes is a lesion protruding into the vessel lumen (the hole through which the blood flows). This restriction in the vessel's cross sectional diameter provokes turbulence in the blood flow, which is normally laminar. The turbulence can sometimes provoke further injury to the endothelium, stimulating the evolution / progression of the disease at that site.
These changes can be very focal, although it would be very unusual to have such a severe stenosis (constriction) in just one place and no trace of disease elsewhere.
Therefore, I suspect that the radiation you received when you underwent prostate treatment may be responsible. If the radiation damaged the endothelium of the affected femoral artery it could well have provoked the cascade of changes I've outlined above.
The good news is that the re-stenosis rates following stenting are not that high (currently at about 5-15%), and are even lower with drug-eluting stents (which block the cell proliferation I mentioned).
Chris
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YEH for me - low probability of restinting. But the US med establishment is finding that when drug-eluting stents are placed in the vascularization of the heart there is a higher death rate than with non-eluting stints.
Thanks for confirming what I had deduced. And for the expanded explination. I just never realized a blocked artery could cause so many different symptoms, conditions and adverse effects to the human body. I am still totally anmased at the difference.
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Nice to have you back jim and we all glad to hear your feeling better these days.
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And good to hear from you as well Michael! AND Chris, the head God here! Oh and a nice guy as well, just like you, Micky.