dicumarol and Arteriosclerosis

During the years 1970 to 1985, 463 patients with obliterative atherosclerosis at the femoropopliteal level underwent elective surgery. The operation performed was an autologous saphenous vein bypass using the reversed technique. The vascular surgical treatment was documented in reasonable detail (both baseline and follow-up) in accordance with the documentation system of the Austrian Society of Vascular Surgery. On-line data entry with use of SAS data-base management software was used. The patency curves were estimated in accordance with the Kaplan-Meier method; possible differences were checked by means Breslow's and Mantel's tests. The preoperative clinical status (claudicants, n = 200; limb salvage, n = 263) influenced the postoperative results in a statistically significant manner (Breslow p less than 0.01; Mantel p less than 0.03). All the other risk factors analyzed (site of distal anastomosis above versus below the knee, n = 231, and n = 232, respectively; Breslow p less than 0.58, Mantel p less than 0.58. Presence [n = 122] or nonpresence [n = 341], of diabetes mellitus [Breslow p less than 0.77, Mantel p less than 0.68]; smoking habits [nonsmokers, n = 93, smokers n = 370, Breslow p less than 0.68, Mantel p less than 0.69;]) did not reach statistical significance. Anticoagulant treatment (n = 101) had no effect (Breslow p less than 0.93, Mantel p less than 0.72), even when the therapy was restricted to cases with disease at advanced clinical stages (stages III, IV; n = 50; Breslow p less than 0.55, Mantel p less than 0.95). On the basis of these analyses, a prospective trial was initiated in 1979. Eighty-eight patients were studied; those in group I (n = 42) received dicumarol, and those in group II (n = 46) were controls who did not receive anticoagulant treatment. At present, the median follow-up time is at 30 months. Treatment with dicumarol favorably influenced graft patency (Breslow, p less than 0.03, Mantel p less than 0.07; one-tailed tests). The patients' preoperative clinical status affected the results of surgery (Breslow p less than 0.03, Mantel p less than 0.02; one-tailed tests). In relation to the preoperative clinical status, a therapeutic effect was observed in stages III and IV (n = 45; Breslow p less than 0.03, Mantel p less than 0.07; one-tailed tests), while no effect of therapy was demonstrable in claudicants (n = 43; Breslow p less than 0.3, Mantel p less than 0.4; one-tailed tests).(ABSTRACT TRUNCATED AT 400 WORDS)

Topics: Aged; Arteriosclerosis; Clinical Trials as Topic; Dicumarol; Female; Femoral Artery; Humans; Male; Middle Aged; Popliteal Artery; Postoperative Care; Prospective Studies; Random Allocation; Recurrence; Risk

A patient is described with polycythemia vera who was taking anticoagulants and developed a spontaneous retropharyngeal hemorrhage after a violent sneezing episode. This progressed to tracheal compression with stridor after he had taken some aspirin for relief of the neck pain. An emergency tracheostomy was life saving.

Topics: Airway Obstruction; Arteriosclerosis; Constriction, Pathologic; Dicumarol; Ecchymosis; Hematoma; Humans; Male; Middle Aged; Neck; Pharyngeal Diseases; Polycythemia Vera; Tracheal Diseases; Tracheotomy

Chronic investigations (up to 3 years) conducted in dogs have evidenced that periodic disturbances of vascular permeability produced by using dicoumarin with a long-term blocking of the thyroid function greatly aggravate pathological manifestations induced by the action of 6-methylthiouracil. They result in the development in the animals of endogenous hypercholesterinemia, elevated content in the blood of beta-lipoproteins and in a periodic rise of the arterial pressure. These changes were particularly spectacular at the final stage of the experiment in animals with marked manifestations of atherosclerosis and were accompanied by reduced stand-by potentialities of the adrenal gland, disruption of metabolic processes in the myocardium along with the slowed down resorption of NaI131 from the heart muscle. The sensitivity of the heart to adrenalin was down too.

Topics: 17-Hydroxycorticosteroids; Adrenal Cortex; Animals; Arteriosclerosis; Capillary Permeability; Dicumarol; Disease Models, Animal; Dogs; Lipids; Methylthiouracil

Topics: Acenocoumarol; Adult; Aged; Arteriosclerosis; Dicumarol; Female; Humans; Male; Middle Aged; Myocardial Infarction; Thromboangiitis Obliterans; Transaminases

Topics: Adult; Aged; Anticoagulants; Aortic Aneurysm; Arteriosclerosis; Arteritis; Blood Coagulation Disorders; Blood Coagulation Tests; Diabetic Angiopathies; Dicumarol; Embolism; Female; Humans; Male; Middle Aged; Raynaud Disease; Thrombophlebitis; Thrombosis; Vascular Diseases

Topics: Aged; Arteriosclerosis; Diagnosis, Differential; Dicumarol; Gastrointestinal Hemorrhage; Hematoma; Humans; Jejunum; Male; Radiography

Topics: Anticholesteremic Agents; Anticoagulants; Arteriosclerosis; Cholesterol; Collateral Circulation; Coronary Disease; Dicumarol; Diet Therapy; Digitalis Glycosides; Humans; Manipulation, Orthopedic; Nikethamide; Vasodilator Agents

Topics: Aneurysm; Animals; Aortic Aneurysm; Aortography; Arteries; Arteriosclerosis; Arteriosclerosis Obliterans; Blood Coagulation; Blood Vessel Prosthesis; Dextrans; Dicumarol; Dogs; Female; Fibrinolytic Agents; Heparin; Humans; Male; Methods; Nylons; Phenindione; Plastics; Postoperative Complications; Suture Techniques; Thrombosis; Vascular Surgical Procedures; Vitamin K

Topics: Adult; Aged; Amputation, Surgical; Arteriosclerosis; Diabetes Mellitus; Dicumarol; Female; Femoral Artery; Follow-Up Studies; Gangrene; Heparin; Humans; Hypercholesterolemia; Male; Middle Aged; Plethysmography; Popliteal Artery; Prognosis; Recurrence; Surgical Wound Infection

Topics: Adult; Aged; Arteriosclerosis; Blood Coagulation; Blood Coagulation Tests; Cerebrovascular Disorders; Coronary Disease; Dicumarol; Female; Femoral Artery; Humans; Male; Middle Aged; Myocardial Infarction; Retinal Vessels; Thrombosis

Topics: Animals; Aorta; Arteries; Arteriosclerosis; Capillary Permeability; Cholesterol; Coronary Vessels; Dicumarol; Dogs; Lipid Metabolism; Lipoproteins; Methods; Methylthiouracil

Topics: Anticholesteremic Agents; Anticoagulants; Arteriosclerosis; Cholesterol; Choline; Diabetes Complications; Dicumarol; Humans; Hyperlipidemias; Hypertension; Nicotinic Acids; Obesity; Phospholipids; Smoking; Stress, Physiological; Thyroxine; Vasodilator Agents; Warfarin

Topics: Arteriosclerosis; Arteriosclerosis Obliterans; Chronic Disease; Dicumarol; Heparin; Humans; Postoperative Complications; Thrombosis

Topics: Animals; Arteriosclerosis; Dicumarol; Diet, Atherogenic; Dietary Fats; Dogs; Electrocardiography; Hypercholesterolemia; Lipids; Methylthiouracil

Topics: Arteriosclerosis; Atrial Fibrillation; Cerebrovascular Disorders; Coronary Disease; Dicumarol; Diet; Diet Therapy; Family Practice; General Practice; Humans; Intracranial Embolism; Intracranial Embolism and Thrombosis; Myocardial Infarction; Prothrombin Time; Thrombosis; Vitamin K; Warfarin

Topics: Arteriosclerosis; Blood Platelets; Dicumarol; Diet; Endothelium; Fats; Heparin; Vascular Diseases

Topics: Anticoagulants; Arteriosclerosis; Cholesterol; Coronary Disease; Dicumarol; Hyperlipidemias; Iodine Isotopes; Lipids; Trichloroacetic Acid; Triolein; Warfarin

Topics: Arteriosclerosis; Blood Platelets; Coumarins; Dicumarol; Humans

Topics: Anticoagulants; Arteriosclerosis; Biomedical Research; Dicumarol; Research Design

Topics: Arteriosclerosis; Blood Coagulation; Coumarins; Dicumarol; Fibrinolysis; Humans; Lipid Metabolism; Lipids

Topics: Anticoagulants; Arteriosclerosis; Atherosclerosis; Blood Coagulation; Dicumarol; Heparin; Humans