OBLITERATIVE VASCULAR DISEASE

Abstract

Obliterative vascular disease is characterized by a sudden organic occlusion or a gradual narrowing of the arterial tree. The viability of the affected part or organ will depend on the rapidity with which a collateral circulation can be established. In studying the methods that nature utilizes to effect the maintenance of a sufficient circulation, one may observe that blood pressure usually rises above an arterial obstruction, thereby forcing blood more readily into the preformed but unused channels. This presupposes an adequate myocardial reserve. Should this be low, as in arteriosclerosis with hypotension, a support of the blood pressure with digitalis or ephedrine is helpful.¹Secondly, the peripheral vascular bed enlarges, an effect designated by Bier "blood thirst" of the tissues and probably due to the accumulation of metabolites in the ischemic or anemic area. This peripheral vasodilatation may be supported and augmented by drugs, notably theobromine,²and by