Regulation of Distal Blood Perfusion: Local Control of the Peripheral Circulation in Functional and Critical Ischemia, and in Patients with Abdominal Aortic Aneurysm
Abstract
The blood flow rate in the tissues of the extremities is autoregu lated so perfusion is constant despite changes in systemic arterial pressure; modulations of arteriolar tone are constantly modifying microvascular blood flow according to metabolic needs, and a local sympathetic venoarteriolar axon reflex is operative as an edema protecting mechanism. In the arteriove nous anastomoses of the pulps there is neither autoregulation nor venoarteri olar reflex. In patients with intermittent claudication, these phenomena are not disturbed, but in patients with critical limb ischemia, the blood flow rate is extremely low, and the vascular bed is paralysed with the absence of autoregulation and of venoarteriolar reflex. In patients with nonspecific infrarenal aortic aneurysm, the peripheral blood flow rate is four times high er than in normal controls, but autoregulation and venoarteriolar reflex are present; the responses of the pulp shunt vessels are like those of normal sub jects. These findings imply a peripheral functional component affecting arte rioles but not arteriovenous anastomoses.
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References
Second European Consensus Document on chronic critical leg ischemia. Circulation 1991;84(4 Suppl):IV1-26
Second European Consensus Document on chronic critical leg ischemia. Eur J Vasc Surg 1992;6(Suppl A):1-32
Henriksen O. , Nielsen SL, Paaske WP, Sejrsen P. Autoregulation of blood flow in human cutaneous tissue. Acta Physiol Scand 1973;89:538-543
Henriksen O. , Nielsen SL, Paaske WP Autoregulation of blood flow in human adipose tissue. Acta Physiol Scand 1973;89:531-537
Tonnesen KH, Sejrsen P. Washout of 133Xenon after intramuscular injection and direct measurement of blood flow in skeletal muscle. Scand J Clin Lab Invest 1970; 25:71-81
Henriksen O. Local sympathetic reflex mechanism in regulation of blood flow in human subcutaneous adipose tissue. Acta Physiol Scand 1977;450(Suppl):1-48
Anderson E., Boesen F., Henriksen O. Local and central sympathetic reflex control of blood flow in skeletal muscle and subcutaneous tissue in man. Clin Physiol 1991;11: 451-458
Paaske WP Capillary permeability in skeletal muscle. Acta Physiol Scand 1977; 101: 1-14
Henriksen O. , Kastrup J., Parving H-H., Lassen NA Loss of autoregulation of blood flow in subcutaneous tissue in juvenile diabetes. J Cardiovasc Pharmacol 1984; 6(Suppl 4):S666-S670
Midttun M., Sejrsen P. Blood flow rate in arteriovenous anastomoses and capillaries in thumb, first toe, ear lobe, and nose. Clin Physiol 1986 ;16:275-289
Midttun M. Blood flow rate in arteriovenous anastomoses: from the cradle to the grave . Clin Physiol 2000;20:360-365
Midttun M., Sejrsen P., Paaske WP Peripheral blood flow rates and microvascular responses to orthostatic pressure changes in claudicants before and after revascularisation. Eur J Vasc Endovasc Surg 1999;17:225-229
Henriksen O. , Sejrsen P. Local reflex in microcirculation in human skeletal muscle. Acta Physiol Scand 1977;99:19-26
Henriksen O. Sympathetic reflex control of blood flow in human peripheral tissues. Acta Physiol Scand 1991;603(Suppl):33-39
Paaske WP, Henriksen O. Vascular resistance in peripheral blood vessels at normotension and at local orthostatic hypertension in healthy humans. Acta Physiol Scand 1975;95:463-469
Nielsen SL, Sejrsen P. Reactive hyperaemia in subcutaneous adipose tissue in man. Acta Physiol Scand 1972;85:71-77
Midttun M., Sejrsen P., Paaske WP Blood flow rate during orthostatic pressure changes in the pulp skin of the first toe. Eur J Vasc Endovasc Surg 1997;13:278-284
Faris I., Nielsen HV, Henriksen O., Parving H-H., Lassen NA Impaired autoregulation of blood flow in skeletal muscle and subcutaneous tissue in longterm Type 1 insulin-dependent diabetic patients with microangiopathy . Diabetologia 1983;25:486-488
Rutherford RB , Baker JD, Ernst C., et al. Recommended standards for reports dealing with lower extremity ischemia: revised version . J Vasc Surg 1997;26:517-538
Watson CJ, Phillips D., Hands L., Collin J. Claudication distance is poorly estimated and inappropriately measured . Br J Surg 1997;84:1107-1109
Henriksen O. Orthostatic changes of blood flow in subcutaneous tissue on patients with arterial insufficiency of the legs. Scand J Clin Lab Invest 1974;34:103-109
Eickhoff JH, Henriksen O. Local regulation of subcutaneous forefoot blood flow during orthostatic changes in normal subjects, in sympathetically denervated patients and in patients with occlusive arterial disease. Cardiovasc Res 1985;19:219-227
Jelnes R., Tonnesen KH Nocturnal foot blood flow in patients with arterial insufficiency . Clin Sci 1984;67:89-95
Jelnes R. Development of gangrene during sleep. Scand J Clin Lab Invest 1990;50: 351-361
Sejrsen P., Henriksen O., Paaske WP Effect of orthostatic blood pressure changes upon capillary filtration-absorption rate in the human calf. Acta Physiol Scand 1981;111: 287-291
Henriksen O. , Sejrsen P., Paaske WP, Eickhoff JH Effect of chronic sympathetic denervation upon the transcapillary filtration rate induced by venous stasis. Acta Physiol Scand 1983;117:171-176
Midttun M., Sejrsen P., Paaske WP Is non-specific aneurysmal disease of the infrarenal aorta also a peripheral microvascular disease? Eur J Vasc Endovasc Surg 2000;19: 625-629
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Article first published: January 2002
Issue published: January 2002
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Published online: January 1, 2002
Issue published: January 2002
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This article was published in Perspectives in Vascular Surgery and Endovascular Therapy.
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