- 1.1. Five classes of turbulence have been described: (1) that exceeding the critical reynolds number; (2) lateral inflow mixing; (3) anatomic expansion; (4) dynamic expansion; (5) orifice or flow-deflection type.
- 2.2. The normal configuration of the aortoiliac area allows for Class 4 turbulence under basal conditions, probably laminar flow during some degree of mild to moderate exercise, and for compression-laminar flow during heavy exercise. The aortoiliac tree, therefore, is an ideal hydraulic system only during one specific degree of body exercise.
- 3.3. Turbulence occurs in the normal arterial tree at each and every site of predilection to atherosclerosis. Intra-arterial turbulence can be Class 1, 3, 4, or 5, or a mixture of these.
- 4.4. Once an atherosclerotic plaque projecting into the lumen occurs, it causes turbulence distal to the site of the plaque.
- 5.5. Thoracic aortic stenosis insufficient to cause a pressure gradient leads to turbulence and intensification of atherosclerosis immediately distal to the site of stenosis in atherosclerotic canine preparations.
- 6.6. Areas of turbulence at sites of predilection may cause or accelerate the onset of the atherosclerotic lesion by causing a critical injury in the wall as a result of highfrequency vibrations and/or by local suppression of secretion (or increased filtration) of lipids secondary to the local hypertension (increased lateral wall pressure) resulting from areas of local stasis and/or jet-stream impingement upon the arterial wall.
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☆Supported in part by grants-in-aid from the United State Public Health Service, the New York City Health Research Council, and the Johnson and Johnson Research Laboratories.
☆☆Presented at the Eighteenth Annual Meeting of the Society for Vascular Surgery, San Francisco, Calif., June 21, 1964.