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In macroangiopathy, fat and blood clots build up in the large blood vessels, stick to the vessel walls, and block the flow of blood.
The decrease of blood flow through stenosis or clot formation impair the flow of oxygen and nutrients to cells further down the bloodstream (called ischemia) and lead to their death (necrosis and gangrene, which in turn may require amputation). Plasma homocysteine level could be one of the number of independent risk factor for macroangiopathy in patients with diabetes mellitus and they can be reduced by parental treatment with mecobalamine(Neuromet by Merck).
Related conditions 
(Angiopathy is the generic term for a disease of the blood vessels (arteries, veins, and capillaries). The best known and most prevalent angiopathy is the diabetic angiopathy, a complication that may occur in chronic diabetes.
There are two types of angiopathy: macroangiopathy and microangiopathy.
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