The effect of continuous i.v. infusion of pentoxifylline, administering 1,200 mg/24 hours through 15 days, was studied in 22 patients (19 m, 3 f) with arterio graphically confirmed extensive occlusion in the femoro-popliteal segment, as sociated with marked intermittent claudication and rest pain of varying sever ity.
The following parameters were used for the verification of the therapeutic response: Flow resistance factor (RF), pressure indices at rest (RPI) and after exercise (PPI and recovery time (RT) assessed by means of ultrasonic Doppler technique; muscle and skin blood flow at rest and after exercise using 99m Technetium Clearance Technique (TC); toe skin temperature (TST) by electric thermometer; painfree walking distance (WD) assessed on treadmill (horizon tal, 4 km/h); rest pain (RP) was assessed by a 4-step-relief-scale.
There was an overall good response to treatment, the studied parameters showing the following changes: RF improved in 12/17 patients (= 70%); RT decreased in 14/22 patients (= 63%) RPI and PPI showed no change; TC (mus cle) increased after exercise in 17/22 patients (= 77%); TC (skin) increased after exercise in 20/22 patients (= 90%); WD increased on average by 80% (from 115 m to 206 m); TS increased in 16 limbs; RP showed an overall relief.
The results of this study indicate that the continuous infusion of pentoxifyl line is safe and effective in improving the condition of patients with severe pe ripheral vascular disease.
Get full access to this article
View all access options for this article.
References
1.
Angelides NS, Nicolaides AN, Eastcott Hhg: The value of Doppler velocity tracings in femoropopliteal disease. In: Kriessmann A and Bollinger A, Eds., Ultraschall-Doppler-Diagnostik in der Angiologie. Stuttgart: Georg Thieme Verlag, 1978.
2.
Angelides NS: Haemodynamic changes in the arterial circulation of the lower limbs in patients with claudication. PhD Thesis, London University, 1980.
3.
Angelides NS: Isolated profunda femoris artery occlusion: The mechanism of thigh claudication studied by 99mTc muscle clearance from the thigh and calf. Angiology2:94-102, 1981.
4.
Angelides NS , Nicolaides AN: Simultaneous isotope clearance from the muscles of the calf and thigh. BrJ Surg67:220, 1980.
5.
Angelides NS , Nicolaides AN, Needham T., Dudley H.: The mechanism of calf claudication: studies of simultaneous clearance of 99mTc from the calf and thigh. Br J Surgery65:204, 1978.
6.
Angelkort B. , Maurin N., Boateng K.: Influence of Pentoxifylline on erythrocyte deformability in peripheral occlusive arterial disease. Curr Med Res Opin6:255, 1979.
7.
Buchanan N., Moodley GP: The effect of Pentoxifylline on human erythrocyte adenosine triphosphate. IRCS Med Sci5:43, 1977.
8.
Carter SA: Indirect systolic pressure and pulse curves in arterial occlusive disease of the lower extremities. Circulation37:624, 1968.
9.
Ehrly AM: The effect of Pentoxifylline on the deformability of erythrocytes and on the muscular oxygen pressure in patients with chronic arterial disease. J Med10:331, 1979.
10.
Leonhardt H. , Grigoleit HG: Effects of Pentoxifylline on red blood cell deformability and blood viscosity under hyperosmoral conditions. Arch Pharmacol299:197, 1977.
11.
Nicolaides AN , Angelides NS: Waveform Index and Resistance Factor using directional Doppler ultrasound and a zero crossing detector. In: Investigation of vascular disorders, Eds., Nicolaides and Yao, Churchill Livingstone, 1981.
12.
Smud R., Sermukslis B., Kartin D.: Changes in blood viscosity induced by Pentoxifylline. Pharmatherapeutica , I:229, 1976.
13.
Störmer B., Kleinschmidt K., Losse D., Kremer K.: Rheological changes in blood of patients with chronic arterial occlusive disease after administration of vasoactive drugs. Curr Med Res Opin4:588, 1977.
14.
Weithmann KU : The influence of Pentoxifylline on interactions between blood vessel wall and platelets. IRCS Med Sci8:293, 1980.
15.
Yao ST: Haemodynamic studies in peripheral arterial disease. Br J Surg57:761, 1970.
