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At least 1,297 records · Page 72Linked to original sources
PubMed1987

Placebo-controlled comparison of captopril, atenolol, labetalol, and pindolol in hypertension complicated by intermittent claudication.

In a six month placebo-controlled cross-over trial twenty patients with hypertension and peripheral arterial disease were randomised to captopril 25 mg twice daily, atenolol 100 mg once daily, labetalol 200 mg twice daily, or pindolol 10 mg twice daily for one month. Although all treatments were equally effective at lowering blood pressure, pain-free and maximum walking distances on a treadmill were decreased by atenolol, labetalol, and pindolol, but not by captopril. Post-exercise calf blood flow availability was impaired by atenolol, labetalol, and pindolol, but not by captopril. Despite ancillary characteristics of cardioselectivity, intrinsic sympathomimetic activity, or combination with alpha-blockade, beta-blockers seem to impair the lower limb circulation in such patients, whereas captopril seems to preserve it, possibly by maintaining the collateral blood supply.

Atenolol↗
PubMed2002

Management of intermittent claudication.

Medical management of PAD is a considerable challenge. Although patients typically present with IC, there is a substantial pool of subclinical PAD patients. PAD, whether symptomatic or not, confers a marked cardiovascular risk; with affected patients dying of heart attack or stroke, identification of index patients and aggressive medical treatment can offer health benefits far in excess of improvement in IC or related symptoms. Management of risk factors, lifestyle interventions, and pharmacologic treatment with agents to provide symptomatic relief have a central role in improving function and quality of life and slowing the progression to advanced endpoints, such as the rest pain, nonhealing ulcers, gangrene, and cardiac death. Surgical or percutaneous revascularization for aorto-iliac disease provides durable treatment for individuals with disabling symptoms. Newer treatments, such as angiogenic growth factor treatments, are being tested in clinical trials and seem promising. There are limited treatment choices for individuals with predominant infra-popliteal disease. In the future, the availability of newer stents and therapies to prevent re-stenosis may extend the applicability of endovascular treatment to difficult-to-treat infra-inguinal lesions.

Disease Susceptibility↗
PubMed2001

Color Doppler used to detect kinking and intravascular lesions in the iliac arteries in endurance athletes with claudication.

OBJECTIVE: In endurance athletes, flow limitations in the iliac arteries are commonly ascribed to mechanically induced intravascular lesions (endofibrosis). We hypothesize that kinking of the vessels, occurring during exercise, can also cause such flow limitations. Conventional diagnostic tests fail to demonstrate such kinking. METHODS: In the current study, the iliac arteries were examined in 50 endurance athletes suffering from flow limitations in the iliac arteries with color Doppler using provocative maneuvers of hip flexion, isometric psoas contraction and exercise. Five had both-sided complaints resulting in 55 symptomatic legs and 45 asymptomatic legs. Sixteen national level competitive cyclists served as control subjects resulting in 32 healthy reference legs. RESULTS: The iliac arteries could be visualized accurately in 127/132 (96%) of the legs. The legs with insufficient image quality were not scored in the further analysis. In the external iliac artery, kinks were detected in 21/54 symptomatic legs (39%) compared to none in 28 reference legs. Intravascular lesions could be detected in 33/54 symptomatic legs (61%) compared to only 1/28 reference legs (4%). In the symptomatic legs Doppler measurements showed significantly higher peak systolic velocities in all test conditions compared to the reference legs (P<0.05). These differences increased significantly with provocative maneuvers (P<0.05).In the common iliac artery, kinks were demonstrated in 3/54 symptomatic legs (6%) and an intravascular lesion in 2/54 symptomatic legs (4%) only. Neither kink nor intravascular lesions were demonstrated in the reference legs. Peak systolic velocity measurements in the common iliac artery were in line with these observations and did not show differences between symptomatic and reference legs. The incidence of intravascular lesions in the external and common iliac artery is as expected, however, the incidence of kinks in the common iliac artery is much lower than reported from magnetic resonance angiography. This discrepancy is most probably caused by the fact that kinks in the common iliac artery are predominantly situated in the coronal plane, which cannot be visualized by color Doppler. CONCLUSION: Both kinks and intravascular lesions are associated with flow limitations in the iliac arteries in endurance athletes. Color Doppler appears to be an effective technique to visualize and scale kinks and intravascular lesions in the external iliac artery and to visualize and scale intravascular lesions in the common iliac artery.

Adult↗
PubMed2003

Effects of orally administered OP-1206 alpha-CD with loxoprofen-Na on walking dysfunction in the rat neuropathic intermittent claudication model.

An orally active prostaglandin E1 analogue, OP-1206 alpha-CD improves walking dysfunction in the rat spinal stenosis model. Loxoprofen-Na, a non-steroidal anti-inflammatory drug, is used to relieve chronic pain in patients with lumbar spinal canal stenosis. To determine whether the OP-1206 alpha-CD in combination with loxoprofen-Na could induce a greater therapeutical effect on walking dysfunction and spinal cord blood flow (SCBF) than OP-1206 alpha-CD treatment alone after chronic spinal stenosis in the rat. Spinal stenosis was induced by placing two pieces of silicon rubber strips in the lumbar (L4 and L6) epidural space of rats. After surgery, walking function was measured using a treadmill apparatus and SCBF was measured using a laser-Doppler flow meter. Drugs were administered orally twice a day for 11 days from the day 3 post-surgery. OP-1206 alpha-CD elicited a significant improvement of walking dysfunction on days 7 and 14 post-surgery and significantly increased spinal cord blood flow on day 15, whereas walking dysfunction and SCBF of rats treated with loxoprofen-Na alone remained unchanged. Combined treatment of OP-1206 alpha-CD with loxoprofen-Na did not provide additive therapeutical effect. These results suggest that a significant improvement seen after OP-1206 alpha-CD treatment is primarily mediated by improvement of the local spinal cord blood flow. This effect is not ameliorated or potentiated by a combined treatment with loxoprofen-Na.

Administration, Oral↗
PubMed1997

Percutaneous transluminal angioplasty increases thromboxane A2 production in claudicants.

Percutaneous transluminal angioplasty is an acute, local stimulus to platelets which activation is regarded as an important factor for a later restenosis. The balance between the production of prostacyclin and thromboxane A2 is of (patho)physiological importance due to their opposite actions on vascular tone and platelet reactivity. In this study we investigated the influence of percutaneous transluminal angioplasty of the peripheral arteries on prostacyclin and thromboxane A2 productions in vivo by measuring the excretions of their urinary index metabolites, 2,3-dinor-6-ketoprostaglandin F1 alpha and 11-dehydrothromboxane B2, respectively, in 10 patients. We found a twofold increase in thromboxane A2, but no significant change in prostacyclin, production after peripheral transluminal angioplasty which shifted prostacyclin/thromboxane A2 balance to the direction of thromboxane A2 formation. This gives theoretical support to the use of thromboxane A2 synthase inhibitors and receptor antagonists as well as prostacyclin analogues in combination with peripheral percutaneous transluminal angioplasty to prevent thrombosis and restenosis.

6-Ketoprostaglandin F1 alpha↗