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PubMed1990

[Acral skin circulation following intra-arterial infusion of vasodilating substances in patients with intermittent claudication].

The value of vasodilator drugs for the conservative treatment of peripheral arterial occlusive disease is widely questioned because clinical and experimental studies have shown paradoxical redistribution phenomena of blood flow in disfavour of an already ischemic peripheral circulation. This paper deals with acute effects of intraarterially infused prostaglandin E1 and buflomedil on the overall foot sole perfusion as well as its distribution patterns. Measurements were performed in patients with sufficiently compensated obstructions of the superficial femoral artery by means of dynamic fluorescein angiography. After i.a. infusion in general an increase of the total blood supply to the feet was found. However, in response to this common vasodilator effect in some patients apparently non-perfused circumscribed skin areas occurred which could never be observed under control conditions. With respect to these results the clinical value of vasodilator drugs as well as the meaning of such adverse redistribution phenomena are discussed from a pathophysiological and pharmacodynamical point of view. It is proposed that the therapeutical concept of pharmacological vasodilation should not be rejected in general. However, special attention should be paid to the development of steal effects.

Aged↗
PubMedDate not supplied

[Relation of social support, stress level and intermittent claudication].

The possible action, as risk factor of peripheral arteriosclerosis, of the emotional stress; the effect of the social support to deaden this stress, and some aspects of the personality as fundamental regulator of the individual behaviour, are analyzed. 23 atherosclerotic patients, II degree, were valued and compared with a control group of the same age and sex.

Adult↗
PubMedDate not supplied

[The importance of the claudication test performed on a treadmill and its use in clinical practice].

A group of 55 patients with lower limb occlusive arterial disease was submitted to a treadmill walking exercise test in order to estimate the walking exercise length. The treadmill speed was fixed at 3 km/h and the carpet incline was 0% and 12% respectively. Doppler method for blood pressure estimation was applied in 10 patients to art. brachialis and art. dorsalis pedis bilaterally prior to and 2.5 and 10 minutes after the test. The ankle pressure index was calculated prior and post exercise. Results showed 51 +/- 9% difference between patients walking (3 km/h/0%) and patients climbing (3 km/h/12%). Ischaemic pain and blood pressure fall over art. dorsalis pedis during exercise correlated significantly 2 and 5 minutes after the test. Arteria dorsalis pedis pressure at rest and 2 and 5 minutes post exercise was statistically significant. Blood pressure indices prior and post exercise were related in the same manner. There was no difference in art. dorsalis pedis pressure and ankle pressure indices in our control group. The walking treadmill exercise test showed to be a simple reliable method for estimation of the functional degree of lower limb arterial insufficiency and for assessment of their surgical or drug therapy.

Adult↗