Effect of vasoactive drugs on antioxidant status and endothelial function in patients with chronic lower limb ischaemia in Fontaine’s stage IIb

Abstract

Background. Atherosclerotic lower limb ischemia is the most important cause of intermittent claudication. Patients with intermittent claudication are at relatively low risk of limb loss. Therefore the predominant therapeutic approach in this group of patients is conservative treatment. The objective of this study was a comparison of bencyclane versus pentoxifilline effects on the clinical picture (pain free walking distance and maximum walking distance) and selected parameters of oxidative stress including blood level of nitric oxide (NO) and total antioxidant status of the plasma in patients with chronic lower limb ischaemia (Fontaine IIb).
Material and methods. Adult patients (60 subjects) with claudication distance shorter than 200 m (Fontaine II b) were divided into three groups: I. 20 patients administered bencyclane 200 mg i.v. for 7 days followed by 2 × 200 mg orally for 21 days; II. 20 patients administered pentoxifilline 300 mg i.v. for 7 days followed by 2 × 600 mg orally for 21 days; III. 20 patients administered placebo i.v. for 7 days followed by 2 × 1 tablet orally for 21 days. In all patients walking distance until first pain, maximum walking distance and ankle brachial index (ABI) were measured. In all patients blood samples were taken on days 0, 7, 14 and 28 of the treatment and blood levels of nitric oxide (NO) and plasma total antioxidant status (TAS) were measured.
Results. Statistically significant increase in pain-free walking distance i.e. 127 ± 37.95 m in patients administered bencyclane (p < 0.001) and 125.29 ± 41.10 m in patients administered pentoxifilline (p < 0.001) was observed. Total antioxidant status (TAS) of the plasma and blood levels of nitric oxide also increased in patients treated with bencyclane and pentoxifilline (p < 0.05).
Conclusions. The administration of bencyclane and pentoxifilline is an effective therapeutic approach for patients with Fontaine II b chronic limb ischaemia. No significant differences were found in efficacy of the two active treatments in the study.