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Vol 7, No 1-2 (2001)
Research paper
Published online: 2001-10-18

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Changes in oxidative stress parameters in patients with peripheral vascular disease in response to conservative and surgical treatment

Łukasz Partyka, Jadwiga Hartwich, Włodzimierz Drożdż, Anna Gruca, Renata Jopek, Danuta Karcz, Aldona Dembińska-Kieć
Acta Angiologica 2001;7(1-2):29-41.


Introduction. Reperfusion of ischemic tissue is associated with oxidative burst. Systemic response e.g. neutrophil and platelet activation, metabolic changes, free radical and cytokine production resulting in endothelial injury are the typical features of ischemia/reperfusion.
Materials and methods. Twenty four patients (group C) with chronic leg ischemia (Fontaine grade II) undergoing conservative (12 weeks of controlled treadmill training and pentoxifylline administration (400 mg p.o; t.i.d.) and 14 patients (group O) (Fontaine grade III), who underwent surgical revascularization were included in the present study. Revascularization included aorto-femoral or femoro-popliteal bypass implantation. Blood samples for evaluation of oxidative stress: plasma lipid peroxide level (TBARS) and the ex vivo LDL suscepti bility for oxidation, as well as for measurement of the plasma antioxidant status (total plasma antioxidative power - FRAP), and total plasma thiol/albumin ratio were collected before and after the treadmill exercise workload at the entry, after 6 and after 12 weeks from initiation of the treatment. The changes in clinical status were expressed by the treadmill pain-free walking distance and ankle/arm index values.
Results. The surgical revascularization resulted in the significant improvement of clinical parameters demonstrated by reduction of patient complaints as well as by increased ankle/arm index values, smaller ischemic field and prolongation of pain-free and maximal walking time. An increase of the pain-free walking distance and the decrease of ischaemic field, but any improvement of the ankle/arm index was observed in the conservative therapy group. However, surgical revascularisation did not protect patients from increased oxidative stress expressed by the TBARS concentration and LDL susceptibility to oxidation ex vivo. On the contrary, the conservative therapy resulted in the increased plasma antioxidant status measured by the FRAP assay and the increased plasma thiol/albumin ratio.
Conclusion. The surgical revascularization did not protect patients with advanced peripheral arterial disease from ischemia/reperfusion oxidative stress what argue for the complementary supplementation of antioxidants during therapy.

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