The early effects of intravenous L-propionyl carnitine on ulcerative trophic lesions of the lower limbs in arteriopathic patients: a controlled randomized study.
Large numbers of patients with severe peripheral arteriopathic disorders (Stage IV) present a characteristic clinical history of pain and ulcerative trophic lesions requiring either major or minor amputation. Recent studies have shown that L-propionyl-carnitine (LPC) can possibly moderate the tissue damage induced by ischaemia in peripheral arteriopathic disorders. In the present study 12 patients with severe obstructive chronic arteriopathy were treated either with 2 g of LPC (plus heparin and buflomedil) by slow infusion b.i.d, or by placebo plus heparin and buflomedil. In the LPC-treated patients, one lesion was completely healed (17%); two showed a > 50% decrease in the surface of the ulcerative lesion (34%) and three a reduction in such surface < 50% (50%). Control patients showed a reduction < 50% of the ulcerative lesions in two cases (34%), unaltered limits of the ulcer margin in three cases (50%) and worsening of such a lesion in one case. In addition, the LPC-treated patients showed a progressive reduction in the evening pain symptom as monitored by the fewer requested doses of the analgesic compound ketoprofen (77 vs 125 requests for administration in treated and control patients, respectively). The long-term effect of LPC treatment evaluated after three months showed that in treated patients only one minor (digital) amputation was performed, whereas in the control group two patients underwent minor (digital and foot) and one major (above knee) amputations. In conclusion, the results of the present preliminary study suggest that LPC administration can improve the healing of ulcerative lesions, can reduce the need for analgesic medication and can lessen the incidence of amputation.
Persico
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G
VII Division of General Surgery and Microsurgery, University of Naples Federico II, Italy.
Amato
B
B
Aprea
G
G
Cerfolio
P
P
Markabaoui
A K
AK
D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D001157:Arterial Occlusive Diseases / Q000150:complications*; D001777:Blood Coagulation / Q000187:drug effects; D002331:Carnitine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007660:Ketoprofen / Q000008:administration & dosage / Q000627:therapeutic use; D007871:Leg Ulcer / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications*; D012039:Regional Blood Flow / Q000187:drug effects / Q000502:physiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; C003223:propionylcarnitine; D007660:Ketoprofen; D002331:Carnitine