Pharmacotherapy for peripheral arterial disease: emerging therapeutic options.
Although endovascular therapy has revolutionized the management of patients with peripheral arterial disease (PAD), noninterventional regimens, such as structured exercise therapy, atherosclerotic risk factor modification, and pharmacotherapy, are effective in patients suffering from mild-to-moderate PAD and intermittent claudication (IC). For more than a decade, the only pharmacologic therapy for IC available in the United States was pentoxifylline, which had demonstrated superiority in improving walking distances but offered minimal clinical benefit. Recently, basic research into the pathophysiology of IC has led to the development of cilostazol, a new pharmacologic agent approved for treatment of this condition in 1999. Ongoing research in the use of angiogenic growth factors has further broadened the range of potential alternatives to treatment in patients with PAD. Revascularization procedures, including nonsurgical and surgical techniques, can thus be reserved to improve patency and reduce the risk of limb loss in patients with PAD and IC with more severe impairment.
Jaff
Michael R
MR
The Vascular Ultrasound Core Laboratory, Morristown NJ 07960, USA. docmrjaff@aol.com
D000924:Anticholesteremic Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001120:Arginine / Q000627:therapeutic use; D001157:Arterial Occlusive Diseases / Q000188:drug therapy*; D002331:Carnitine / Q000627:therapeutic use; D000077407:Cilostazol; D006801:Humans; D007383:Intermittent Claudication / Q000188:drug therapy; D010431:Pentoxifylline / Q000627:therapeutic use; D016491:Peripheral Vascular Diseases / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011453:Prostaglandins / Q000627:therapeutic use; D013777:Tetrazoles / Q000627:therapeutic use; D014654:Vascular Patency; D014665:Vasodilator Agents / Q000627:therapeutic use*
D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D010975:Platelet Aggregation Inhibitors; D011453:Prostaglandins; D013777:Tetrazoles; D014665:Vasodilator Agents; D001120:Arginine; D000077407:Cilostazol; D002331:Carnitine; D010431:Pentoxifylline