Pharmacologic treatment for intermittent claudication.
In contradistinction to chronic critical limb ischemia, the peripheral arterial disease patient with intermittent claudication is at relatively low risk for limb loss. As a result, initial claudication management should employ non-interventional therapies rather than immediate catheter-based or surgical revascularization. Although exercise therapy is the most efficacious conservative treatment for claudication, supervised exercise programs are not widely available at present. Consequently, a pharmacologic agent can be utilized to lessen the symptoms and improve the function of the claudicant. This manuscript provides a comprehensive review of the various pharmacotherapies that have been investigated for improving walking distance in the setting of intermittent claudication. Cilostazol, a phosphodiesterase III inhibitor, appears to provide the greatest benefit, significantly improving not only walking distance but quality of life as well. Early trials indicate that propionyl-L-carnitine, oral prostaglandins, L-arginine, and therapeutic angiogenesis may eventually yield significant benefit in lessening the symptoms of intermittent claudication.
Dean
Steven M
SM
Vascular Services of Ohio, Columbus, OH, USA. sdean1@columbus.rr.com
D002986:Clinical Trials as Topic; D006801:Humans; D007383:Intermittent Claudication / Q000188:drug therapy*; D014665:Vasodilator Agents / Q000627:therapeutic use*
D014665:Vasodilator Agents