ABSTRACT
Treatment Claudicatio Occlusive disease of the femoropopliteal artery, if symptoms are absent or limited to mild claudicatio, can be treated conservatively with smoking cessation, control of cholesterol, maintenance of arterial blood pressure below 140/90 in nondiabetics and 130/80 in diabetics, accurate control of blood sugar, and antiplatelet therapy. If symptoms of claudicatio impair the quality of life, a supervised exercise program should be considered. Several drugs have been evaluated in the medical treatment of claudicatio. Cilostazol (a phosphodiesterase III inhibitor) is the most effective available drug and has been shown to be superior to pentoxifylline in increasing peak treadmill performance and quality of life. However, it can have side-effects such as headache, diarrhea, and palpitations and is contraindicated in congestive heart failure.4,5 Naftidrofuryl (a 5-hydroxytryptamine type 2 antagonist with few, mild sideeffects) improves by 26% treadmill performance when compared with placebo.6 Pentoxifylline and buflomedil have few side-effects but their clinical impact on claudicatio seems very limited when compared with placebo. Vasodilators are ineffective, as are antiplatelet drugs, but this latter group is essential in preventing further complications and advancement of cardiovascular disease. Intravenous prostaglandins improve performance in the treadmill test while effectiveness of oral prostaglandins has not been proven and cannot be currently recommended in the treatment of claudicatio.4 Research is still under way to evaluate the efficacy of fibroblast growth factor and vascular endothelial growth factor.
