[Spinal electrostimulation in the treatment of advanced chronic obliterating arteriopathies]. / L'elettrostimolazione spinale nel trattamento delle arteriopatie obliteranti croniche in stadio avanzato.

From 1989 to 1992 83 patients suffering from peripheral vascular disease without medical or surgical possibilities, were treated by spinal cord stimulation (SCS). We studied claudicatio intermittens, rest pain and ischemic lesion behaviour in all the patients. We also studied microcirculation behaviour of 21 patients, by oxygen transcutaneous tension (vasodilatation index VI = TcPO2 42 degrees C: TcPO2 45 degrees C) and laser Doppler flowmetry (resting flow RF, standing flow SF, venoarteriolar reflex VAR = RF - SF, flow temperature increase FTI = F 40 degrees C 15'-RF). The clinical follow-up at 2 years showed an improvement of walking distance in 85.7% of 7 controls, a complete rest pain control in 82.35% of 17 controls, an improvement and healing of ischemic lesions respectively in 27.07% and 53.86% of 18 controls. In arteriosclerotic arteriopathy with or without diabetes but without neuropathy VI increased and FTI decreased, after SCS, showing a sympathetic tone decrease. In arteriosclerotic arteriopathy with diabetic neuropathy V.I. decreased and FTI increased, after SCS, showing a sympathetic tone reappearance. VAR improved or reappeared, in arteriosclerotic arteriopathy with or without diabetes, showing improvement of tissue perfusion as regards a better efficiency of "paramicrovessels" and "microvascular unit". We believe that SCS, as regards favourable clinical results represents a useful and effective treatment in peripheral vascular disease treatment.

Indobufen vs acetylsalicylic acid plus dipyridamole in long-term patency after femoropopliteal bypass.

To compare the effects of indobufen (INB) with those of ASA+dipyridamole (DP) on graft patency, 113 patients undergoing femoropopliteal bypass surgery were randomly and blindly assigned to treatment with INB 400 mg daily or with ASA 900 mg daily plus DP 225 mg daily. Treatment started 2 days before surgery and lasted for 12 months. All patients underwent two angiographic examinations: the first early after surgery (mean 6 days) and the second at the end of the study (mean 368 days). The 1 year cumulative patency rate for INB was 60% higher but not statistically different from the ASA-DP group (53.2%). The relative risk (INB/ASA+DP) calculated by the Mantel-Haenszel test was 0.86 (confidence limits 0.54-1.35). Only the site of operation (above-knee or below-knee) has a significant prognostic value on the fate of the graft.

[Buflomedil in the treatment of chronic peripheral arterial diseases. Case contribution]. / Il Buflomedil nel trattamento delle arteriopatie croniche periferiche. Contributo casistico.

A group of 29 patients with arteriopathy, many inoperable or unsuccessfully operated, were treated intravenously and/or orally with Loftyl. 14 2nd stage patients benefited from the treatment, as shown by the prolongation of the interval between attacks in 3 cases and by the disappearance of a limp in one case. 3rd and 4th stage patients also showed good results, especially considering the severity of some cases. Loftyl was also well-tolerated, even at higher doses than those recommended.