Pharmacotherapy for critical limb ischaemia

Critical limb ischaemia involves a severe disturbance of both macrocirculation and microcirculation. Provided revascularisation can be performed (balloon angioplasty, bypass procedures or other reopenings), the major pharmacological problem is to reduce the risk of early thrombosis and midterm hyperplastic growth. Adjuvant treatment for the former is useful, while the latter has not yet found any specific solution. When no technical prerequisites exist for revascularisation, which means extremely deranged vascular morphology, pharmacotherapy can be tried to reduce the specific micro-circulatory events. Results are far from good, though significant reduction of amputations and deaths may be achieved with certain drugs.