Medical treatment of peripheral vascular disease: are there new perspectives?

In Raynaud's phenomenon few new medical treatment options have become available in recent years, but the merits and demerits of drugs already longer available have been established more firmly. Calcium antagonists remain the treatment of first choice even despite their frequent side effects. Prostacyclin analogues are effective but oral formulations are still eagerly awaited. In PAOD attention is shifting from the often disappointing medical treatment of symptoms to possible secondary prevention. Except for the effects of some prostanoids little clinical benefit is obtained from vasodilators and rheologically active drugs. Attempts to influence skeletal muscle metabolism with carnitine-analogues like 1-carnitine are interesting but clinical benefit has not yet been proven. In the next few years results of trials with lipid-lowering drugs to stop progression of atherosclerotic lesions will become available.