[Drug therapy in peripheral arterial occlusive disease]

Drugs used for improvement or stabilization of peripheral circulation include antiaggregants or anticoagulants for secondary prevention of arteriosclerosis, vasoactive substances and fibrinolytic agents. -Two prospective trials document that aspirin or the combination of aspirin and dipyridamole reduce progression of arterial occlusive disease significantly in comparison to placebo. Aspirin is best suited for secondary prevention of recurrent stenoses or occlusions after carotid or femoral endarterectomy, whereas anticoagulants are preferred in patients with embolism and after peripheral implantation of venous bypasses. -Significant improvement of walking distance is achieved by several compounds influencing blood rheology. The effect does not exceed that obtained by physical training. If reconstructive arterial surgery or percutaneous transluminal angioplasty are not possible, some patients with rest pain or gangrene may be successfully treated by intraarterial administration of prostaglandin E1.