The Efficacy of the Transdermal Isosorbide Dinitrate Patch in Patients With Chronic Limb-Threatening Ischemia

Area of Science:

• Vascular Medicine
• Dermatology
• Regenerative Medicine

Background:

• Peripheral artery disease (PAD), particularly chronic limb-threatening ischemia (CLTI), is increasing globally, driven by rising rates of diabetes and dialysis.
• Revascularization is standard for CLTI, but some patients experience persistent poor circulation, necessitating additional treatments.
• Existing therapies like apheresis, hyperbaric oxygen, and spinal cord stimulation have variable efficacy, highlighting the need for novel approaches.

Purpose of the Study:

• To evaluate the efficacy and safety of transdermal isosorbide dinitrate patch (ISDN-P) for patients with CLTI.
• To assess the impact of ISDN-P on skin perfusion pressure (SPP) as an indicator of wound healing potential in CLTI patients.

Main Methods:

• The study involved healthy volunteers and patients diagnosed with CLTI.
• Transdermal isosorbide dinitrate patch (ISDN-P) was applied to the foot.
• Skin perfusion pressure (SPP) was measured on the dorsal and plantar aspects of the foot before and after ISDN-P application.

Main Results:

• ISDN-P application significantly increased SPP in both healthy volunteers and CLTI patients.
• Specifically, SPP increased on both dorsal and plantar aspects in CLTI patients (P < .05).
• No major complications or significant changes in blood pressure were observed in patients treated with ISDN-P.

Conclusions:

• Transdermal isosorbide dinitrate patch (ISDN-P) is an effective and safe therapeutic option for improving peripheral circulation in patients with CLTI.
• The observed increase in SPP suggests ISDN-P may enhance wound healing potential in this patient group.
• ISDN-P represents a promising adjunctive therapy for refractory cases of CLTI where conventional treatments are insufficient.