Gangrene of the toes with palpable peripheral pulses

Thirty-five patients with gangrene or pregangrene of the feed associated with palpable peripheral pulses have been treated with the platelet suppressive drugs aspirin and dipyridamole. Sulphinpyrazone was substituted for two patients who could not tolerate aspirin. Complete reversal of the signs and symptoms occurred in more than 50% of the treated patients. Recurrence of pain occurred in the five patients in whom antiplatelet therapy was discontinued. Reversal of symptoms was again achieved by reintroduction of the drugs. An increased incidence of spontaneous platelet aggregation and hypersensitive platelets was observed in those patients who responded to platelet suppressive therapy. These results indicate that platelet suppressive therapy is of therapeutic value in selected patients with peripheral gangrene.