[Drug therapy of peripheral arterial occlusive disease]

Vasoactive drugs may be effective via four mechanisms of action: vasodilatation, increase of driving pressure, improvement of blood fluidity and amelioration of the metabolism of the perfused tissue. Vasodilators in severe stages of peripheral arterial occlusive disease may involve hazards due to redistribution phenomena. The newer vasoactive drugs supposedly act by improving rheology and/or metabolism. Although a number of trials suggest clinical improvement of claudication, the primary use of vasoactive drugs cannot be recommended. In clinical practice vasoactive drugs should be discontinued when no effect can be verified in the individual treated. In pain at rest and/or gangrene, all the deobliterating procedures must be exhausted before drug therapy is given.