Related Experiment Videos
Effect of high dose verapamil on restenosis after peripheral angioplasty
1Klinik für Innere Medizin I der Klinikum Chemnitz gGmbH, Germany.
Insights
High-dose verapamil effectively prevented restenosis after peripheral angioplasty in high-risk patients. This treatment was well-tolerated and reduced intima-media thickening and stenosis over six months.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Pharmacology
Background:
- Restenosis remains a significant complication following percutaneous transluminal coronary angioplasty (PTCA).
- Calcium channel blockers, including verapamil, have shown potential in mitigating the restenosis process.
Purpose of the Study:
- To evaluate the efficacy of high-dose verapamil in preventing restenosis post-PTCA.
- To assess verapamil's impact on vascular remodeling and clinical outcomes in high-risk patients.
Main Methods:
- A placebo-controlled, double-blind, randomized trial involving 98 patients with peripheral occlusive arterial disease (POAD) and other risk factors for restenosis.
- Patients received either high-dose verapamil (240 mg twice daily) or placebo for six months post-PTCA.
- Efficacy was measured by intima-media thickness, degree of stenosis, septal thickness, vascular pressures, claudication distance, and vessel diameter.
Main Results:
- Verapamil significantly inhibited intima-media thickening at six weeks and six months post-PTCA compared to placebo.
- Significant reduction in septal thickness and a lower restenosis rate were observed in the verapamil group.
- No significant intergroup differences were noted immediately after PTCA, but verapamil demonstrated clear benefits by six months.
Conclusions:
- High-dose verapamil effectively prevents restenosis in high-risk POAD patients for up to six months after peripheral angioplasty.
- Verapamil treatment was well-tolerated, with only minor side effects reported.
- These findings support verapamil as a therapeutic option to improve outcomes after PTCA in at-risk populations.
Objectives:
We sought to determine whether treatment with high dose verapamil prevents restenosis in patients at high risk for reoccurrence after successful percutaneous transluminal coronary angioplasty (PTCA).
Background:
Restenosis is the major limitation of PTCA. Calcium antagonists have demonstrated some potential as inhibitors of this process.
Methods:
A total of 98 patients with peripheral occlusive arterial disease (POAD), stable angina pectoris, mild hypertension and at least one additional risk factor increasing the likelihood of restenosis after angioplasty were selected for this placebo-controlled, double-blind, randomized trial. Verapamil (240 mg twice daily) or placebo was taken for 6 months. Efficacy variables assessed before and after angioplasty and at 6 weeks and 6 months after PTCA included thickness of the intima/media complex degree of stenosis, interventricular septal thickness, crurobrachial pressure ratios of dorsalis pedis and posterior tibial arteries, distance to claudication and total vessel diameter.
Results:
No significant intergroup differences emerged before or immediately after PTCA. Six weeks after angioplasty, a significant thickening of the intima/media complex in the treated vascular segment of 14.3% occurred in the placebo group versus 0% among verapamil patients (p < 0.01). At 6 months, the intima/media thickness was 35.7% greater in the placebo group but had decreased by 14.3% in the verapamil group (p < 0.001). At 6 months, a marked reduction in septal thickness was observed in the verapamil group versus that in the placebo group (p < 0.001). The rate of restenosis was also significantly lower in the verapamil group (p < 0.001). Few minor side effects were reported.
Conclusions:
In patients with POAD at increased risk for restenosis, the administration of high dose verapamil prevented recurrent stenosis for 6 months after successful peripheral angioplasty and was well tolerated.