A new study demonstrates the efficacy of naftidrofuryl in the treatment of intermittent claudication. Findings of the Naftidrofuryl Clinical Ischemia Study (NCIS).

Background: The efficacy and safety of naftidrofuryl were assessed in a double blind, placebo controlled, parallel group study, in patients presenting with intermittent claudication, according to the latest European guidelines.

Methods: The outpatients selected were of both sexes, aged 35 to 85, with moderately severe chronic, stable intermittent claudication and a pain-free (PFWD) and maximum walking distance (MWD) on the treadmill of between 100 and 300 metres. They received naftidrofuryl 200 mg tid or placebo for six months and were then assessed during a six-month follow-up period without treatment.

The effect of naftidrofuryl on transcutaneous oxygen tension during a treadmill test in patients with peripheral arterial occlusive disease.

Tissue hypoxaemia can be evaluated by the noninvasive method of transcutaneous oxygen tension (tcpO2) measurement in patients with peripheral arterial occlusive disease (PAOD). The effects of naftidrofuryl (Praxilene) on exercise-induced tissue ischaemia was objectively assessed by continuously measuring the tcpO2 in 30 patients during three treadmill tests over a 3-month period in a randomized double-blind, placebo controlled, parallel group study. To be included in the study, the tcpO2 and total walking distance had to be stable during the washout period (D-15-D0).

Short-term evaluation of plaque area measurement reproducibility from computer-assisted sonography.

One reason why quantifying plaque regression is difficult is the poor spatial control of the shooting angle whether in angiography or ultrasonography techniques. A computer-assisted technique has been developed to assess absolute carotid plaque dimensions from B-mode ultrasonography, with enhanced capability of comparative examinations at large time intervals. Plaque area is measured from arterial lumen to adventitia with a real-time tissular detection program.

Evaluation of ifenprodil efficacy on exercise-induced tissue ischemia in stage II arteriopathy by measurement of transcutaneous oxygen tension during a standard treadmill test: double-blind study of injectable ifenprodil versus placebo.

Measurement of transcutaneous oxygen tension (TcPO2) is a noninvasive and easily reproducible method for objectifying and quantifying exercise ischemia in patients with stage II occlusive arterial disease. This technique is also used at rest to evaluate the therapeutic effect of vasoactive treatments. To objectively assess the effectiveness of a vasoactive treatment on the conditions of tissue perfusion, a randomized double-blind study of ifenprodil tartrate versus placebo was performed in 20 patients, whose TcPO2 was continuously measured while they walked on a treadmill.

[Venous endoscopy].

The miniaturization of endoscopic equipment now allows exploring the superficial venous system and visualizing the endovein in situ and in vivo. This type of venous endoscopy is an ambulatory procedure, performed during a simple outpatient consultation of angiology, after which the patient is immediately discharged. Although this examination is invasive, non-physiological and expensive, it allows the video recording of the morphology, dynamics and kinetics of the values, of the endovein and of the liquid flows (blood, washing fluid and sclerosing products).

Objectifying exercise ischemia in peripheral vascular disease: a study in 120 patients.

This study presents the results of transcutaneous oxygen pressure (TcPO2) monitoring during a treadmill test walk performed in the early stages of peripheral obliterative vascular disease. The study population consisted of a first group of 50 known arteriopathic patients presenting, on questioning, with intermittent claudication; a second group of 50 known arteriopathic patients void of any symptoms of intermittent claudication; and a third group, which was a control cohort of 20 nonarteriopathic, nonclaudicating patients. Though resting TcPO2 cannot be used to aid the clinical diagnosis of exercise ischemia it may be useful in revealing asymptomatic chronic resting ischemia (9% of cases in this series).

[Hormones and venous system].

Sex hormones have an effect on venous "content" and "container" according to their chemical nature, their dosage and their mode of administration: 17 beta-estradiol (endogenous): protective effect; synthetic estrogens, at normal or low doses: thrombogenic; oral natural estrogens: thrombogenic; extra-digestive natural estrogens: non thrombogenic; non steroid progestagens (androgenic): thrombogenic; non androgenic progestagens: non thrombogenic. Clinically, the venous disease si characterized by sudden episodes occurring at key-periods of the hormonal life: puberty, pregnancy, menopause, oral contraceptives intake, substitute treatments of menopause, premenstrual syndrome. Evaluation of these different situations shows that an early treatment is possible and needed, which, although not providing a new venous wall for these constitutionally fragile patients, may act effectively at two levels: 1) correction of the haemodynamic disorder (venous reflux in the saphenous arches and the perforators; 2) resorption of tissue infiltration.

[Modification of the level of adenosine triphosphate in digital pulp capillary blood in patients with microcirculatory disorders following i.v. injection of coenzyme A (CoA 1000)].

Capillary blood ATP assay was performed in 2 groups of patients (diabetic and non-diabetic) with disorders of microcirculation, before and several minutes after 2 mg I.V. of Coenzyme A (CoA 1000).