Intravenous naftidrofuryl for critical limb ischaemia

Smith, F. B.; Bradbury, Andrew W.; Fowkes, Gerry

doi:10.1002/14651858.cd002070

Cited by 17 publications

(9 citation statements)

References 9 publications

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“…A recent Cochrane review of intravenous administration of naftidrofuryl included eight trials with a total of 269 participants . The trials were generally of low quality, and the duration of treatment was short.…”

Section: Primary Treatment Of CLImentioning

confidence: 99%

Medical management of critical limb ischaemia: where do we stand today?

Lambert

Belch

2013

J Intern Med

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Critical limb ischaemia (CLI) is a severe form of peripheral arterial disease (PAD). CLI often causes disabling symptoms of pain and can lead to loss of the affected limb. It is also associated with increased risk of myocardial infarction, stroke and death from cardiovascular disease. The aims of management in patients with CLI are to relieve ischaemic pain, heal ulcers, prevent limb loss, improve function and quality of life and prolong survival. Here, current evidence regarding the medical management of CLI is reviewed. Cardiovascular risk factors should be assessed in all patients with CLI; smoking cessation and treatment of hypertension, hyperlipidaemia and diabetes all reduce the mortality rate in those with PAD. Antiplatelet agents (either aspirin or clopidogrel) are recommended to reduce both the incidence of cardiovascular events and risk of arterial occlusion. By contrast, routine use of anticoagulation (either warfarin or heparin) is not recommended.

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Section: Primary Treatment Of CLImentioning

confidence: 99%

Medical management of critical limb ischaemia: where do we stand today?

Lambert

Belch

2013

J Intern Med

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“…Further vasoactive drugs such as naftidrofuryl, buflomedil or pentoxifylline did not show additional benefit with regard to reduction of amputations and wound healing. 2,52 Recommendation Parenteral prostanoids can be used in patients with critical limb ischaemia not suitable for arterial revascularisation or after unsuccessful revascularisation. (Level 1b; Grade B)…”

Section: Vasoactive Drugsmentioning

confidence: 99%

Chapter III: Management of Cardiovascular Risk Factors and Medical Therapy

Diehm

Schmidli

Setacci

et al. 2011

European Journal of Vascular and Endovascular Surgery

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Critical limb ischaemia (CLI) is a particularly severe manifestation of lower limb atherosclerosis posing a major threat to both limb and life of affected patients. Besides arterial revascularisation, risk-factor modification and administration of antiplatelet therapy is a major goal in the treatment of CLI patients. Key elements of cardiovascular risk management are smoking cessation and treatment of hyperlipidaemia with dietary modification or statins. Moreover, arterial hypertension and diabetes mellitus should be adequately treated. In CLI patients not suitable for arterial revascularisation or subsequent to unsuccessful revascularisation, parenteral prostanoids may be considered. CLI patients undergoing surgical revascularisation should be treated with beta blockers. At present, neither gene nor stem-cell therapy can be recommended outside clinical trials. Of note, walking exercise is contraindicated in CLI patients due to the risk of worsening pre-existing or causing new ischaemic wounds. CLI patients are oftentimes medically frail and exhibit significant comorbidities. Co-existing coronary heart and carotid as well as renal artery disease should be managed according to current guidelines. Considering the above-mentioned treatment goals, interdisciplinary treatment approaches for CLI patients are warranted. Aim of the present manuscript is to discuss currently existing evidence for both the management of cardiovascular risk factors and treatment of co-existing disease and to deduct specific treatment recommendations.

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“…When revascularization procedures have failed or for whom revascularization is not technically possible, particularly when amputation is the only alternative, a category of drugs called vasoactives could be one of the best alternatives (Smith, Bradbury, & Fowkes, ). Also, because there is a high incidence of coronary events and stroke in patients with peripheral arterial disease, the antiplatelet therapy has been recommended to minimize vascular events and increase survival of patients (Baigent et al, ; Committee, ).…”

Section: Conventional Therapies For CLI Treatmentmentioning

confidence: 99%

Critical limb ischemia: Current and novel therapeutic strategies

Hassanshahi

Khabbazi

Peymanfar

et al. 2019

Journal Cellular Physiology

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Critical limb ischemia (CLI) is the advanced stage of peripheral artery disease spectrum and is defined by limb pain or impending limb loss because of compromised blood flow to the affected extremity. Current conventional therapies for CLI include amputation, bypass surgery, endovascular therapy, and pharmacological approaches. Although these conventional therapeutic strategies still remain as the mainstay of treatments for CLI, novel and promising therapeutic approaches such as proangiogenic gene/protein therapies and stem cell‐based therapies have emerged to overcome, at least partially, the limitations and disadvantages of current conventional therapeutic approaches. Such novel CLI treatment options may become even more effective when other complementary approaches such as utilizing proper bioscaffolds are used to increase the survival and engraftment of delivered genes and stem cells. Therefore, herein, we address the benefits and disadvantages of current therapeutic strategies for CLI treatment and summarize the novel and promising therapeutic approaches for CLI treatment. Our analyses also suggest that these novel CLI therapeutic strategies show considerable advantages to be used when current conventional methods have failed for CLI treatment.

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Intravenous naftidrofuryl for critical limb ischaemia

Cited by 17 publications

References 9 publications

Medical management of critical limb ischaemia: where do we stand today?

Medical management of critical limb ischaemia: where do we stand today?

Chapter III: Management of Cardiovascular Risk Factors and Medical Therapy

Critical limb ischemia: Current and novel therapeutic strategies

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