defibrotide and Chronic-Disease

The authors provide evidence for the efficacy of the buflomedil-pentoxifylline-defibrotide combination for treatment of lower limb chronic obstructive arterial disease, Fontain stage II. Improvement of walking autonomy obtained with these agents ranged from 50 to 100% in 29 of 36 patients (relative frequency = 0.80).

Topics: Aged; Aged, 80 and over; Arterial Occlusive Diseases; Chronic Disease; Drug Therapy, Combination; Female; Fibrinolytic Agents; Humans; Male; Middle Aged; Pentoxifylline; Polydeoxyribonucleotides; Pyrrolidines; Vasodilator Agents

Topics: Aged; Anaphylaxis; Chronic Disease; Drug Hypersensitivity; Female; Fibrinolytic Agents; Humans; Polydeoxyribonucleotides; Skin Tests; Venous Insufficiency

In the present study the effect of defibrotide, an antithrombotic and profibrinolytic agent, was investigated in patients with chronic venous insufficiency (CVI) due to deep vein obstruction and/or reflux (chronic deep vein insufficiency, CDVI).. The study was a multicenter, randomized, double blind placebo controlled trial in which only patients with CDVI confirmed by ultrasound were enrolled. All patients were treated with adequate elastic compression and randomized to receive either oral defibrotide (800 mg/die) or matching placebo for 1 year. Patients with active or previous leg ulcer were excluded.. A total of 288 patients were randomized and 159 completed the study. At baseline ultrasound investigation, obstructive changes were found in 2/3 of all patients thus ascertaining a post-thrombotic syndrome (PTS). The primary endpoint, ankle circumference, was significantly reduced under defibrotide from day 120 throughout 360. Scores for pain and edema were improved. The number of episodes of superficial thrombophlebitis and deep vein thrombosis was significantly lower under defibrotide (n=2) than under placebo (n=10). The majority of these events occurred in the subset of patients with documented PTS.. Treatment with defibrotide in addition to elastic compression in patients with objectively assessed CDVI, mostly due to PTS, resulted in clinical benefits and prevented thrombotic complications harmful to the limb conditions.

Topics: Aged; Ankle; Bandages; Chronic Disease; Double-Blind Method; Female; Fibrinolytic Agents; Humans; Male; Middle Aged; Polydeoxyribonucleotides; Ultrasonography, Doppler; Vascular Diseases; Venous Thrombosis

Primary deep venous insufficiency (PDVI) represents an important cause of chronic venous insufficiency (CVI). The clinical picture is generally related to a congenital weakness of the vein wall at the level of the valvular ring which may dilate its diameter with consequent lengthening and prolapse of the valvular cusps. However, in an initial stage of PDVI the leaflets are normally formed and may undergo restorative surgery. In this condition an external banding valvuloplasty (EBV) with a Dacron sleeve around the incompetent valve may restore the competence. The authors report 54 cases of superficial femoral vein EBV performed over a period of 1986 to 1991. The patients were affected by signs of CVI and/or relapsing, complicated or atypical varices in which descending venography showed a grade II, III or IV primary deep reflux. In a mean follow-up of 38 months (4 to 63 months) deep reflux had disappeared in 41 patients (76%), had significantly decreased in 8 (14.8%) and was completely unmodified in 5 (9.2%). According to the experience of other authors, these results suggest the therapeutic validity of EBV in the initial stage of PDVI.

Topics: Adolescent; Adult; Chronic Disease; Female; Femoral Vein; Fibrinolytic Agents; Follow-Up Studies; Heparin; Humans; Male; Phlebography; Polydeoxyribonucleotides; Postoperative Complications; Treatment Outcome; Venous Insufficiency

Topics: Arterial Occlusive Diseases; Aspirin; Chronic Disease; Epoprostenol; Fatty Acids, Monounsaturated; Humans; Methacrylates; Polydeoxyribonucleotides; Pyridines; Thromboxane A2; Thromboxane-A Synthase