piperidines and Arteriosclerosis-Obliterans

Ketanserin is a new strong antiserotoninergic drug that, unlike the previous ones, is selective for 5-hydroxytryptamine receptors. This drug has been employed successfully in the treatment of arterial hypertension and of some peripheral vascular diseases. The authors are carrying out a trial on medium term treatment with ketanserin (K) or propranolol (P) in comparison with placebo, to evaluate their effects on blood pressure, haemocoagulative parameters and peripheral circulation. The trial is a double-blind cross-over random trial on subjects with mild or moderate hypertension. Until now 13 patients have ended the study; six of them are suffering from arteriosclerosis obliterans of the lower limbs at 1st or 2nd stage according to Fontaine. Both propranolol and ketanserin significantly reduced the blood pressure, although the decrease in systolic blood pressure was more evident after propranolol. Heart rate diminished significantly only after propranolol administration. The noninvasive, intermittent (every 30 min) monitoring of blood pressure showed a significant 24-hour reduction of blood pressure after administration of propranolol or ketanserin without significant changes of circadian behaviour of the blood pressure. After administration of ketanserin a slight improvement in peripheral circulation was demonstrated, evaluated by using strain-gauge plethysmography. As regards the results obtained for platelet function and other haemocoagulative parameters examined, adenosine diphosphate-induced platelet aggregation, adenosine diphosphate slope, collagen lag period, antithrombin III biological activity, and serum fibrinogen did not show noticeable modifications after treatment, while beta-thromboglobulin levels decreased slightly after ketanserin administration.

Topics: Adult; Antihypertensive Agents; Arteriosclerosis Obliterans; Blood Coagulation; Blood Pressure; Double-Blind Method; Female; Heart Rate; Humans; Hypertension; Ketanserin; Leg; Male; Middle Aged; Piperidines; Propranolol; Random Allocation; Regional Blood Flow

An 82-year-old woman with amyotrophic lateral sclerosis (ALS) with bulbar paralysis, respiratory muscle paralysis, and arteriosclerosis obliterans (ASO) of the lower extremities, underwent uneventful general anesthesia with remifentanil and sevoflurane for bilateral below-knee amputation. Remifentanil is a potent ultra short-acting opioid analgesic drug, undergoes rapid metabolism by non-specific tissue and plasma esterases, and does not accumulate to any clinically important degrees. Furthermore, when remifentanil is used together with propofol during anesthetic induction, successful tracheal intubation can be accomplished without muscle relaxants. These features of remifentanil make it an ideal agent for use in patients with neuromuscular diseases, including ALS, with higher risks of postoperative opioid-induced respiratory depression.

Topics: Aged, 80 and over; Amputation, Surgical; Amyotrophic Lateral Sclerosis; Anesthesia, General; Arteriosclerosis Obliterans; Female; Humans; Leg; Methyl Ethers; Piperidines; Postoperative Complications; Remifentanil; Respiratory Distress Syndrome; Sevoflurane

A seventy-four-year-old woman with arteriosclerosis obliterans, diabetes mellitus, and hypertension was admitted for the treatment of intermittent claudication and coldness and pain in the right lower extremity. After the administration of a vasopressin V1 antagonist, OPC21268, the symptoms were markedly improved. Furthermore, blood flow in the dorsalis pedis artery and the cutaneous temperature in the right foot increased in response to acute and chronic administration of OPC21268. OPC21268 may be a new useful therapeutic tool for the treatment of arteriosclerosis obliterans.

Topics: Aged; Arteriosclerosis Obliterans; Female; Foot; Humans; Piperidines; Quinolones; Radiography; Regional Blood Flow; Skin; Skin Temperature

A new technique consisting of continuous intraarterial infusion of the ultra-short-lived 81mKr for the study of blood flow in patients with severe peripheral vascular disease is described. With the gamma camera high resolution images and typical time activity curves, reflecting local regional blood flow in the feet, could be obtained under resting conditions during reactive hyperemia and administration of vasodilating drugs. Preliminary promising results of Ketanserin, a new selective serotonin antagonist, in patients with impending gangrene and ulcerations are discussed.

Topics: Animals; Arteriosclerosis Obliterans; Cats; Diabetic Angiopathies; Female; Humans; Hyperemia; Ketanserin; Krypton; Leg; Male; Piperidines; Radioisotopes; Radionuclide Imaging; Regional Blood Flow; Serotonin; Serotonin Antagonists; Thromboangiitis Obliterans; Vascular Diseases

Topics: Arteriosclerosis Obliterans; Humans; Piperidines; Plethysmography; Propiophenones; Raynaud Disease; Theophylline; Xanthinol Niacinate

Topics: Aged; Arteriosclerosis Obliterans; Female; Humans; Leg; Male; Middle Aged; Muscles; Piperidines; Retrospective Studies; Thromboangiitis Obliterans

Topics: Adult; Aged; Anticonvulsants; Arteriosclerosis Obliterans; Blood Pressure; Femoral Artery; Hemodynamics; Humans; Kidney; Leg; Middle Aged; Muscles; Piperidines; Propiophenones; Renal Artery