Value of vasoactive drugs in conservative therapy of peripheral arterial occlusive disease

: Based on controlled clinical trials, vasoactive drugs (pentoxyfylline, naftidrofuryl, buflomedil) and prostanoids (alprostadil, iloprost) are used in symptomatic peripheral arterial occlusive disease: In stage II, vasoactive drugs are prescribed in order to improve leg hyperemia in response to muscular work; in complicated stage II (e.g., non-healing traumatic skin lesions), and in stages III/IV, prostanoids are given in order to increase forefoot skin blood flow. These drugs should only be applied if neither angioplasty nor vascular surgery are recommendable, possible, or successful after complete angiological diagnostic. It should be considered that these substances have a rather limited clinical efficacy in both stage II and stages III/IV and therefore attempts should be made to select patients with a reasonable chance to benefit. These drugs are also not suitable for primary or secondary prophylaxis against the progression of vascular lesions.