Peripheral Vascular Disease (cont.)

Medical Author:

Shabir Bhimji, MD

Coauthor:

Kathryn L Hale, MS, PA-C

Medical Editor:

Alan D Forker, MD

Medical Editor:

Francisco Talavera, PharmD, PhD

Medical Editor:

Jonathan Adler, MD

Medications

Whether medication is a good choice for you depends on the underlying cause of your peripheral vascular disease. Medications used to treat peripheral vascular disease and intermittent claudication include those that aim to lower the risk and progression of atherosclerosis throughout the body, such as those to help stop smoking, lower blood pressure, lower cholesterol, and optimize the blood sugar in people with diabetes.

Two medications have been approved by the United States Food and Drug Administration (FDA) for direct treatment of the symptom of intermittent claudication.

• Pentoxifylline (Trental): How this drug helps in intermittent claudication is not completely understood. It is believed to improve blood flow by decreasing the viscosity of blood and making red blood cells more flexible. With these alterations, the blood can move more easily past obstructions in the blood vessel.
  
  
• Cilostazol (Pletal): This drug keeps platelets from clumping together. This clumping promotes formation of clots and slows down blood flow. The drug also helps dilate, or expand, the blood vessels, encouraging the flow of blood.

Sudden blockage of an artery by a blood clot (thrombus) has been treated with medication for many years. Choices include antiplatelet agents, anticoagulants, and "clot-busters" (thrombolytics).

• Antiplatelet agents include aspirin, ticlopidine, and clopidogrel. These agents do not get rid of an existing clot. They prevent further clots from forming by keeping blood cells and platelets from clumping together.
  
  
• Anticoagulant agents include heparin, warfarin (Coumadin), enoxaparin (Lovenox), and low-molecular-weight heparin: These agents also do not remove an existing clot. They interfere with the sequence of blood clotting factors that causes a clot to form.
  
  
• Thrombolytics: These are powerful drugs that can actually dissolve an existing clot. They can be used only under certain circumstances and are given only in the hospital. They can be injected directly into the blocked artery under angiographic guidance. To be effective, they have to be administered intravenously within the first 4-8 hours after a patient develops symptoms. 
  
  

The most effective medications are those that help prevent the development and progression of atherosclerosis.