Effect of oral pentoxifylline therapy on venous lower extremity ulcers due to deep venous incompetence.

The effect of oral pentoxifylline, administered 1,200 mg/day (400 mg slow-release tablets tid) through six weeks, was studied in 10 patients with established deep venous incompetence and persisting venous ulcers. The following parameters were used for verification of the therapeutic result: venous patency (VP) and valvular competence (VC) assessed by means of Doppler ultrasound; venous refilling time (VRT) assessed by photoplethysmography; skin blood flow (SBF) at rest and after tiptoeing exercise, as well as skin perfusion pressure (SPP), both assessed by means of 99mtechnetium clearance technique. Finally, photo documentation of the tissue lesion was obtained, using a two-dimensional (max and min diameter = Dmax, Dmin) metered scale photo. There was an overall good response to the treatment, the studied parameters showing the following changes: VP and VC remained unchanged; VRT improved in 8 patients, SBF increased in 10; SPP slightly improved in 5; and Dmax and Dmin in all 10 patients. Removal or substantial diminution of the ulcers was obtained in 8 patients. These findings indicate that oral administration of pentoxifylline over a period of six weeks supports the conservative treatment and improves considerably the condition of patients with persisting venous ulcers.

Intravenous pentoxifylline in the treatment of rest pain: a preliminary report.

Twenty patients with ischemic rest pain were treated with intravenous pentoxifylline, 1,200 mg daily, for up to three weeks. Ten patients obtained sufficient relief to avoid surgical intervention. Seven of these had complete or near complete relief of rest pain, but the other three required continuing analgesia. Transcutaneous oxygen measurements showed a significant increase after the course of treatment. There were marked gastrointestinal side effects in six patients, necessitating early withdrawal from the study. Three of these six patients had shown a favorable response to medication prior to withdrawal. These preliminary results suggest that pentoxifylline may provide a sufficient increase in tissue oxygen availability to avoid, or at least postpone, surgical intervention. A double blind controlled study is required to further assess the efficacy of this drug as an intravenous treatment.