Arteriographic findings in EDTA chelation therapy on peripheral arteriosclerosis

Article Abstract:

Ethylenediaminetetraacetic acid (EDTA) chelation therapy has been used as alternative treatment for peripheral vascular disease. The goals of conservative treatment are to improve circulation, avoid adverse effects of nicotine and carbon monoxide and, if necessary, reduce the weight load on the legs. Supporters of EDTA claim that it not only provides symptomatic relief, but also cures arteriosclerotic disease. Reports on its effectiveness have been reported in holistic medicine literature, but these studies have not met scientific standards. A report is presented of a randomized, double-blind controlled study of the effectiveness of EDTA chelation therapy for treatment of intermittent claudication (weakness and cramps of the legs). There were 150 patients with intermittent claudication randomized to receive 20 infusions of either EDTA or saline (salt solution). Before, during and after treatment measurements were made of ankle/brachial indices (ratio of systolic blood pressure in the lower leg to that at the end of the arm) and maximum walking distance. Patients' subjective evaluations were also recorded. No significant difference between the treatment groups was found in distance that could be walked, nor was there any significant difference between the groups in ankle/brachial indices. Arteriography (X-ray examination of the artery following injection of radio-opaque contrast dye) was performed on 30 patients before and after treatment. This study showed no change or worsening in 28 patients; two cases showed improvement, but one patient had received saline while the other received EDTA. There was no significant difference between the two treatment groups in pre- and post-treatment transcutaneous oxygen tension. It is concluded that EDTA chelation therapy has no beneficial effect on patients with intermittent claudication due to arteriosclerosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Arteriosclerosis, EDTA, Ethylenediaminetetraacetic acid

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Conventional versus thrombolytic therapy in spontaneous (effort) axillary-subclavian vein thrombosis

Article Abstract:

Spontaneous, or effort-induced, axillary-subclavian vein thrombosis is an abnormal condition in which clotting elements and debris attach to the interior wall of a major vein in the area of the collar bone and shoulder. This condition more commonly occurs in men under 40 and is believed to be multifactorial in origin. External compression of the vein by the shoulder muscles may reduce blood flow; exercise may cause the blood to become excessively vulnerable to clotting; and repeated arm motions may cause microscopic tears in the vessel wall. This condition can cause long-term disability because of failure of the obstructed vessel to reopen. A review was undertaken of 10 patients with spontaneous effort-induced venous thrombosis to compare the outcome of conventional versus thrombolytic (clot-dissolving) therapy. No patient had a specific underlying cause of the marked edema and pain of the arm which was experienced. Seven of the 10 patients had a history of activities in which the shoulders were held in a downward and backward position. Four patients received thrombolytic treatment: three had complete resolution of the thrombosis and symptoms and one had partial resolution. Six patients received conventional treatment including bedrest, heat, arm elevation and anticoagulation therapy. Three of the conventionally treated patients had no resolution, two patients had partial resolution of symptoms but not of thrombosis, and one patient had total resolution of both thrombosis and symptoms. These results indicate that thrombolytic therapy seems to be superior to anticoagulation therapy in the treatment of effort-induced venous thrombosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Thrombophlebitis, Thrombosis, Fibrinolytic agents, Thrombolytic drugs

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Effects and limitations of pentoxifylline therapy in various stages of peripheral vascular disease of the lower extremity

Article Abstract:

Pentoxifylline (Trental) reduces blood viscosity, or thickness, and is used to treat all stages of peripheral vascular disease. One of the symptoms of peripheral vascular disease of the legs is claudication (weakness and cramps). There are conflicting reports on the usefulness of pentoxifylline in treating patients with claudication. A study was undertaken of 93 patients with peripheral vascular disease to determine the effectiveness of pentoxifylline for the treatment of various stages of the disease. Patients were evaluated before and after eight weeks of pentoxifylline therapy on the basis of distance they were able to walk (when they could walk) and Doppler ankle/arm index (a method of comparing blood flow in the leg and arm to determine the amount of disease in the leg vessels.) Patients were grouped by disease severity: 16 had pain at rest or foot ulcers due to inadequate blood supply; 24 had disabling claudication (could walk less than 50 yards); 43 had moderately severe claudication (could walk between 50 and 300 yards); and 18 had mild claudication (could walk 300 or more yards). After eight weeks of drug therapy, patients with moderately severe claudication showed increased walking distance and improved Doppler ankle/arm indices. But the drug therapy was less effective in patients with both severe and mild disease. Overall, only 5 percent of the patients said they were satisfied with the treatment. It is concluded that pentoxifylline may be useful only in selected patients with moderately severe peripheral vascular disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Product/Service Evaluation, Pentoxifylline, Trental (Medication)

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