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KMID : 0378019890320100111
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New Medical Journal
1989 Volume.32 No. 10 p.111 ~ p.120
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Clinical Experience with Buflomendial Hel(Lofton^(®)) in Buerger´s Disease of Lower Extremities
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Abstract
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In recent years we have seen the introduction of a number of new drugs for the treatment of patients with occlusive vascular disease.
Buflomedil Hcl(Lofton®) is one of these vasoactive drugs and was known to improve microcirculation in impaired vascular beds of ischemic areas by antiplatelet aggregation, increasing erythrocyte flexibility and a-receptor blocking action.
Mary reports of clinical studies of Buflomedial Hcl use are seen in western literatures, but most of them is cencerning to atherosclerotic occlusive disease. This clinical trial was done in 14 patients with Buerger´s disease of lower extremities not amenable to r- instructive arterial surgery.
All was male in sex and age was raged from 21 to 49.
Clinical status before drug treatment was in Fontaine II or Fontaine N category,
During first 2 weeks, 200mg Buflomedil Hcl per day was administered intrave ously, and
then 450mg was given per os for 2-3 months.
All patients underwent femoral angiography to ascertain diagnosis and to co pare the angiographic findings with drug efficacy.
Ankle brachial blood pressure indices(ABI) were obtained before and after drug therapy. All patients were followed up for 3-6 months.
The observed results were as follows ;
1. Six of 7 patients with only claudication experienced improvement of walk´ g distance
and the remaining one patient didn´t feel any improvement.
One of 6 improved patients experienced markedly improved walking distance.
2. Six of 7 patients with agonizing pain at rest due to ischemic necrosis or skin ulcer experienced no improvement and eventually 4 B-K and 2 toe amputations were required. But in one patient, ischemic toe ulcer healed up and rest pain disappeared. 3. ABI was increased only in improved patients.
4. Symptomatic improvement seemed to be related with whether pedal arches were visuaiiz ed or not, by collaterals in femoral angiography.
5. Overall efficacy of Buflomedil Hcl in this clinical trial for 14 Buerger´s disease of lower extremities can be summarized as excellent improvement in 2(14.3%), moderate improvement in 2(14.3%), mild improvement in 3(21.4%) and no improvement in 7 patients (50.0%).
This clinical study found that symptomatic improvement by Buflomedil Hcl can be expected in claudicants without ischemic ulcer or necrosis in Buerger´s disease.
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