Follow-up of the long-term effect of intraarterial vasodilator administration in patients with PAOD by means of changes in resting arterial and venous lactate and pyruvate levels, and in ABB parameters.

The aim of the study was to assess, on the basis of changes in the resting arterial and venous values and arteriovenous difference of pH, pCO2, pO2, lactate, pyruvate and the lactate/pyruvate ratio in blood collected from the common femoral artery and vein before and after therapy, and at 4 weeks after therapy, the long-term effect of intraarterial vasodilator administration in 42 lower extremities with the chronic ischaemic syndrome in stages IIb, III and IV according to Fontaine. Ten intraarterial vasodilator infusions containing 300 mg trimecaine and 60 mg papaverine in 200 ml of saline led to an increase in oxygen extraction from circulating blood, as demonstrated by a statistically significant rise in arteriovenous pO2 difference persisting as long as 4 weeks after termination of therapy. The finding of increased CO2 release and the permanent drop in venous lactate levels suggest stimulation of aerobic metabolism of the chronically ischaemic tissue of the lower extremity induced by intraarterial vasodilator administration.