Intra-arterial Injections in Treatment of Peripheral Vascular Disease

Edwards, Jonathan W.; Jones, Nick; McConnell, R. B.; Pemberton, H. S.; Watson, Donald C.

doi:10.1136/bmj.2.4788.808

Cited by 22 publications

(10 citation statements)

References 3 publications

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“…Although intra-arterial administration of alcohol has been used in the treatment of peripheral vascular disease (Edwards et al, 1952), the demonstration of a direct constrictor action on the vessels of normal limbs indicates that such administration is likely to be detrimental if alcohol has similar effects on both normal and diseased vessels. A study of the action of alcohol on the vessels of the lower limbs and of limbs exhibiting vascular disease has not yet been made.…”

Section: Discussionmentioning

confidence: 99%

“…Abramson, Zazeela & Schkloven (1941) reported that after administration of whisky an increase in blood flow was generally seen in the hand and little or no effect in the leg or forearm. Edwards, Jones, McConnell, Pemberton & Watson (1952) described the use of infusions of ethyl alcohol into the femoral artery in the treatment of occlusive vascular disease, and observed an increase in skin temperature of the toes in one of six patients so treated. Conrad & Green (1964) found an increase in digital blood flow after ingestion of 60 ml.…”

mentioning

confidence: 99%

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The Effects of Ethyl Alcohol on the Blood Vessels of the Hand and Forearm in Man

Fewings

Hanna

Walsh

et al. 1966

British Journal of Pharmacology and Chemotherapy

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The Effects of Ethyl Alcohol on the Blood Vessels of the Hand and Forearm in Man

Fewings

Hanna

Walsh

et al. 1966

British Journal of Pharmacology and Chemotherapy

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“…A wide range of drugs including acetylcholine, histamine, papaverine, " hydergine," hexametbonium, and tolazoline have been used by Edwards et al (1952). These authors have been encouraged by improvement in a large perccntage of their patients to use the method on an increasing scale; in some cases surgical intervention was rendered unnecessary, and benefit was obtained in others in whom symptoms had recurred following surgery.…”

Section: Discussionmentioning

confidence: 99%

Intra-arterial Oxygen in Peripheral Vascular Disease

Marshall¹,

Whelan²

1956

BMJ

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The injection of small quantities of oxygen or of various other gases into the brachial artery of the normal subject is followed by marked vasodilatation in the hand and forearm which persists for an hour or more (Duff, Greenfield, and Whelan, 1953). This observation suggested a possible application in the treatment of patients with ischaemic disorders of the limbs. Much of the disability in these patients is a direct consequence of reduced blood flow to skin and muscle, and it was felt that if vasodilatation could be obtained comparable in degree and duration to that in normal people symptomatic benefit might result. Intra-arterial oxygen has been employed as a mode of therapy in ischaemic disorders of the lower limbs by Lemaire, Loeper, and Housset (1948); they were impressed with its effect in improving symptoms. Since then several workers in Germany (Wernitz and Dorken, 1954; M. Ratschow, personal communication, 1955;Hasse, Koble, and Linker, 1955) have claimed therapeutic benefit from intra-arterial oxygen therapy. This paper presents the results of a detailed study of circulatory changes induced by intra-arterial oxygen injections in patients with peripheral arterial disease involving upper and lower limbs. The changes are compared with those following intra-arterial injection of three potent vasodilator drugs: tolazoline (" priscol "), hydrallazine (" apresoline "), and phenyl-iso-butyl-np-hydroxy ephedrine (" dilatal "). MethodsThe investigations were carried out at a room temperature of 20-24' C. The patient rested on a couch for at least an hour before observations were made. In the case of the upper limb, injections were made into the brachial artery in the antecubital fossa; for the lower limb, they were made into the femoral artery in the groin. The limb into which the injection was made was raised slightly. A continuous infusion of 0.9% saline was maintained into the artery from a mechanically driven syringe, and the gaseous oxygen was added slowly to the stream of saline through a side-arm in the connecting tubing.On most occasions measurements of blood flow were made by the technique of venous occlusion plethysmography (Barcrdft and Edholm, 1943). The segment of limb being investigated was enclosed in a water-filled mechanically stirred plethysmograph (Greenfield, 1954), the water temperature being 31-32' C. for the hand and foot, and [34][35] inflated to a pressure of 200 mm. Hg for one minute before and during the recording of calf and forearm blood flows.After each injection of oxygen or of a vasodilator drug, blood flow records were taken at frequent intervals for one and a half to three hours. If at the end of this time the blood flow was still significantly raised further observations were made at intervals until it had returned to the resting level.On some occasions changes in the skin temperature of the foot following injection were measured by a thermo-electric junction.The dose of oxygen was 10 ml. for the upper limb and 30 ml. for the lower limb, given over a period of 10 to 15 min...

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“…Tolazoline hydrochloride was given orally-50 mg. thrice daily. Papaverine sulphate (60 mg.) was given by intraarterial injection (Edwards et al, 1952). Paravertebral lumbar sympathetic block was performed (Dr. G. Jackson Rees) on November 11 and 12.…”

Section: Discussionmentioning

confidence: 99%