Propionyl-L-Carnitine Improves Endothelial Function,Microcirculation and Pain Managementin Critical Limb Ischemia.

Introduction Chronic critical limb ischemia (CLI) is a severecondition of hypo-perfusion of lower limbs, which isassociated with inflammation and a pro-coagulative state. Itis a disease at high risk of amputation and cardiovasculardeath. Propionyl-L-carnitine (PLC) is efficacious in improvingpain free walking distance in peripheral arterial diseasewith claudication; it also exerts favorable effects on thearterial wall and on endothelial function. The purpose ofthis study was to evaluate the effects of PLC on microcirculation,endothelial function and pain relief in patientsaffected by CLI not suitable for surgical intervention.Patients and methods We enrolled 48 patients with CLI.Patients were randomized into two groups: the first groupwas treated with PLC, the second was treated with salinesolution. All of them underwent the following tests: laserDoppler flowmetry at the forefoot at rest and after ischemia,trans cutaneous oxygen partial pressure and carbon dioxidepartial pressure at the forefoot at rest and after ischemia,endothelium dependent dilation of the brachial artery. Alltests were repeated after treatments. Pain was assessed byvisual analog pain scale.