Effect of Clofibrate on Blood Viscosity in Intermittent Claudication

Sixty-two patients with intermittent claudication associated with peripheral arterial diseases were treated with clofibrate, 2 g daily, for a minimum of six months. Progress was compared with that in a similar pretreatment period and also with that of a matched untreated control group of 27 patients. The most striking effect of clofibrate was a steep and sustained fall in whole-blood viscosity measured over a wide range of shear rates. This was associated with a significant fall in abnormally raised initial plasma-fibrinogen levels. An increased proportion of patients on treatment showed evidence of clinical improvement. Clofibrate had no effect on the susceptibility of red blood cells to autoxidation but it led to a significant shift in the red cell fatty acid pattern.     

Place of Achilles Tenotomy in the Treatment of Severe Intermittent Claudication

Achilles tenotomy was performed on 66 limbs in 60 patients with severe intermittent claudication and the results were assessed two years later. Early improvement occurred in half of them but decreased to 17% two years postoperatively. Sympathectomy did not influence the result. The postoperative morbidity was 14%, and 21% of limbs were subsequently amputated. The late mortality in the group studied was 8%.