Red cell deformability in patients with chronic atheromatous ischemia of the legs.

BACKGROUND: It has been shown that atherosclerosis can cause not only lowering of the perfusion pressure gradient at the macro/micro circulation level, but can bring about untoward rheological changes such as e.g. loss of the red blood cells (RBC) elasticity. This can participitate in mechanism of impairment of the blood flow through the microcirculation as well. The aim of this study was to measure RBC elasticity in the claudicants, and to evaluate the effect of the applied treatment either conservative or surgical revascularisation on this rheological parameter.

MATERIAL AND METHODS: RBC deformability was examined in claudicants 83 of them (mean claudication distance 400 m) were treated conservatively (walking exercise on a treadmill and Pentoxyphilline 600 mg b.i.d.) 44 claudicants with the critical leg ischemia (mean claudication distance below 50 m or rest pain) underwent surgical revascularisation. The measurements of RBC elongation (under selected values of the shear stress) were made on entry to the study, after 6 weeks, and 12 weeks of observation.

RESULTS: After 12 weeks of conservative treatment, RBC elasticity both at rest and after walking exercise significantly increased. In the patients undergoing surgery mean RBC elasticity both at rest and after walking exercise 12 weeks following surgery was not significantly different compare with the respective levels at the beginning of the study.

CONCLUSIONS: In the group of claudicants with less advanced atherosclerosis (conservative group), the treatment brought about significant increase of RBC elasticity. On the contrary in case of the patients with advanced atherosclerosis and critical leg ischemia revascularisation alone appeared to be ineffective in correction of untoward rheologic alteration such as rigidity of the erythrocytes.