BACKGROUND: To establish the effects of exercise therapy and additive vasoactive drugs in stage II of peripheral arterial occlusive disease. METHODS: A literature survey. RESULTS: In 2 level 2 studies, vasoactive drugs additive to physical training were better as exercise training only. The difference in absolute claudication distance between drug plus training and training groups was 28 to 272%. Among the agents used (Oxyfedrine, Naftidrofuryl, Pentoxifylline, Prostaglandin E-1), PGE-1 was the most effective. After adjuvant PGE-1 IV infusion during training the increase in the walking distance occurred earlier, was significantly more pronounced and longer lasting. Moreover, a significant and prognostically relevant improvement in exercise capacity was only found in patients treated with PGE-1 adjuvant to physical training. CONCLUSIONS: The use of vasoactive drugs additive to physical training is a reasonable approach. Its value is not only to improve the effects of the training but also to make it more effective. For practical purposes, the IV infusion of PGE-1 adjuvant to training seems to be the best method. For improvement of the general outcome in stage II of peripheral arterial occlusive disease and confirmation of this therapeutical approach, further studies are needed.

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