Can aortocoronary and peripheral venous bypass graft patency be improved by the administration of pentoxifylline on a long-term basis?

Abstract

Background: Venous bypass grafts to coronary and peripheral arteries have a high rate of occlusion at follow-up. Pentoxifylline, known to reduce blood viscosity, has the potential theoretically to reduce venous graft occlusion. We tested this hypothesis in this study.

Methods: The effect of pentoxifylline (Trental) on the early and late failure of venous bypass grafts was studied on 107 patients who underwent a total of 159 aortocoronary and 55 peripheral venous bypass grafts. Pentoxifylline was initially administered in the prime of the heart-lung machine in coronary patients and intra-arterially in peripheral vascular patients. All patients were treated postoperatively with oral administration of pentoxifylline at a dose of 400 mg daily, during the 2-year follow-up period. The short- and long-term graft patency in this unit was compared to that of an identical placebo unit, composed of 105 patients (141 aortocoronary and 55 peripheral venous bypass grafts). The patients of the placebo unit had the same operative treatment but were not treated with pentoxifylline. These patients were pre- and postoperatively examined by the same methods as the patients of the pentoxifylline unit.

Results: The 2-year follow-up demonstrated that in cardiac patients aortocoronary graft patency was 92.5% in the pentoxifylline unit, and 80.6% in the placebo unit. Similar results were observed in peripheral vascular patients, as well as in a small group of patients with multifocal arterial disease.

Conclusions: These results indicate that pentoxifylline affects favorably the patency of both aortocoronary and peripheral bypass grafts.