THERMAL-TREATMENT IN PERIPHERAL ARTERIAL- DISEASE - AN EXPENSIVE PLACEBO OR AN EFFECTIVE THERAPY

Each year, Royat (Auvergne) receives about 20,000 patients (80 per cen t with intermittent claudication), treated by thermal gas (99.5 per ce nt of CO2). CO2 therapy is dispensed with thermal water or with dry ga s (general or local immersion and local subcutaneous injections of gas ) during 3 weeks. Local vasodilator effects of CO2 have been demonstra ted with several methods in Royat. Physiological and therapeutic effec ts of thermal CO2 therapy, also used in Germany and Central Europe, we re precisely reported during the Consensus Congress of Fribourg in Bri sgau (1989); more particularly, this treatment seems provide a reduced ability of haemoglobin to fix oxygen, and therefore a release of oxyg en within the cells. Patients with peripheral arterial disease (stage 2) have a walking distance increased and post-exercise ankles' pressur es improved after a thermal course of treatment in Royat, while a cont rol group has no significant changes. The discussion will concern also the socioeconomic aspects of thermal treatment of arterial diseases.