LOCAL TRANSDERMAL GLYCERYL TRINITRATE HAS AN ANTIINFLAMMATORY ACTION ON THROMBOPHLEBITIS INDUCED BY SCLEROSIS OF LEG VARICOSE-VEINS

To test the antiinflammatory and analgesic effects of transdermal glyc eryl trinitrate (GTN) the authors carried out a double-blind, randomiz ed, controlled clinical study in 21 patients with mild to moderate leg varicose veins who underwent vein sclerotherapy in both legs. GTN or placebo ointment was applied in a blinded protocol along the surface o f the sclerosed vein every eight hours until disappearance of inflamma tion signs. The varicose vein in one leg was treated with GTN and comp ared with placebo for the vein of the other leg used as control of thr ombophlebitis (TP) signs. Fifteen minutes after first application infl ammation signs were observed in all cases. The intensity of inflammati on signs was assessed as 26% (10.4 +/- 4.1) in GTN-treated veins and a s 61.5% (24.6 +/- 6.3) (P < 0.001) in the placebo-treated veins. One h our later only 63% of cases in the GTN group and all cases in the plac ebo group showed signs of TP (P < 0.00 1). The reduction in the intens ity of signs at this time was 7.7 +/- 3.9 in the GTN group and 19.7 +/ - 6.3 in the placebo group (P < 0.001). All veins in the GTN group wer e free of signs of TP in less than forty-eight hours. In the placebo g roup, 45% of veins required more than forty-eight hours for complete d isappearance of signs of TP (P < 0.001). The authors conclude that GTN has an antiinflammatory effect in TP induced by sclerotherapy. This a ction may be related to the nitric oxide released from GTN, through a direct action on the vein and the surrounding inflamed tissue.