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Vasoactive preparations (cavinton, corinfar, phinoptin, pentoxyphylline and sermion) were studied for their effect on systemic and cerebral hemodynamics in 232 patients with cerebrovascular insufficiency in the presence of atherosclerotic lesion of the precerebral arteries, and for that on rheologic properties of blood in 91 of them. It has been established that the highest effect from the use of calcium antagonists and sermion with respect of the blood flow linear velocity (BFLV) increase occurs predominantly in stenotic precerebral arteries; the normalization of the platelet-erythrocyte homeostasis is also considerably influenced by these. Calcium antagonists and sermion are capable of lowering arterial pressure, diminishing the volume of circulating blood and cardiac index thereby making for more economic heart performance. Cavinton has only minor effects on systemic hemodynamics, slightly increases BFLV reduces the extent of the erythrocyte aggregation only. Pentoxyphylline has a positive effect on normalization of platelet and erythrocyte homeostasis, reduces blood viscosity and does not influence the parameters of systemic hemodynamics, only slightly increases the linear velocity of the bloodflow in the precerebral arteries. Recommendations on the use of the preparations studied are presented.

Studied was an effect of pentoxyfilline on systemic and cerebral haemodynamics in 33 patients with discirculatory encephalopathy in the presence of atherosclerotic lesion of the precerebral arteries, with the aid of dye-dilution methods using Evans blue (T-1824) and ultrasonic dopplerography. Pentoxyfilline was found to be associated with significant reduction of the circulating blood volume at the expense of its globular fraction, diminution of the cardiac and stroke work indices; the drug has only minor effects on the peripheral vascular resistance and linear velocity of bloodflow in the precerebral arteries; it makes for an increased number of cases of eukinetic type of blood circulation and causes regression of subjective neurologic symptomatology. On account of its antihypertensive and cardiodepressive effect the drug is contraindicated in patients with low AP and hypokinetic type of systemic haemodynamics. If intracerebral steal syndrome is detected, the institution of the pentoxyfilline therapy cannot be recommended.

Transient circulatory disorders of the brain arising in response to stenosis and occlusion of the major head arteries in 111 patients were treated with cardiotonic and vasoactive drugs (corglycon, strophanthin, sulfocamphocain, euphylline++, cavinton, finoptin). The treatment was controlled by monitoring systemic and cerebral hemodynamic parameters. An appreciable clinical response was achieved in more patients (by 16.3%) than it was usually the case in thus untreated patients.

Blood Evans Blue dilution and ultrasound Doppler cardiography were used to examine systemic and cerebral hemodynamic changes after a single intravenous administration of finoptin (5 mg) and its course treatment (a daily dose of 120-240 mg) in 30 patients with initial signs of cerebrovascular insufficiency and 30 patients with transient cerebrovascular disorders in the presence of atherosclerotic stenoses of the cephalic great arteries. Finoptin was found to increase the linear velocity of blood flow mainly in stenotic arteries, without causing intracerebral steal. The agent also exerted a clear-cut cardiodepressive action which was levelled off by its vasodilating effect by the end of its course therapy.

Parameters of the general and cerebral hemodynamics were examined in 45 patients with cerebral circulation disturbances developed in the presence of atherosclerosis (30 patients) and atherosclerosis plus arterial hypertension with cardiac arrhythmias (15 patients) and without the latter (72 patients). The examinations were carried out with the use of the Evans blue dilution method (T-1824) and rheoencephalography. Shifts in the general and the cerebral hemodynamics were revealed in the patients with and without cardiac arrhythmias, these shifts being more pronounced in patients with atherosclerosis complicated with the heart ischemic disease and cardiac arrhythmia. In the course of complex treatment which included cardiotonics and beta-adrenoblocking agents the parameters of the general hemodynamics got better along with the clinical improvement.

Fifty atherosclerotic patients with chronic disorders of the cerebral blood circulation (CDCBC) were involved in this study of both systemic hemodynamics (by diluting Evans blue) and rheoencephalographic parameters of the cerebral circulation with regard to the stage of the CDCBC. Compensated vascular-cerebral insufficiency was associated with a significant rise in the arterial pressure, acceleration of the blood flow in the hand-ear region and with an increase in the heart rate. Visual and amplitude-frequency characteristics of REGs in a compensatory stage of the CDCBC deepened only slightly; in a remitting stage they deepened significantly in the left carotid and vertebral-basal basins; in a subcompensated stage, in both basins bilaterally; and in a decompensated stage, predominantly in the carotid basin.

In 370 atherosclerotic patients with chronic cerebrovascular insufficiency (CCVI) the authors have investigated the cerebral (by rheoencephalography) and the systemic (by diluting Evans blue) haemodynamics before and after correcting it with papaverine, euphylline, complamin, cavinton, corglycon, strophanthin, and sulfocamphocaine. They have also specified the characteristics of the action of the drugs studied, as well as indications and contraindications for their use in chronic CCVI treatment. The given therapy optimizes the current methods of rehabilitation of patients with chronic cerebrovascular insufficiency, ensures clinical improvement in 89.5% of cases (by 18.5% more than in the control group) and reduces the period of hospitalization by an average of 3.6 days.