Cor Vasa 2025, 67(5):646-650 | DOI: 10.33678/cor.2025.032

Potential of pentoxifylline in preventing reperfusion injury after surgery on limb ischemia: a literature review

Abu Rizal Dwikatmono Johan, Danang Himawan Limanto, Heroe Soebroto

Cardiothoracic and Vascular Surgery Department, Faculty of Medicine, Airlangga University, Surabaya, Indonesia

Background: Acute limb ischemia (ALI) is characterized by a sudden loss of blood flow to the lower limbs, often resulting from embolism or thrombosis. Management of ALI is critical, as it can lead to severe complications, including ischemia-reperfusion injury (IRI) during revascularization procedures. IRI involves complex functional and structural changes following restoration of blood flow, leading to inflammation and oxidative stress. These pathological processes can exacerbate tissue damage and impede recovery. Pentoxifylline has emerged as a potential therapeutic agent due to its ability to improve blood flow and reduce the inflammatory response.

Aim: This literature review investigates the role of pentoxifylline (PTX) in reducing ischemia-reperfusion injury associated with acute limb ischemia (ALI), a condition that poses significant challenges to prognosis and survival.

Methods: This review synthesizes findings from multiple preclinical and clinical studies examining the protective effects of PTX across different models of IRI. The primary mechanisms of action include inhibition of platelet-activating factor (PAF) production, reduction of inflammation, and enhancement of hemorheological properties, which collectively improve microcirculation during reperfusion.

Results: PTX has demonstrated efficacy in reducing tissue necrosis and improving outcomes in models of skeletal muscle and cerebral ischemia. In addition, it has been shown to reduce lung damage from IRI. This review also highlights the potential benefits of combination therapy, particularly with antioxidants such as vitamin C, which may further enhance the protective effects of PTX.

Conclusions: Pentoxifylline shows promise as a therapeutic agent to prevent reperfusion injury after ischemic events such as ALI. However, further clinical trials are needed to optimize its application and confirm its efficacy in human populations.

Keywords: Acute limb ischemia, Antioxidant, Limb ischemia, Pentoxifylline, Reperfusion injury

Received: December 30, 2024; Revised: February 2, 2025; Accepted: February 28, 2025; Prepublished online: June 2, 2012; Published: November 6, 2025  Show citation