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Modulation of intravariceal pressure with pentoxifylline: a possible new approach in the treatment of portal hypertension

Objective:In this study the effect of the hemorheological agent pentoxifylline on the pressure of esophageal varices was investigated in portal hypertensive cirrhotic patients.Methods:Intravariceal pressure was measured endoscopically using the direct puncture technique in 20 patients. Measurements were obtained under baseline conditions and 30 min after double-blind administration of pentoxifylline (1.4 mg/kg BW, n = 10 patients) or an indentical volume of NaCl 0.9% solution (n = 10 patients).Results:Under baseline conditions, intravariceal pressure was similar in pentoxifylline and placebo groups (17.3 ± 5.5 mm Hg vs 18.8 ± 4.6 mm Hg, respectively; p= N.S.). Placebo administration had no significant effect on intravariceal pressure (18.8 ± 4.6 mm Hg vs 18.3 ± 4.1 mm Hg; p= N.S.). In contrast, pentoxifylline caused a highly significant reduction of intravariceal pressure, (from 17.3 ± 5.5 mm Hg to 11.4 ± 5.9 mm Hg; p= 0.0001), the overall mean reduction being 36.1 ± 14.1% mm Hg.Conclusion:We concluded that pentoxifylline, by reducing blood flow viscosity, caused a significant decrease in variceal pressure in patients suffering from portal hypertension.