[Treatment of chronic atherosclerotic obliterative arteriopathy in the II and IV Fontaine stage. Personal observations using iloprost].
The traditional medical treatment of atherosclerotic artery disease of the lower limbs with vasodilators, antiplatelet agents, hemorheologic agents and heparin has so far yielded only partly satisfactory results. In view of this, we have treated ten patients with lower limb arterial disease, Fontain stages III and IV, with a stable prostacyclin analogue, iloprost, with antiaggregant, vasodilating, and cytoprotective activity. Patients' mean age 73.6 +/- 9.9 yrs., M/F ratio 9/1. The drug was infused by peristaltic pump at dosages varying from 1.5 to 2 ng/kg body weight/min for 6 hours daily and for an average of 25 days. Our observations, albeit on a limited number of subjects, appear to confirm the good tolerability, and above all the efficacy of iloprost (relative number of patients improved: 0.70). Nevertheless, in our view, a hypertensive diabetic woman who under treatment developed a lower myocardial infarction deserves special attention. Data found in the literature do not allow us to hold iloprost responsible for this effect with any degree of certainty. However, the doubt remains that as a result of its vasodilating action the drug may have caused steal phenomena from the subendocardial to subepicardial districts, thus provoking the ischemic event.
Marci
M
M
Divisione di Medicina Generale, USL RM G, Ospedale A. Angelucci, Subiaco.
Raffa
S
S
Panzini
E
E
Russo
F
F
D000368:Aged; D000369:Aged, 80 and over; D001162:Arteriosclerosis Obliterans / Q000188:drug therapy*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D016285:Iloprost / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
D016285:Iloprost