Intra-arterial and intravenous administration of prostaglandin E1 cause different changes to skin microcirculation in patients with peripheral arterial occlusive disease.
BACKGROUND
Disturbed skin microcirculation in patients with peripheral arterial occlusive disease (PAOD) might be affected by prostaglandin E1 (PGE1). The purpose of this study was to investigate local skin perfusion at the forefoot and toe of PAOD patients during different modes of administration of PGE1.


METHODS
In 17 patients with severe PAOD local intradermal haemoglobin oxygen saturation (SHB) and dermal vascular reserve capacity, transcutaneous oxygen pressure (tcPO2) and laser Doppler flux (LDF) were determined during intra-arterial (1.5 ng/kg body weight/min) and intravenous (6 ng/kg body weight/min) infusion of PGE1.


RESULTS
SHB significantly increased at both locations during intravenous PGE1; intra-arterial administration significantly increased SHB in the skin of the forefoot only. Reserve capacity increased during intravenous administration and was markedly reduced during intra-arterial infusion. No significant changes were found regarding tcPO2 and LDF.


CONCLUSIONS
These data suggest different therapeutic mechanisms for intra-arterial and intravenous administered of PGE1.
Thum
J
J
Department of Angiology, Medizinische Hochschule Hannover, Germany.
Caspary
L
L
Creutzig
A
A
Alexander
K
K
D000368:Aged; D000369:Aged, 80 and over; D000527:Alprostadil / Q000008:administration & dosage*; D001157:Arterial Occlusive Diseases / Q000188:drug therapy* / Q000503:physiopathology; D001785:Blood Gas Monitoring, Transcutaneous; D005260:Female; D005545:Forefoot, Human / Q000098:blood supply; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D012867:Skin / Q000098:blood supply*; D014034:Toes / Q000098:blood supply; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D000527:Alprostadil