[Increasing transcutaneous PO2 in arteriopathies during treatment with PGE1 alpha-cyclodextrin].
BACKGROUND
Transcutaneous PO2 values (at the dorsum of the foot) were evaluated in a group of 8 patients (mean age 66 +/- 11) with critical ischemia including 4 patients (mean age 65 +/- 10) with gangrene[. A group of 5 comparable normal controls was also studied.


METHODS
Patients were treated with PGE1 alpha-ciclodestrina (60 mu/die, in two infusions lasting 3 hours; one in the morning and one in the afternoon) for 6 days.


RESULTS
Results indicated a maximum increase in PO2 between the second and third day which remains higher than values observed before treatment up to 4 weeks. In another group of patients (6 claudicants with walking distance between 200 and 400 m, 4 with rest pain and 4 with localised gangrene) PO2 foot/chest ratio was studied. The ratio was significantly increased after 6 days of PGE1 alpha-ciclodestrina treatment. The evaluation of PO2 with an exercise test on treadmill (including 6 claudicants, 4 patients with rest pain and 5 normal controls) indicated a large decrease in PO2 with exercise in limbs with critical ischemia; the PO2 decrease on effort was less visible in claudicants. Recovery time to pre-exercise values was also very long in subjects with critical ischemia. The exercise test may be useful to monitor the efficacy of PGE1 alpha-ciclodestrina treatment. However the test is not standardised and commonly used.


CONCLUSIONS
In conclusion this study indicated that PO2 increases after PGE1 alpha-ciclodestrina treatment may last for at least 4 weeks and also that transcutaneous PO2 could be an effective method to follow up changes in perfusion. However tests based on PO2 measurements should be standardised to constitute a common evaluation method.
Belcaro
G
G
Angiology and Vasc. Surgery, Clinical Trials Unit, Pierangeli Clinic, Pescara.
Cesarone
M R
MR
D000368:Aged; D000527:Alprostadil / Q000494:pharmacology / Q000627:therapeutic use*; D001161:Arteriosclerosis / Q000188:drug therapy; D003505:Cyclodextrins / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005734:Gangrene / Q000188:drug therapy; D006801:Humans; D007383:Intermittent Claudication / Q000188:drug therapy*; D007511:Ischemia / Q000188:drug therapy; D007866:Leg / Q000098:blood supply; D008297:Male; D010100:Oxygen; D010313:Partial Pressure; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use
D003505:Cyclodextrins; D014665:Vasodilator Agents; D000527:Alprostadil; D010100:Oxygen