Effect of intravenous iloprost and alprostadil (PGE1) on peripheral resistance during femoro-distal reconstructions.
BACKGROUND
A prospective, randomised study was undertaken to investigate the effect of intravenous infusion of either iloprost, the stable prostacyclin (PGI2) analogue, or alprostadil (prostaglandin E1) on peripheral resistance (PR) during femoro-distal reconstruction.


METHODS
A prospective randomised study was performed with 35 patients. The PR Measurement of peripheral resistance involved a silicon tube temporarily inserted between the donor and recipient vessel. A flowmeter probe and a pressure transducer were inserted into the tube. The peripheral resistance was calculated as a quotient of pressure and flow under approximate physiological conditions. Patients received either alprostadil (4.4 ng/min/kg) or iloprost (2 ng/min/kg) intravenously over ten minutes. After the end of the infusion, the measurements were taken for five minutes.


RESULTS
Baseline peripheral resistance was similar for both groups (iloprost 0.76+/-0.54 mmHg/ml/min, alprostadil 0.72+/-0.35 mmHg/ml/min, p>0.05). Following the measurement procedure, the final peripheral resistance in the iloprost group was reduced (0.57+/-0.33 mmHg/ml/min), but the difference to the alprostadil group (0.70+/-0.36 mmHg/ml/min) was not significant (p>0.05). The different decrease of ratio peripheral resistance (quotient between final and baseline resistance times one hundred) was highly significant (iloprost: 79.4+/-13.4% vs alprostadil: 97.0+/-15.6%, p<0.01).


CONCLUSIONS
Intravenous application of prostanoids, infused with usual doses over ten minutes during femoro-distal reconstructions, produces significant differences in decrease of peripheral resistance. Alprostadil only causes a slight drop of resistance, whereas iloprost causes a significant higher reduction of peripheral resistance.
Krueger
U
U
Department of Vascular Surgery, Queen Elisabeth Hospital, Berlin, Germany.
Scholz
H
H
Heise
M
M
Adeberg
P
P
Petzold
M
M
Zanow
J
J
Karrenberg
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000527:Alprostadil / Q000008:administration & dosage*; D001157:Arterial Occlusive Diseases / Q000601:surgery; D001807:Blood Vessel Prosthesis; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D016285:Iloprost / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D014655:Vascular Resistance / Q000187:drug effects*; D014665:Vasodilator Agents / Q000008:administration & dosage*
D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D014665:Vasodilator Agents; D000527:Alprostadil; D016285:Iloprost