PGE(1) short term therapy in critical lower limb ischemia.
OBJECTIVE
Our study aims to evaluate the efficiency of short-term therapy with alprostadil (a PGE molecular derivative) on patients affected by critical ischemia of the lower limbs and unsuitable for surgical revascularization. The study was carried out on two groups of patients treated with the traditional long-term or a short-term protocol respectively.


METHODS
The parameters evaluated and statistically compared to existing studies were, the side effects, subjective pain measured on an analogic scale, objective pain calculated according to analgesic intake, and change in trophic lesions.


RESULTS
Our results revealed some differences between the two groups. The manifestation of side effects led to treatment suspension in 8% of long-term therapy cases only. Subjective pain was reduced or disappeared in 83.83% of cases (p<0.001) and there was no statistically significant difference between the two groups. The course of analgesic intake was again similar in both groups. Trophic lesions improved or completely healed in 64.7% (p<0.005) and although a greater tendency towards complete healing was evident in the short-term patients, it was not statistically significant. There was no significant difference between the two groups in the ankle/arm pressure index, but a significant improvement has been observed in 30.88% of cases. The results we obtained from both groups are similar and confirm the valid therapeutic use of alprostadil in patients with peripheral arterial occlusive disease (PAOD).


CONCLUSIONS
Our study reveals the presence of intrinsic advantages to the physician with the short-term schedule, through its higher tolerability, improved and more frequent patient and therapy controls and shorter hospitalization.
Bandiera
G
G
Third Division of Vascular Surgery, Department of Vascular Surgery and Pathology, IDI-IRCCS, Rome, Italy. g.bandiera@idi.it
Forletta
M
M
Di Paola
F M
FM
Cirielli
C
C
D000368:Aged; D000527:Alprostadil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001157:Arterial Occlusive Diseases / Q000188:drug therapy*; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D003925:Diabetic Angiopathies / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000188:drug therapy*; D007866:Leg / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016491:Peripheral Vascular Diseases / Q000188:drug therapy*; D013997:Time Factors; D014463:Ultrasonography; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D014665:Vasodilator Agents; D000527:Alprostadil