Treatment of ischemic ulcers of the lower limbs with alprostadil (prostaglandin E1).
BACKGROUND
Hemodynamic, hemorheologic, and metabolic changes are main determinants in the genesis of ischemic leg ulcers. Because prostaglandin E1 (alprostadil) could successfully counteract these changes, it has been intravenously used in the treatment of this disease.


OBJECTIVE
The aim of this study was to evaluate the efficacy of alprostadil in the treatment of ischemic ulcers and to compare subcutaneous with intravenous administration.


METHODS
Eighty patients were enrolled. Twenty-five were treated by injecting low doses of alprostadil around ischemic ulcers of the leg and saline solution intravenously and 25 were treated with intravenous alprostadil and local injections of saline solution; the control group was composed of 30 patients who received saline solution around the ulcers and intravenously.


RESULTS
All patients showed a statistically significant improvement in ulcer diameter, pain, and transcutaneous oxygen pressure compared to the control group. No relevant differences in the clinical outcome in the two treated groups were found, but patients treated with subcutaneous alprostadil experienced no side effects and showed higher values of transcutaneous oxygen pressure.


CONCLUSIONS
Both intravenous and local subcutaneous alprostadil are useful in the treatment of ischemic leg ulcers, but subcutaneous administration is less expensive and easier to perform.
Department of Internal Medicine, A. Gemelli University Hospital, Catholic University of Sacred Heart, Rome, Italy. angiologia@rm.unicatt.it
Paolo
P
Tondi
Laura
L
Gerardino
Angelo
A
Santoliquido
Roberto
R
Pola
Maurizio
M
Gabrielli
Pierangelo
P
Papaleo
Antonio
A
Gasbarrini
Paolo
P
Pola
Roberto
R
Flore
D000368:Aged; D000369:Aged, 80 and over; D000527:Alprostadil / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D007871:Leg Ulcer / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing
D010975:Platelet Aggregation Inhibitors; D000527:Alprostadil