Prostaglandin E1 versus lumbar sympathectomy in the treatment of peripheral arterial occlusive disease: randomised study of 86 patients.
OBJECTIVE
The aim of this study was to compare the effects of a pharmacological and a surgical vasodilatatory therapy in the treatment of chronic arterial diseases of the lower limbs.


RESULTS
After giving their informed consent, 40 patients were randomised to receive a slow (approximately 2-hour) infusion of 40 microg of prostaglandin E1 twice daily for 28 days (group A), and 46 were randomised to undergo lumbar sympathectomy, including the second and third ganglion. Twenty-four (60%) of the patients in group A experienced complete remission, seven (17.5%) were partial responders, and nine (22.5%) failed to respond. Of the 46 patients in group B, 29 (63%) experienced complete remission, seven (15.2%) were partial responders, and 10 (21.7%) failed to respond.


CONCLUSIONS
Broadly similar results were obtained with the two types of treatment, both of which are indicated mainly in Fontaine stages IIB and III (non-advanced), particularly when revascularising therapy is impossible or excessively risky. The two strategies can be advantageously combined with direct revascularisation surgery and may therefore constitute a first-line approach favouring subsequent therapy.
Petronella
P
P
Department of Anesthesiology, Surgical Sciences and Emergencies, School of Medicine, Second University of Naples, Naples, Italy. pasquale.petronella@unina2.it
Freda
F
F
Nunziata
L
L
Antropoli
M
M
Manganiello
A
A
Cutolo
P P
PP
D'Amodio
A S
AS
D000368:Aged; D000527:Alprostadil / Q000627:therapeutic use*; D001157:Arterial Occlusive Diseases / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008160:Lumbosacral Plexus / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013562:Sympathectomy; D016896:Treatment Outcome
D000527:Alprostadil