title: Prostaglandin E1 versus lumbar sympathectomy in the treatment of peripheral arterial occlusive disease: randomised study of 86 patients.
abstract: 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.
authors.affiliation: Department of Anesthesiology, Surgical Sciences and Emergencies, School of Medicine, Second University of Naples, Naples, Italy. pasquale.petronella@unina2.it
authors.forename: P
authors.initials: P
authors.lastname: Petronella
authors.forename: F
authors.initials: F
authors.lastname: Freda
authors.forename: L
authors.initials: L
authors.lastname: Nunziata
authors.forename: M
authors.initials: M
authors.lastname: Antropoli
authors.forename: A
authors.initials: A
authors.lastname: Manganiello
authors.forename: P P
authors.initials: PP
authors.lastname: Cutolo
authors.forename: A S
authors.initials: AS
authors.lastname: D'Amodio
mesh_terms: 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
chemical_list: D000527:Alprostadil