Improvement of microcirculation after percutaneous transluminal angioplasty in the lower limb with prostaglandin E1.
OBJECTIVE
The aim of the study was to investigate prospectively the microcirculation after angioplasty and its improvement with additional Prostaglandin E1 (PGE1) therapy assessed by transcutaneous pressure of oxygen.


METHODS
45 patients with intermittent claudication eligible for angioplasty were enrolled in a prospective randomised controlled clinical trial. Patients received either intra-arterial bolus of 40 microg PGE1 in addition to angioplasty or a 40 microg PGE1 intravenous infusion. Control group received no trial medication. Additional 15 patients undergoing intra-arterial angiography were also investigated. tcpO(2) values were recorded distal to the PTA region before, during the intervention, 24h, 2 and 4 weeks after intervention. Clinical endpoint was the change of tcpO(2) values 4 weeks after intervention.


RESULTS
During the 4 week follow-up tcpO(2) values decreased in patients treated with angioplasty. At the same time tcpO(2) increased significantly in those patients additionally treated with intra-arterial PGE1 bolus injection as well as with intravenous PGE1 infusion.


CONCLUSIONS
Impaired microcirculation after angioplasty can be improved with additional intravenous as well as intra-arterial PGE1 administration.
Heider
Peter
P
Department of Vascular Surgery, Rechts der Isar Medical Center, Technical University of Munich, München, Germany. heiderpeter@t-online.de
Wildgruber
Moritz
M
Wolf
Oliver
O
Schuster
Tibor
T
Lutzenberger
Werner
W
Berger
Hermann
H
Eckstein
Hans-Henning
HH
D000368:Aged; D000527:Alprostadil / Q000008:administration & dosage*; D000800:Angioplasty, Balloon; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000188:drug therapy / Q000628:therapy*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008833:Microcirculation; D011446:Prospective Studies; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D000527:Alprostadil