Prostacyclin therapy in peripheral arterial disease.

Abstract

Abstract Thirty patients with advanced peripheral arterial disease of lower extremities were treated with a single or multiple courses of prostacyclin /2–10 ng/kg/min intraarterially or intravenously for about 72 hours/. The observation period ranged from 2 to 15 months. The sustained improvement, as evidenced by alleviation of rest pain and healing of ischemic ulcers, occurred in 40 per cent of patients. Severity of local symptoms and arteriographic localization of the lesions are of essential prognostic value for the efficacy of prostacyclin therapy, however, they do not comprise all of the factors which determine responsiveness to prostacyclin. Platelet activity as assessed by several in vitro and in vivo methods was suppressed during the therapy, and returned to normal shortly after termination of the infusions. These short-lasting anti-platelet as well as vasodilatory effects of prostacyclin are in contrast with persistance of the clinical improvement which occurred in a substantial number of patients.