Non-atherosclerotic Vasculopathy Research Articles

Antithrombin III Level in Nonatherosclerotic Vasculopathy

To the Editor.— Regarding a recent BRIEF REPORT, Intra-arterial Alprostadil for Nonatherosclerotic Vasculopathy (1981;245:1846), there is no mention of antithrombin III levels. In a patient in this age group with a history of venous thromboembolism, who on angiography has evidence of multiple arterial occlusions, I think it would be important to rule out antithrombin III deficiency as a possible cause, as this condition may be treatable with long-term warfarin sodium therapy.

Intra-arterial Alprostadil for Nonatherosclerotic Vasculopathy

A 33-year-old man with a nonatherosclerotic vasculopathy of undetermined origin had progressive occlusive disease of the lower limb vessels. The resultant severe rest pain and ischemic ulceration of his foot were inoperable and unresponsive to conventional drug therapy. Treatment was begun with intra-arterially administered alprostadil (prostaglandin E1), a vasodilator and inhibitor of platelet aggregation. Although immediate benefit was equivocal, his rest pain had disappeared six weeks after infusion, and the ischemic ulcer almost healed completely. Blood flow studies showed increased flow to the feet, consistent with the subjective improvement. The beneficial effect of alprostadil suggests that further studies with this agent are warranted for patients with nonatherosclerotic vasculopathy.