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A Journal on Angiology

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2003 March;22(1):58-63


language: English

PGE1 short term therapy in critical lower limb ischemia

Bandiera G., Forletta M., Di Paola F. M., Cirielli C.

3rd Division of Vascular Surgery, Department of Vascular Surgery and Pathology, IDI-IRCCS, Rome, Italy


Aim. Our study aims to eval­u­ate the effi­cien­cy of short-term ther­a­py with alpros­ta­dil (a PGE molec­u­lar deriv­a­tive) on ­patients affect­ed by crit­i­cal ische­mia of the lower limbs and unsuit­able for sur­gi­cal revas­cu­lar­iza­tion. The study was car­ried out on two ­groups of ­patients treat­ed with the tra­di­tion­al long-term or a short-term pro­to­col respec­tive­ly.
Meth­ods. The param­e­ters eval­u­at­ed and sta­tis­ti­cal­ly com­pared to exist­ing stud­ies were, the side ­effects, sub­jec­tive pain meas­ured on an ana­log­ic scale, objec­tive pain cal­cu­lat­ed accord­ing to anal­ge­sic ­intake, and ­change in tro­phic ­lesions.
­Results. Our ­results ­revealed some dif­fer­enc­es ­between the two ­groups. The man­i­fes­ta­tion of side ­effects led to treat­ment sus­pen­sion in 8% of long-term ther­a­py cases only. Sub­jec­tive pain was ­reduced or dis­ap­peared in 83.83% of cases (p<0.001) and there was no sta­tis­ti­cal­ly sig­nif­i­cant dif­fer­ence ­between the two ­groups. The ­course of anal­ge­sic ­intake was again sim­i­lar in both ­groups. Troph­ic ­lesions ­improved or com­plete­ly ­healed in 64.7% (p<0.005) and ­although a great­er ten­den­cy ­towards com­plete heal­ing was evi­dent in the short-term ­patients, it was not sta­tis­ti­cal­ly sig­nif­i­cant. There was no sig­nif­i­cant dif­fer­ence ­between the two ­groups in the ankle/arm pres­sure index, but a sig­nif­i­cant improve­ment has been ­observed in 30.88% of cases. The ­results we ­obtained from both ­groups are sim­i­lar and con­firm the valid ther­a­peu­tic use of alpros­ta­dil in ­patients with periph­er­al arte­ri­al occlu­sive dis­ease (PAOD).
Con­clu­sion. Our study ­reveals the pres­ence of intrin­sic advan­tag­es to the phy­si­cian with the short-term sched­ule, ­through its high­er tol­er­abil­ity, ­improved and more fre­quent ­patient and ther­a­py con­trols and short­er hos­pi­tal­iza­tion.

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