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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

A Journal on Vascular and Endovascular Surgery


Official Journal of the Italian Society of Vascular and Endovascular Surgery
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Giornale Italiano di Chirurgia Vascolare 2003 March;10(1):53-65

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: English, Italian

Treatment with prostanoids. Personal experience

Castagno P. L., Mosso F., Carignano G., Leotta L., Apostolou D., Buzzacchino A.

Divisione di Chirurgia Vascolare Azienda Ospedaliera San Giovanni Battista, Torino


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Back­ground. Aim of ­this ­study is to eval­uate the effi­cacy of treat­ment ­with pros­tan­oids ( Ilo­prost or Alpros­tadil) in ­patients ­with periph­eral vas­cular dis­ease ­that are not suit­able for sur­gical revas­cu­lar­iza­tion or ­redo sur­gery; more­over we ­tried to ­define the ­role ­that ­this ­kind of ­drug ­could ­assume in the ­area of ther­a­peutic ­strategy avail­able at the ­moment.
­Methods. We ana­lyzed the ­results of 185 ­cases of ­patients suf­fering periph­eral vas­cular dis­ease of dif­ferent eti­ology all ­treated at the Day Hos­pital of our insti­tute ­from 1/1/1993 to 31/12/2000. Eval­u­a­tion was car­ried out on the ­basis of the clin­ical pic­ture (­healing or reduc­tion of ­trophic ­lesions—reduc­tion or dis­ap­pear­ance of ­rest ­pain—improve­ment or ­restoring the ­ability to ­walk).
­Results. Effi­cacy of ­this ­kind of ­therapy has ­been estab­lished in 71.26% of ­patients ­that ­brought to the end the ­expected ­cycle. ­This is a per­centage of ­great ­respect, espe­cially in con­sid­er­a­tion of the ­very ­stern sit­u­a­tion of the ­patients ­that we ­treated. Inter­rup­tions due to the occur­rence of uncon­trol­lable ­side ­effects ­were few (5.94%). A ther­a­peutic advan­tage was ­found in ­clearly ­defined cat­e­go­ries of ­patients (arte­rial dis­ease not asso­ciated ­with dia­betes, clin­ical pic­ture not ­very ­advanced, ­female ­gender). Ilo­prost ­proved to be ­superior to Alpros­tadil ­both on the ­whole and in rela­tion to the dif­ferent pathol­o­gies.
Con­clu­sions. Our ­work ­shows ­that the use of pros­tan­oids is ­widely jus­ti­fied in ­patients ­with ­poor or no sur­gical oppor­tu­nities, ­becoming a ther­a­peutic oppor­tu­nity of alter­na­tive ref­er­ence or com­ple­men­tary to ­other med­ical treat­ments ­already ­tested.

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