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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Giornale Italiano di Chirurgia Vascolare 2003 March;10(1):53-65
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
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.