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Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,899
Online ISSN 1827-1839
Krueger U., Scholz H., Heise M. *, Adeberg P., Petzold M., Zanow J., Karrenberg R.
From the Department of Vascular Surgery, Queen Elisabeth Hospital, Berlin, *Humbolt University Medical School (Charité), Department of Surgery, Campus Virchow, Berlin, Germany.
Background. A prospective, randomised study was undertaken to investigate the effect of intravenous infusion of either iloprost, the stable prostacyclin (PGI2) analogue, or alprostadil (prostaglandin E1) on peripheral resistance (PR) during femoro-distal reconstruction.
Methods. A prospective randomised study was performed with 35 patients. The PR Measurement of peripheral resistance involved a silicon tube temporarily inserted between the donor and recipient vessel. A flowmeter probe and a pressure transducer were inserted into the tube. The peripheral resistance was calculated as a quotient of pressure and flow under approximate physiological conditions. Patients received either alprostadil (4.4 ng/min/kg) or iloprost (2 ng/min/kg) intravenously over ten minutes. After the end of the infusion, the measurements were taken for five minutes.
Results. Baseline peripheral resistance was similar for both groups (iloprost 0.76±0.54 mmHg/ml/min, alprostadil 0.72±0.35 mmHg/ml/min, p>0.05). Following the measurement procedure, the final peripheral resistance in the iloprost group was reduced (0.57±0.33 mmHg/ml/min), but the difference to the alprostadil group (0.70±0.36 mmHg/ml/min) was not significant (p>0.05). The different decrease of ratio peripheral resistance (quotient between final and baseline resistance times one hundred) was highly significant (iloprost: 79.4±13.4% vs alprostadil: 97.0±15.6%, p<0.01).
Conclusions. Intravenous application of prostanoids, infused with usual doses over ten minutes during femoro-distal reconstructions, produces significant differences in decrease of peripheral resistance. Alprostadil only causes a slight drop of resistance, whereas iloprost causes a significant higher reduction of peripheral resistance.