ORIGINAL ARTICLES   

International Angiology 2000 December;19(4):358-65

Copyright © 2001 EDIZIONI MINERVA MEDICA

lingua: Inglese

Effect of intravenous Iloprost and Alprostadil (PGE1) on peripheral resistance during femoro-distal reconstructions

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.