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[Intra-arterial administration of prostaglandin E1 in occlusive arterial diseases]
L Davidović1, M Vranes, I Cernak
1Institute for Cardiovaskular Diseases, University Clinical Centre, Belgrade.
Insights
Intra-arterial prostaglandin E1 infusion is a successful limb salvage procedure for patients with advanced occlusive arterial disease. This treatment effectively healed ulcers and eliminated pain, preserving limbs when surgery was not an option.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Pharmacology
Context:
- Focuses on patients with advanced (Fontaine Stage III-IV) occlusive arterial diseases.
- Addresses cases where surgical reconstruction is not feasible.
- Includes diverse patient groups: diabetic angiopathy, atherosclerosis, Burger disease, and adjuvant therapy.
Purpose:
- To evaluate the efficacy of intra-arterial prostaglandin E1 as a limb salvage procedure.
- To assess treatment outcomes over a two-year follow-up period.
- To determine the effectiveness in eliminating rest pain, healing trophic ulcers, and demarcating gangrene.
Summary:
- 106 patients received continuous intra-arterial prostaglandin E1 (PGE1) infusion (10 ng/kg/min) via catheterization of the femoral artery.
- Doppler sonography and angiography were used for measurements.
- Treatment success was evaluated based on pain relief, ulcer healing, and gangrene demarcation, with positive outcomes observed.
Impact:
- Intra-arterial PGE1 administration demonstrated significant success as a limb salvage procedure.
- Treatment was particularly effective when the arterial network between the knee and pedal arches remained intact.
- Provides a viable therapeutic option for limb preservation in complex vascular disease patients.
Abstract:
The authors present their result of a two-year follow-up of 106 patients to whom an intra-arterial perfusion of prostaglandin E1 was administered, as limb salvage procedure. The patients were in the IIIrd and IVth stage of occlusive diseases by Fountain, and surgical reconstructions were not possible. All patients were divided into five groups: A--diabetic angiopathy (5), B--distal form of atherosclerosis (40), C--diabetic angiopathy and atherosclerosis (45), D--Burger disease (10) and E--adjuvant therapy in reconstruction with poor run-off (6). The Doppler sonographic and angiographic measurements were performed. After transcutaneous (16 cases), or intraoperative (90 cases) introduction of the catheter into superficial of profunda femoral artery, a continuous intraarterial administration of prostaglandin E1 was carried out in a dose of 10 nanograms/kg body weight/minute (total dosage 3000 nanograms). The patients were controlled immediately after the treatment, as well as 1, 3, 6, 12, 24 and 36 months after the treatment. In efficiency of the treatment was estimated on the following basis: elimination of rest pain, healing of trophic ulceration and demarcation of gangrenous processes. Our late results of intra-arterial administration of prostaglandin E1 proved to be a very successful limb salvage procedure. The treatment was more successful in a connections between the upper knee arterial net and pedal arterial arches were preserved.