Treatment of complications of peripheral obstructive arterial disease with prostaglandin E1

Forty-one subjects diagnosed with complications of peripheral obstructive arterial disease were treated with continuous infusions of Prostaglandin E1 (PGE1) over a three-week period during 1981-1982 in an open-label, uncontrolled study under ward conditions. Ischemic rest pain and ulcers were treated with intravenous infusions of PGE1 at dose rates of 14-21 ng kg-1 min-1 for seventy hours, once a week. Symptomatic relief of rest pain and spontaneous healing of stable ulcers occurred. Whereas classically dependable noninvasive circulation evaluations were not prognostic of the treatment's success, they did suggest local and rheological changes rather than a generalized vasodilation. The PGE1 infusion is efficacious for an unknown length of time, which may somehow be related to inhibition of platelet aggregation. Since transient ischemic attack (TIA) and cerebrovascular accident (CVA) were found to be associated with PGE1 infusion, cerebrovascular evaluation must be conducted prior to considering PGE1 replacement therapy for the individual patient.