PGE-1 and iloprost: Effect on nutritive skin blood circulation and clinical influence on patients with critical limb ischaemia

Method: In a prospective study 27 patients with critical limb ischaemia rec eived infusion therapy with either PGE-1 (Prostavasin(R)) at a dosage of 0, 75 to 5,3 ng/kg body weight per minute or with Iloprost at a dosage of 0,39 to 2,8 ng/kg body weight per minute. Result: 5 of the 27 patients lost the ir rest pain entirely or their necrosis cleared, the symptomatology showed no change in eight patients and 14 showed a marked deterioration despite tr eatment. The filling time determined by fluorescence videomicroscopy on the dorsum of the fool proximal to the 1st and 2nd toes shortened in those pat ients who showed a clinical improvement from 53.4 +/- 35.9 seconds to 29.2 +/- 6.6 seconds and, in those patients who showed no improvement, remained largely unchanged on the whole. The three treatment groops differed with re gard to the partial pressure of oxygen measured transcutaneously over the d orsum of the foot prior to treatment. The patients who showed a clinical im provement had appreciably better figures (23.8 +/- 13.6 mmHg) than those in the less favourable treatment groops (8.8 +/- 6.5 and 6.5 +/- 9.2 mmHg). C onclusion: Thus the tcPO(2) of the dorsum of the fool appears to be importa nt for the prognosis of the course of peripheral ischaemia under prostaglan din infusion therapy. The prospect of improvement for patients with a tcPO( 2) of less than 10 mmHg over the dorsum of the foot is very slight.