Intravenous iloprost for treatment of critical limb ischemia in patients unsuitable for revascularization

Vascular. 2015 Oct;23(5):483-9. doi: 10.1177/1708538114552839. Epub 2014 Oct 14.

Abstract

Introduction: Whether medical therapy alone may reduce the amputation rates in patients with chronic limb ischemia and who are unsuitable for revascularization is a controversial topic. In this study, we aimed to investigate the effects of 1 week infusion of iloprost in the treatment of patients with chronic limb ischemia.

Materials and methods: Twenty-seven consecutive patients were included in the study. There were 23 men (85.2%) and 4 women (14.8%) with a mean age of 68.93 ± 14.84 years. Patients were considered eligible if they were unsuitable for surgical and endovascular revascularization. Follow-up was made on 10th day and 6th month and included ankle brachial index and clinical assessment.

Results: Minor side effects occurred in four patients (16.0%), but the treatment was continued. In-hospital mortality occurred in one patient (4.0%). Another two patients died and four patients received amputation until follow-up (overall mortality 11.1%). There was significant increase in mean ankle-brachial index values between 1st day and 10th day (p < 0.001), between 1st day and 6th month (p < 0.001), and between 10th day and 6th month (p < 0.001).

Conclusion: One-week treatment with iloprost may provide both long lasting symptomatic benefit and may improve hemodynamic parameters, which were shown to predict future amputation.

Keywords: Critical limb ischemia; iloprost; peripheral artery disease.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amputation, Surgical
  • Ankle Brachial Index
  • Chronic Disease
  • Critical Illness
  • Drug Administration Schedule
  • Endovascular Procedures / adverse effects
  • Female
  • Hospital Mortality
  • Humans
  • Iloprost / administration & dosage*
  • Infusions, Intravenous
  • Ischemia / diagnosis
  • Ischemia / drug therapy*
  • Ischemia / mortality
  • Ischemia / physiopathology
  • Lower Extremity / blood supply*
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Vascular Surgical Procedures / adverse effects
  • Vasodilator Agents / administration & dosage*

Substances

  • Vasodilator Agents
  • Iloprost