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.
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References
1.
Moncada S., Vane J.: Unstable metabolites of arachidonic acid and their role in hemostasis and thrombosis. Br Med Bull34:129, 1978.
2.
Johnson M., Harrison H.: Vascular prostacyclin may be reduced in diabetes in man. Lancet12:325, 1979.
3.
Golub M., Zia P., Matsumo M., et al: Metabolism of prostaglandin A, and E1 in man. J Clin Invest56:1404, 1975.
4.
Ambrus J., Taheri P., Killion D., Donaldson G.: Clinical experience with prostaglandin E, in the treatment of arteriosclerosis obliterans. A preliminary report. J Med13:1, 1982.
5.
Born G.: Quantitative investigation into the aggregation of blood platelets. J Physiol162:67, 1962.
6.
Reid HL, Barnes AS, Lock PS, Dormandy TL: A simple method for measuring erythrocyte deformability. J Clin Pathol29:855, 1976.
7.
Ambrus J., et al: Red cell flexibility and platelet aggregation in patients which chronic obstructive vascular disease (COAD) and study of therapeutic approaches . Angiology135:418, 1984.
8.
Clifford P., et al: Treatment of vasospastic disease with prostaglandin E,. Br Med J281:1031, 1980.
9.
Carlson L., Olsson A.: Intravenous prostaglandin E, in severe peripheral vascular disease. Lancet2:810, 1976.
10.
Carlson L., Eklund B.: Recent Advances in Cardiology. 1980. Stockholm , Sweden: Department of clinical physiology and King Gustav VResearch Institute, Karolinska Hospital.
11.
Hirai M., et al: Hemodynamic effects of intravenous PGE, on patients with arterial occlusive disease of the leg. Angiology36:407, 1985.
12.
Beitner H., et al: Prostaglandin E, treatment of leg ulcers caused by venous or arterial incompetence. Acta Derm60:425, 1980.
13.
Data J., et a: Prostaglandin E,: Treatment for diabetic ulcerations. Fed Proc39:747, 1980.
14.
Oudhof, et al: Platelet hyperaggregability in acute coronary disease managed with prostaglandin E,. University Hospital, Leiden , Netherlands.
15.
Popat K., Pitt B.: Prostaglandin E, infusion in acute myocardial infarction with left ventricular dysfunction. Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
16.
Miyazaki M. : JapaneseCirc J43:433, 1978.
17.
Kuriyama Y., et al: The effects of intravenous administration of prostaglandin E, on cerebral circulation in patients with cerebrovascular disease. Med J (Osaka University) 26:3, 1976.
18.
Welch K., et al: Effects of prostaglandins on the external and internal carotid blood flow in the monkey. Neurology24:705, 1974.
19.
Spira P., Mylecharane E., Lance J.: The effects of humoral agents on the cranial circulation of the monkey. Res Clin Stud4:37, 1976.
