Summary
Twelve patients (age 33–77 years, mean age 68.4 years) with peripheral vascular disease (PVD) stage III–IV received continuous intravenous infusions of 5 ng prostacyclin (PGI2)/kg/min and physiological saline for 7 days. The administration was randomized and double-blind with an interval of 7 days between the infusions. During PGI2 infusion systolic blood pressure fell significantly from 147.8±4.8 mm Hg to 140.6±4.0 mm Hg (P<0.01) and returned to 144.5±4.9 mm Hg post infusion. Transcutaneous p O2 (tcp O2 ) measured on the instep of the affected limb increased significantly by 8.9±3.8 Torr during PGI2 infusion and remained elevated during the subsequent week. A significant reduction of pain was observed from the 5th day of PGI2 infusion, lasting for at least the following observation period. Platelet cAMP increased from 18.8±1.5 pmol/108 platelets to 24.7±1.6 pmol/108 platelets on the 3rd day of PGI2 infusion (P<0.01). Spontaneous platelet aggregation was also significantly reduced during PGI2 infusion. However, 7 days after the infusion thromboxane B2 (TXB2) in plasma and spontaneous platelet aggregation significantly increased in comparison with the preinfusion values, indicating a rebound phenomenon. The clinical outcome was favorable in 9 of 12 patients, was unchanged in two patients, while progressing to limb amputation in one patient.
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Abbreviations
- TXA2 :
-
Thromboxane A2
- PGI2 :
-
Prostacyclin
- PVD:
-
Peripheral Vascular Disease
- tcpO2 :
-
transcutaneous pO2
- VAS:
-
Visual Analog Scale
- PAT III:
-
Platelet Aggregation Test III by Breddin
- HDL:
-
high density lipoprotein
- AT III:
-
antithrombin III
- SFMC:
-
Soluble fibrinogen-fibrin monomer complexes
- PAR:
-
platelet aggregation ratio
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For Professor Dr. W. Kaufmann on his 60th Geburtstag
Supported by the Landesamt für Wissenschaft und Forschung, NRW
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Hossmann, V., Auel, H., Rücker, W. et al. Prolonged infusion of prostacyclin in patients with advanced stages of peripheral vascular disease: A placebo-controlled cross-over study. Klin Wochenschr 62, 1108–1114 (1984). https://doi.org/10.1007/BF01782467
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DOI: https://doi.org/10.1007/BF01782467