Abstract:

Purpose: In this study, we evaluated to effectiveness and clinical benefit of iloprost that alternative therapy in patients with chronic and critical lower limb ischemia who were not candidate for surgery because of poor distal arterial bed. Methods: Clinical response for iloprost administration evaluated in sixteen patients. Surgery was performed to bypass stenoses located proximal to crural arteries in 8 patients. Patients were grouped into combined treatment group in which patients who had a bypass procedure were included, and medical treatment group in which patients who had only iloprost administration were included. A comparative analysis of improvement in clinical findings was performed between two groups. Recession of rest pain, reduce of need for analgesic drug usage, healing of limb wound, ABI (ankle / brachial pressure index) and increasing of walk interval without pain evaluated in this cases. Results: After the therapy, pain severity and need for analgesic drug were reduced and walk interval increased in all patients. Patient"s Fontaigne class was decreased after the therapy. Improvement in ABI of combined treatment group was better than that of medical therapy group. Conclusion: Iloprost usage may be useful in patient"s with poor arterial distal bed and may also benefit in combining of the surgery in proximal arterial stenosis. We think that by determination of iloprost effectivity with prospective randomized studies with more cases, it can be a.valuable alternative for routine therapy. (Turkish J Vasc Surg 2006;15(1):21-24).

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