Iloprost, a Prostacyclin Analog in the Treatment of Advanced Peripheral Arterial Disease:

Iloprost (ZK 36 374), a derivative of carbaprostacyclin, was infused intravenously for seventy-two hours to 10 patients with advanced obliterative peripheral arterial disease. Nine patients reported subjective improvement after the treatment. In 6, the effect lasted for up to two months. In 2, chronic crural ulcers healed for at least a year and a half. In objective circulatory parameters (angiography, plethysmography, ankle blood pressure), no uniform findings could be registered. The possible role of vasodilative, antiaggregative, or micro-circulatory actions of iloprost remains an open question. If the dose is kept in the range of 2ng · kg-1 min-1, iloprost is generally well tolerated, except for its side effects originating from vasodilation or stimulation of the motility of the gastrointestinal tract. No serious side effects were observed. In selected, not very advanced cases, iloprost offers a new approach in the treatment of peripheral arterial disease.