Document Detail


Adjuvant prostanoid treatment during femorodistal reconstruction.
MedLine Citation:
PMID:  7686028     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A prospective randomized placebo-controlled trial was conducted to determine the effects of the stable prostacyclin analogue iloprost on early graft patency and hemodynamic parameters during femorodistal reconstruction for critical leg ischemia. Peripheral resistance and graft blood flow were measured using an operative Doppler flowmeter and graft pressure transducer. Postoperative graft surveillance was continued at 1-month and then at 3-month intervals by duplex Doppler ultrasonography, measurement of ankle-brachial pressure indices, and intravenous digital subtraction angiography when indicated. In patients receiving 3000 ng of iloprost (n = 45) infused into the graft on completion there was an immediate mean decrease in peripheral resistance of 44% that persisted to skin closure in comparison with controls (n = 38) in whom no such decrease in resistance occurred (p < 0.001, Wilcoxon test). During the same period, mean graft blood flow increased in iloprost-treated patients by 74.5% compared with controls in whom there was a 6% increase in flow (p < 0.001). Primary cumulative patencies at 1 month were significantly higher in iloprost-treated grafts, 98% compared to 83% for controls (p < 0.05, log-rank test). Cumulative primary patencies at 1 year and secondary patencies at 1 month and 1 year were also greater in the iloprost-treated group (67%, 98%, and 87.6%, respectively) compared to controls (65%, 86%, and 79.3%, respectively), but these did not achieve statistical significance. A single bolus infusion of iloprost has prolonged beneficial effects on graft blood flow and peripheral resistance during femorodistal reconstruction. This is reflected by improved early primary graft patencies.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
F C Smith; I A Thomson; N C Hickey; I S Paterson; G M Tsang; M H Simms; C P Shearman
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  7     ISSN:  0890-5096     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  1993 Jan 
Date Detail:
Created Date:  1993-07-29     Completed Date:  1993-07-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  88-94     Citation Subset:  IM    
Affiliation:
University Department of Vascular Surgery, Queen Elizabeth Hospital, Birmingham, U.K.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Blood Flow Velocity / drug effects
Female
Femoral Artery / surgery*
Graft Occlusion, Vascular / prevention & control
Humans
Iloprost / administration & dosage*
Intraoperative Period
Ischemia / surgery*
Leg / blood supply*
Male
Middle Aged
Prospective Studies
Saphenous Vein / transplantation
Vascular Patency / drug effects
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
78919-13-8/Iloprost

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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