Document Detail


Iloprost reduces peripheral resistance during femoro-distal reconstruction.
MedLine Citation:
PMID:  1374040     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A randomised placebo-controlled trial was conducted to investigate the effect of iloprost, a stable prostacyclin mimetic, on peripheral resistance during femoro-distal bypass. Patients undergoing femoro-distal long saphenous vein bypass for critical ischaemia received 3000 ng of iloprost or placebo infused into the graft via an unligated side branch over 2 min. Graft blood flow and peripheral resistance were measured for 20 min, using an operative Doppler flowmeter (OpDop 130, SciMed, U.K.) and a pressure transducer to record graft pressure. Postoperatively, graft blood flow was assessed by daily duplex ultrasound for 7 days. Iloprost produced an immediate drop in peripheral resistance in all cases (n = 18) by a mean (range) of 40% (4-80%) compared with controls (n = 15) in whom there was a 5.3% (-8 to +36%) increase in resistance (p less than 0.01, Wilcoxon test). Decreased peripheral resistance in iloprost-treated patients persisted to 20 min. The largest decreases in peripheral resistance occurred in patients with the highest initial resistances (r = 0.56, p less than 0.02). Graft flow during the same period increased by 52% (-7 to 294%) compared with controls in whom there was a 6% (-17 to 26%) increase in flow, (p less than 0.01). Flow remained elevated by 53% over baseline values at 1 week post-infusion in the iloprost-treated group but this did not achieve statistical significance compared to controls in whom flow also increased by 13%. Iloprost produces an immediate decrease in peripheral resistance associated with a prolonged increase in graft blood flow. This may reduce graft failure in the early postoperative period.
Authors:
F C Smith; G M Tsang; H R Watson; C P Shearman
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European journal of vascular surgery     Volume:  6     ISSN:  0950-821X     ISO Abbreviation:  Eur J Vasc Surg     Publication Date:  1992 Mar 
Date Detail:
Created Date:  1992-06-02     Completed Date:  1992-06-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8709440     Medline TA:  Eur J Vasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  194-8     Citation Subset:  IM    
Affiliation:
University Department of Vascular Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham, U.K.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anastomosis, Surgical
Drug Administration Schedule
Female
Femoral Artery / surgery*
Humans
Iloprost / administration & dosage,  pharmacology*
Intraoperative Period
Ischemia / physiopathology,  surgery*
Leg / blood supply*
Male
Middle Aged
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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