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In 12 patients with peripheral vascular disease (Fontaine, stage II-IV), PGI2 (3-5ng/kg/min) was given intra-arterially continuously during 7 days. Besides angiological and hormonal control, the platelet behaviour was monitored by ADP- induced platelet aggregation (1μM), platelet sensitivity to PGI2, the platelet proteins β-TG and PF4, thromboxane B2 (RIA) and platelet count before, during and up to one week after termination of PGl2-infusion. In some patients platelet life span was performed by autologous 111 In-oxine labelled platelets prior and during PGl2-infusion. Immediately after beginning of PGI2-infusion, in general, a significant decrease in platelet activity can be detected. The response to ADP is diminished, as well as BTG and PF4. Between 24 and 48 hours after starting the PGI2-infusion, the levels reach again the starting level, followed thereafter by a significant increase in most of the patients. An increase in platelet count (in one patient to the fourfold) , a decrease in platelet sensitivity to PGI2 (≤50%) and a hyper-reactivity of the platelets to the in vitro ADP- stimulus is found. After termination of PGI2-treatment, the levels are returning back to normal within 48 hours, A trend to a prolonged platelet life span after PGI2-infusion is noted. Beside the clinical data, the prolonged platelet survival suggests a beneficial effect of the intra-arterial PGI2-application. The possible causes and risks of the temporary platelet activation during thePGI2-infusion are discussed.

Platelet Function During One Week Continuous Intra-Arterial PGI2-Infusion In Peripheral Vascular Disease