Intra-Arterial Prostaglandin E1Infusion in Patients with Rest Pain: Short-Term Results

Purpose . To present our results after short-term (1 month) intra-arterial infusion therapy of PGE 1 -alprostadil via a port system implanted in the ipsilateral external iliac artery (EIA) in patients with severe rest pain. Methods . Ten patients with severe rest pain were included. All patients showed extensive peripheral vascular disease below the knee. The tip of the catheter was introduced via a retrograde puncture in the ipsilateral external iliac artery (EIA). The patients received intraarterial infusion of PGE 1 , 20 mgr alprostadil daily, via the port catheter for 1 month. Results . Clinical success was evaluated according to subjective grading of pain (group A significant decrease, group B moderate decrease and group C no response). A significant decrease of rest pain was observed in 8 (group A, 80%) patients, a moderate decrease in 2 (Group B, 20%), whereas no patients demonstrated any significant response. Both patients of group B had Buergers' disease and continue to smoke during therapy. No peripheral thrombosis or clinical deterioration was noticed. Conclusion . Intraarterial infusion of PGE 1 alprostadil on a daily basis, using a port catheter into the ipsilateral EIA, in selected patients with severe rest pain, seems to be very effective, without any serious complications.