[The role of iloprost in the treatment of critical XXXX of the limbs].

@entity1 @entity1671 @entity390 @entity63 @entity1066 @entity117 @entity4218 @entity2407 @entity391 @entity294 @entity591 @entity10 @entity613 @entity951 @entity158 @entity594 @entity2119 @entity551
Iloprost is a synthetic stable analogue of prostacyclin (PGI2), which shares its antiaggregating and vasodilating properties. Iloprost has been administered by i.v. route to @entity1 with @entity4218 ( @entity4218 ) of different origin (maximal dosage: 2 ng/kg/min 6 hours/day infusion for 14-28 days). In @entity1 with claudicatio intermittens (Fontaine stage II) iloprost improved the time to @entity613 and the maximal walking distance on treadmill, with an effect still lasting 60 days after suspension. This benefit was not related to a significant improvement in blood flow. Five multicentric, perspective, randomized versus placebo studies in @entity1 with more severe @entity4218 (Fontaine stage III-IV) susceptible to surgical treatment, showed that iloprost was able to reduce @entity158 and @entity1066 dimensions. Furthermore, tha amputation rate of the @entity63 limb was significantly lower in @entity1 treated with iloprost during a 6 month follow-up (p < 0.01). Iloprost was also more effective than @entity117 in causing @entity158 relief and @entity1066 in @entity1 with @entity2119 and more effective than @entity594 in reducing frequency, intensity and duration of @entity63 episodes in @entity1 with @entity2407 . Minor side effects of iloprost administration are represented by facial @entity1671 , @entity591 , @entity10 , @entity390 , @entity391 , abdominal cramping, @entity294 , whose frequency ranges from 16% to 70%; major collateral effects, occurring in less than 5% of @entity1 , are above all represented by severe @entity551 and @entity951 . Clinical data indicate therefore that iloprost treatment can allow to improve the clinical conditions and the prognosis in @entity1 with critical @entity63 of the limbs, not candidate to surgical revascularization, by causing a relief of @entity158 , a reduction in @entity1066 dimensions and deferring amputation.
