Intra-arterial injection of iloprost reduces the risk of early recoil after balloon angioplasty of below-the-knee vessels in patients with critical limb ischemia

Troisi, Nicola; Farina, Alberto; Chisci, Emiliano; Ercolini, Leonardo; Frosini, Patrizio; Pigozzi, Clara; Guidotti, Azzurra; Michelagnoli, Stefano

doi:10.23736/s0021-9509.16.09617-8

Cited by 2 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One study found reduced risk of early elastic recoil, with a consequent decrease in early restenosis in patients receiving iloprost injection during infrapopliteal angioplasty with DEB. 16 In our study, DEB and DEB-I groups had similar rates of mortality, restenosis, and major and minor amputations at one year, with comparable rates of total wound healing, although the wound healing time was significantly shorter in the latter group of subjects.…”

Section: Discussionsupporting

confidence: 55%

Iloprost treatment on top of infrapopliteal angioplasty accelerates wound healing in critical leg ischemia

İnan

2019

Vascular

View full text Add to dashboard Cite

Objectives This study aimed to examine the efficacy of the concomitant use of infrapopliteal drug-eluting balloon angioplasty and a medical treatment (iloprost) in the treatment of critical leg ischemia. Methods Eighty-seven patients that underwent infrapopliteal drug-eluting balloon angioplasty for critical leg ischemia were included in this retrospective study. For analyses, patients were allocated into one of the two groups: 55 patients that underwent drug-eluting balloon angioplasty alone (drug-eluting balloon Group), and 32 patients that received intravenous iloprost for one week after drug-eluting balloon (DEB-I Group). Demographic, perioperative and follow-up clinical data were extracted retrospectively and analyzed. Results Duration of hospitalization was significantly longer in the DEB-I group (9.7 vs. 3.1 days, p < 0.001); however, the two groups were similar in terms of other clinical outcomes including early postoperative mortality, and primary patency, wound healing, reintervention, mortality, and amputation rates at one year ( p > 0.05 for all). Primary patency was similar across groups. Wound healing occurred earlier in the DEB-I group when compared to drug-eluting balloon group, in the subgroup of patients with ischemic wound at baseline. Mean time to wound healing was 3.0 ± 0.6 and 4.4 ± 0.6 months in DEB-I and drug-eluting balloon groups, respectively ( p = 0.037). Conclusions Iloprost add-on treatment in patients undergoing drug-eluting balloon angioplasty for critical limb ischemia seems to have additional benefits, at least in terms of accelerated wound healing. Further large prospective studies are warranted.

show abstract

Section: Discussionsupporting

confidence: 55%

Iloprost treatment on top of infrapopliteal angioplasty accelerates wound healing in critical leg ischemia

İnan

2019

Vascular

View full text Add to dashboard Cite

show abstract

“…Prolonged infusion of iloprost is a first-line option in the treatment of patients with CLTI unsuitable for revascularization [21], nevertheless several studies have shown a favourable effect also in improving patency and clinical outcomes after revascularization of the lower limbs. Furthermore, intra-arterial administration is effective in inhibiting the early elastic recoil [11]. In the present study the rate of complications after intra-arterial iloprost administration was not negligible.…”

Section: Discussioncontrasting

confidence: 42%

“…Maybe intra-arterial administration of 3 μg over 1-3 minutes is too much higher for the majority of patients. We used this dosage previously reported in other papers [9,11]. Anyway, further studies are needed to evaluate the appropriate dosage of iloprost for intra-arterial administration.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

2D perfusion angiography as quantitative method to evaluate iloprost effect on foot circulation

Troisi

Panci

Piazza

et al. 2022

Vasa

Self Cite

View full text Add to dashboard Cite

Summary: Background: Two-dimensional (2D) perfusion angiography is useful for the evaluation of foot perfusion in patients with critical limb-threatening ischemia (CLTI). Iloprost is a synthetic prostacyclin analogue presenting vasodilating properties. Aim of this study was to demonstrate the utility of 2D perfusion angiography as quantitative method to evaluate iloprost effect on foot circulation. Patients and methods: Between January 2020 and June 2020 25 patients with CLTI underwent below-the-knee (BTK) endovascular revascularization, intra-arterial administration of iloprost, and assessment of foot perfusion by 2D perfusion angiography. Iloprost was administered as an intra-arterial bolus of 3 μg over 1–3 minutes immediately after BTK revascularization. The 2D perfusion angiography was performed in a standardized manner with a 5-F catheter placed into the popliteal artery. A wide region of interest (ROI) was identified to assess the foot perfusion. Time–density curves were calculated by the perfusion software. Changes of the overall time-density curves before and after the administration of iloprost were evaluated. Results: Endovascular revascularization was successful in all cases. The mean reduction of systolic pressure value after iloprost administration was 23.1 mmHg. Eight patients (32%) experienced a minor complication (6 cutaneous rush, 2 symptomatic hypotension >40 mmHg). In 20 patients the time-density curves under ROI increased after the intra-arterial administration of iloprost (+31.6%, range from +4.9% to +78.7%). Five patients had no modification or a slight decrease of foot perfusion after iloprost administration (non-responders patients). Conclusions: Patients undergoing intra-arterial administration of iloprost accounted for a not negligible rate of minor complications. 2D perfusion angiography was valuable as quantitative method to evaluate the iloprost effect on foot circulation. This technique could be useful to classify the patients in responders or non-responders to iloprost therapy.

show abstract

Intra-arterial injection of iloprost reduces the risk of early recoil after balloon angioplasty of below-the-knee vessels in patients with critical limb ischemia

Cited by 2 publications

References 0 publications

Iloprost treatment on top of infrapopliteal angioplasty accelerates wound healing in critical leg ischemia

Iloprost treatment on top of infrapopliteal angioplasty accelerates wound healing in critical leg ischemia

2D perfusion angiography as quantitative method to evaluate iloprost effect on foot circulation

Contact Info

Product

Resources

About