Prostanoids for critical limb ischaemia

Abstract

Despite some positive results regarding rest-pain relief, ulcer healing and amputations, there is no conclusive evidence based on this meta-analysis of the long-term effectiveness and safety of different prostanoids in patients with CLI. Further well-conducted, high quality randomised double-blinded trials should be performed.

Molecular Mechanisms Regulating the Vascular Prostacyclin Pathways and Their Adaptation during Pregnancy and in the Newborn

“…Three IP analogs are currently approved by the FDA for treatment of PAH: epoprostenol and treprostinil, administered by subcutaneous infusion and inhalation, and iloprost, given by inhalation (Ivy, 2010). IP analogs are also used in peripheral vascular diseases such as acute lower limb ischemia (Ruffolo et al, 2010), diabetic macro-and microangiopathy, intermittent claudication, Buerger's disease, arteriosclerosis obliterans, and Raynaud's phenomena (Melian and Goa, 2002;de Leval et al, 2004). On the other hand, the effectiveness of IP analogs in sepsis and adult respiratory distress syndrome is controversial (Zardi et al, 2007;Afshari et al, 2010).…”

Effect of fibroblast growth factor NV1FGF on amputation and death: a randomised placebo-controlled trial of gene therapy in critical limb ischaemia

“…At present, no eff ective alternatives to either percutaneous or surgical revascularisation in patients with critical limb ischaemia exist. 9,10 Techniques to improve the perfusion of the ischaemic leg by less invasive means are needed. Substantial research has focused on development of therapeutic angiogenesis.…”

Emergency in Diabetic Foot

“…Also CT allows an optimal evaluation of examined arterial district. It is limited by the use of iodinated contrast organ that increases the risk of nephro toxicity in patients with severe chronic kidney disease specially if performed at short distance from a revascularization [57,58]. Arteriography never must be considered a diagnostic examination.…”