Tratamiento de la isquemia crítica de las extremidades inferiores. Cirugía distal y endovascular

Use of intravenous alprostadil in patients with severe critical ischemia of the lower limbs

“…Surgical management studies performed in patients with ages similar to those of patients in this study, although with a lower proportion of cases of pain at rest (95.1% vs. 73.6%) or ulcers in the extremities (81.2% vs. 26%), showed similar proportions of amputations (22.9% vs. 16.8%) and salvaged limbs, 10,14 which may be evidence of the benefits achieved with conservative management of patients with severe PAD, as performed in this study. However, a recently published clinical trial showed no significant differences between alprostadil and a placebo in the rates of complete cure and amputation, with the exception of the group of patients with diabetes mellitus, in whom the amputation rate was significantly lower.…”

“…11 The mean age of the patients evaluated was similar to that reported in studies by Peña-Corte´s et al, Karles-Ernotte et al, and Lawell et al, which had similar populations (72 to 74.5 years); however, these studies had a greater proportion of men, which did not occur in our series of cases, which had a symmetric distribution in both sexes. 9,[12][13][14][15] The discrepancy in results may be related to the high cardiovascular risk and increased peripheral arterial damage in the elderly female population of Colombia.…”