CONSERVATIVE TREATMENT OF PERIPHERAL ARTERIAL OCCLOSIVE DISEASE WITH ILOPROST AND HOME EXERCISE PROGRAM. EVALUATION OF THE RESULTS OBTAINED IN 5 YEARS FROM A STUDY MADE ON 360 PATIENTS

Abstract

Introduction: The treatment of patients with Pheripheral Arterial Occlusive Disease (P.A.O.D.) is, until now, a the rapeutics challenge. The purpose of this study was to con firm the safety of Iloprost infusion, to estimate the results after an Home Exercise Program joined to the therapy and to identify groups of patients with P.A.O.D. that can bene fit from Iloprost therapy.

Material and Methods: 360 patients with and without diabetet, with P.A.O.D. (Peripheral Arterial Occlusive Disease) at the stage of II, III, & IV, with Buerger Syndrom, were treated with Iloprost at the maximum dosage: 2 ng/kg/min for 6 hours a day, for a minimum of 1 week and a maximum of 3 weeks with cycles of therapy every 3, 6 or 12 months. At the end of each cycle of therapy there was assigned an Home Exercise Program. Patients with symptoms of pain are observed in the study and monitored for how long the pain lasted or diminished. The clinical benefit was evaluated on the reduction of the pain and analgesics, on the improvement of the trophics lesions and on the increase of gait’s distance.

Results: After 5 years of follow up, it was reported 12.2% of major amputations and 3.6% of deads. Over 60% of the patients, that were at risk for ampution at the begin ning of the study, were alive. The tollerability of therapy was been very accetable.

Conclusions: This study, at the end of 5 years, showed that the therapeutic infusion of Iloprost associated with an intensive Home Exercise Program, can, before 12 months, show patient improvement of the gait’s distance from 50-200%.