iloprost and Foot-Ulcer

The flux distribution within ischemic ulcers and adjacent skin and its change by prostanoids was investigated using laser Doppler flux scanning. A prostanoid-induced increase in ulcer flux could be a rationale for the improved wound healing. In a single-blind prospective study 18 patients received prostaglandin E1 (PGE1) (333.3 ng/min.), iloprost (41.7 ng/min final dose), and 0.9% saline in a randomized order. The average laser Doppler flux within the ulcer (LFU, x +/- SEM, arbitrary units) or in the adjacent skin (LFS) was evaluated before and 30, 60, 90, and 120 min after prostanoid/saline infusion. LFU increased with PGE1 from 2.30 +/- 0.27 to 3.08 +/- 0.31 (+33.9%; P < 0.001) and with iloprost from 2.37 +/- 0.26 to 3.03 +/- 0.27 (+27.8%; P < 0.001) after 120 min, respectively. Saline did not change LFU significantly: 2.19 +/- 0.18 vs 2.55 +/- 0.26 (+16.4%; P > 0.05). Simultaneously, LFS was not significantly changed when pretreatment values were compared with mean flux at 120 min: PGE1 2.13 +/- 0.27 vs 2.54 +/- 0.34, iloprost 2.03 +/- 0.26 vs 1.94 +/- 0.21, and saline 1.74 +/- 0.27 vs 1.92 +/- 0.30 (P > 0.05, each), respectively. The laser Doppler flux scanning technique might be a tool to study the distribution of laser Doppler flux within ischemic ulcers. This might be useful to study the physiological or pathophysiological control of flux within ischemic ulcers as well as possible therapeutic approaches.

Topics: Adult; Aged; Alprostadil; Arterial Occlusive Diseases; Cross-Over Studies; Female; Foot Ulcer; Humans; Iloprost; Ischemia; Laser-Doppler Flowmetry; Leg; Leg Ulcer; Male; Middle Aged; Ultrasonography; Vasodilator Agents

Topics: Aged; Analgesics, Opioid; Anti-Bacterial Agents; Drug Therapy, Combination; Factor Xa Inhibitors; Female; Foot Ulcer; Humans; Iloprost; Naloxone; Nifedipine; Oxycodone; Rivaroxaban; Scleroderma, Systemic; Vasodilator Agents

The aim of this study is to evaluate the role of Iloprost as an early predictor of successful revascularization in patients affected by ischemic diabetic foot ulcers (DFUs).. Consecutive patients with ischemic DFUs with persistent low TcPO2 (<30mmHg) one day after a technical successful Percutaneous Transluminal Angioplasty (PTA) have been included. All patients underwent Iloprost infusion and TcPO2 has been recorded at days 3, 14 and 30. According to the TcPO2 reported at day 3, patients were divided into two groups: group A (patients with TcPO2 ≥30mmHg) and group B (patients with TcPO2 <30mmHg). Baseline TcPO2 values at days 3, 14 and 30 after Iloprost infusion and needing of re-intervention (re-PTA) have been evaluated.. Twenty-five patients have been included, 12/25 (48%) in Group A and 13/25 (52%) in Group B. There were no significant differences at the baseline and one day after PTA between the two groups while TcPO2 values recorded in Group A at days 3, 14 and 30 after Iloprost infusion were significant higher in comparison to the Group B (χ = 0.005). The rate of re-PTA were respectively 33,3% (Group A) and 53,8% (Group B) (p = 0.03).. Iloprost may be an early predictor of successful revascularization in patients affected by critical limb ischemia (CLI) and DFUs.

Topics: Diabetes Mellitus; Diabetic Foot; Epoprostenol; Foot Ulcer; Humans; Iloprost; Ischemia

Topics: Diabetes Mellitus; Epoprostenol; Foot Ulcer; Humans; Iloprost; Ischemia; Limb Salvage

Topics: Adolescent; Age of Onset; Antiphospholipid Syndrome; Child; Female; Foot; Foot Ulcer; Humans; Iloprost; Ischemia; Raynaud Disease; Regional Blood Flow; Treatment Outcome; Vasoconstriction; Vasodilator Agents; Wound Healing