A randomized, placebo controlled trial of prostacyclin (PGI 2) in peripheral arterial disease

Observational studies suggest that short term infusion of prostacyclin (PGI 2) may be of rapid and prolonged benefit in peripheral arterial disease. 10 patients with peripheral arterial disease received 72 hour intravenous infusions of PGI 2 and saline alone. The administration was randomized and single blind and 7 days separated the infusions. Calf muscle blood flow did not alter during PGI 2 or control infusions. Reactive hyperaemia improved slightly after PGI 2 but not significantly more so than after the control infusion. Leg pain improved during both infusions, but more so during PGI 2 infusion. Systolic pressure in the cubital, posterior tibial and dorsal pedal arteries was unaltered by PGI 2 infusion. Both the inhibition of spontaneous platelet aggregability and the aggregation response to ADP had returned to baseline 72 hours after PGI 2, although platelet adhesion remained impaired. Coagulation, fibrinolysis and apparent viscosity were unaltered by PGI 2 infusion. Healing of ischaemic ulcers was not observed within 7 days of either infusion. However, within 8 weeks, 6 patients had undergone ulcer healing and 3 had progressed to amputation.