Prostacyclin for ischemic ulcers in peripheral arterial disease. A random assignment, placebo controlled study.

A 72 h infusion of prostacyclin or placebo was given into femoral artery as a treatment for ischemic ulcers in 30 patients with peripheral arterial disease. Patients were well matched for age, sex, type and localization of disease, rest pain, number and area of ulcers, calf blood flow and previous sympathectomies. They had no diabetes mellitus, gangrene or marked aorto-iliac involvement. Six weeks after the infusion there was a significant difference in ulcer area between the two groups (p less than 0.02, t unpaired test): mean ulcer area decreased (p less than 0.02, t paired test) in the prostacyclin-treated group, but not in the placebo group (p greater than 0.05, t paired test). Thus, intra-arterial infusion of prostacyclin promotes healing of ischemic ulcers in non-diabetic patients with peripheral arterial disease without gangrene.