Evaluation of prostaglandin E1 analogues to promote wound healing after infrapopliteal angioplasty in patients with critical limb ischemia

Introduction: Revascularization is the cornerstone of critical limb ischemia (CLI) treatment for lower limb preservation.2 Prostaglandins E1 analogues has a vasodilator effect. Its pharmacological effect have been documented in preclinical and clinical studies.3 this study aim to study the evaluation of prostaglandins E1 analogue to promote wound healing in patients affected by ischemic foot ulcers after infra-popliteal angioplasty. Patients and methods: This is prospective cohort study conducted on 40 patients with critical limb ischemia after failed infrapopliteal angioplasty. Wound assessment was done according to WIFI classification. After debridement of ischemic wound, prostaglandins E1 analogues infusion administered twice daily. additionally, we have injected prostaglandins E1 analogues daily dose in skin ulcer area. Main study end-points were ABI increase, wound healing and Limb salvage. Results: Wound healing is the main outcome in this study. Patients showed significant improvement of wound healing and decrease the risk of major amputation. 17 of 40 patients (42.5%) showed healed wound after 6 months. 7 of 40 patients (17.5%) showed good granulation of the ischemic ulcer. (P-value 0.001). Morbidity occurred in 11 patients (27.5%) underwent major amputation due sever infection during the study (three below knee amputations and eight above knee amputations). Mortality occurred in five patients (12.5%). Conclusion: Prostaglandin E1 analogue administration showed accepted clinical outcomes in terms of technical success, high rate of limb salvage and amputation-free survival.