Key result
Treatment with iloprost and physical therapy resulted in the preservation of 53.85% (7 of 13) of limbs at 1 year that had previously been scheduled for amputation.
Why the study?
Does a combination of iloprost and physical therapy prevent amputation in patients with limbs scheduled for amputation?
Does a combination of iloprost and physical therapy prevent amputation in patients with limbs scheduled for amputation?
Iloprost combined with physical therapy may serve as a viable alternative to amputation in severe limb ischemia, with TcPO2 monitoring helping to predict limb preservation.
Answers are grounded in this paper and cite their sources.
Should not yet change practice in critical limb ischemia; leaves open a role for iloprost plus physical therapy in amputation candidates.
To help in determining management strategy as an alternative to amputation by using a synthetic prostacycline, a preliminary study was undertaken in 12 patients (11 men and one woman), with a mean age of 71.08 years, ie, 13 limbs evaluated at the stage of amputation. All patients were treated with a combination of iloprost and physical therapy (massage, specific exercises, cardiorespiratory training). Static transcutaneous oxygen pressure (TcPO2) was measured, with a sensitization test by verticalization and inhalation of oxygen, on day (D) D0, D15, D28, D60, D180, and D365. Results were analyzed in absolute terms and by tissue oxygenation ratio (TOR) (ratio between absolute values of TcPO2 in the foot and those of a reference chest electrode). Supine TOR and vertical TOR, with values of 36.67 and 65.08, respectively, appeared to be significantly linked to the variable "preservation of limb". At 1 year, seven limbs were preserved (53.85%) while amputation had been scheduled for all the patients treated. Evidence was found in all patients who kept their limb of stability (7.69%) and a decrease in (30.77%) or disappearance of pain (15.38%) at 1 year.
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Chomard et al. (1999) studied Limbs evaluated at the stage of amputation (n=12). Iloprost and physical therapy was evaluated on Preservation of limb at 1 year. Treatment with iloprost and physical therapy resulted in the preservation of 53.85% (7 of 13) of limbs at 1 year that had previously been scheduled for amputation.
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