Acute limb ischemia in elderly patients: can iloprost be useful as an adjuvant to surgery? Results from the ILAILL study
Articolo
Data di Pubblicazione:
2007
Citazione:
Acute limb ischemia in elderly patients: can iloprost be useful as an adjuvant to surgery? Results from the ILAILL study / G. de Donato, G. Gussoni, G. de Donato, P. Cao, C. Setacci, C. Pratesi, A. Mazzone, M. Ferrari, F. Veglia, E. Bonizzoni, P. Settembrini, H. Ebner, A. Martino, D. Palombo. - In: EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY. - ISSN 1078-5884. - 34:2(2007 Aug), pp. 194-198.
Abstract:
OBJECTIVES:
To evaluate the effects of iloprost, in addition to surgery, on the outcome of acute lower limb ischemia (ALLI).
DESIGN:
Post-hoc analysis of a randomized, double-blind, placebo-controlled study.
METHODS:
In the context of the ILAILL (ILoprost in Acute Ischemia of Lower Limbs) study, 192 elderly patients (>70 years old) undergoing surgery for ALLI were assigned to receive perioperative iloprost (intra-arterial, intra-operative bolus of 3000 ng, plus intravenous infusion of 0.5-2.0 ng/kg/min for six hours/day for 4-7 days following surgery), or placebo (iloprost: n=100; placebo: n=92). Patients were followed-up for three-months following surgical revascularization.
RESULTS:
The combined incidence of death and amputation (primary study end-point) was significantly reduced in patients treated with iloprost (16.0% vs 27.2% in the placebo group; hazard ratio 1.99, 95% confidence interval 1.05-3.75, p=0.03). A statistically significant lower mortality (6.0%) was reported in patients receiving iloprost, compared to controls (15.2%) (hazard ratio 2.93, 1.11-7.71, p=0.03). The overall incidence of death and major cardiovascular events was lower in patients receiving iloprost compared to those assigned placebo (24.0% and 35.9%, respectively), at the limits of statistical significance (relative risk 1.64, 0.97-2.79, p=0.06).
CONCLUSIONS:
These results confirm the poor outcome in elderly patients with ALLI. Based on a subgroup analysis iloprost, as an adjuvant to surgery, appears to reduce the combined end-point of death and amputation.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Acute limb ischemia; Elderly patients; Iloprost; Reperfusion; Surgical revascularization
Elenco autori:
G. de Donato, G. Gussoni, G. de Donato, P. Cao, C. Setacci, C. Pratesi, A. Mazzone, M. Ferrari, F. Veglia, E. Bonizzoni, P. Settembrini, H. Ebner, A. Martino, D. Palombo
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