Introduction: The condition of the microcirculation is one of the decisive factors regulating proper tissue blood supply. Due to the very difficult treatment of the disease concerning this level of the vascular bed, the damage of microvessels occurring in patients with inflammatory arterial diseases still remains an unsuccessfully resolved problem for the vascular surgeon. The treatment of the disease using lumbar or thoracic sympathectomy is very often insufficient.
In looking for a new promising pharmacological therapy improving microcirculation flow, the use of prostanoids was proposed (e.g. Prostaglandin E₁ - alprostadil).
Material and methods: A group of 122 patients (aged 20–55 years) treated with prostanoids at the Department of General and Vascular Surgery of the Silesian Medical Academy was investigated. All the patients underwent previous surgical (sympathectomy, distal amputations) or pharmacological treatment (heparin, pentoxyfilin, dextran), usually with moderate and short clinical condition improvement. The patients were qualified according to clinical examination (excluding the existence of femoral and iliac artery occlusions) and the results of capillaroscopy and Laser Doppler Flowmetry of the affected limb.
Results: Clinically documented significant improvement was obtained in 60.2% of patients. There were no cases of local conditions worsening the present condition. In 3 cases the treatment was stopped due to allergic reaction or bad tolerance of the prostanoids. In 46 cases (37.5%) the clinical condition remained unchanged.
Conclusions: 1. The use of prostanoids (PGE₁, alprostadil) is an effective treatment of inflammatory peripheral vessel diseases. In the case of insufficient surgical or pharmacological therapy, the prostanoids should be the treatment of choice in this kind of pathology.
2. The implementation of both capillaroscopy and Laser Doppler Flowmery allows a proper assessment of the degree of the microcirculation injury and treatment results.