Continuous infusion of Iloprost by elastomeric pump in stage IIb and III peripheral occlusive arterial disease

From September 1999 to September 2001 we treated 45 patients affected with peripheral occlusive arterial disease at Stage IIb (25) and III (20, of whom 6 had Buerger's disease) with a continuous infusion of Iloprost. We used an alternative infusion method: 28 consecutive days by elastomeric pump. The outcome was encouraging: increased walking distance in 76% of the Stage IIb patients, marked decrease in pain in the Stage III patients (complete regression of pain in the patients with Buerger's disease). The side-effects were: fushing in two patients, which receded after three days' treatment; phlebitis at the infusion site in 5 cases, which required a new venous access. The infusion method we used offers the advantages of achieving a steady plasma drug concentration throughout the 24 hour period, markedly reducing hospitalisation costs (3-5 days' hospitalisation, after which the elastomeric pump can be recharged once a week in day-hospital) and minimal or no discomfort for the patient.