Pharmacological manipulation of peripheral resistance during distal vascular reconstruction.

A randomised placebo-controlled trial was conducted to investigate the effects of iloprost, a stable prostacyclin analogue, on peripheral resistance, during femoro-crural arterial bypass. 3000 ng of iloprost, infused into the graft, produced an immediate drop in peripheral resistance by a mean (range) of 43% (4-80%; p less than 0.01, Wilcoxon). Decreased peripheral resistance persisted to 20 minutes. Graft flow during the same period increased by 59.8% (-7 to 294%; p less than 0.01) and this increase persisted after the operation. Iloprost produces an immediate decrease in peripheral resistance associated with a prolonged increase in graft blood flow. This may reduce graft failure in the early postoperative period.