Severe pain at rest is a major symptom of advanced peripheral arterial occlusive disease (PAOD). Preliminary studies of treatment with iloprost, a prostacyclin analogue, showed encouraging results in patients with ischaemic rest pain. Therefore a randomized, placebo-controlled multicentre study was undertaken in 113 patients admitted to hospital with rest pain of at least 2 weeks duration caused by severe PAOD. The patients were randomly assigned to receive 2-week placebo or iloprost infusions for 6 hours per day at a dose of 0.5-0.2 ng/kg/min in addition to conventional care. Demographic data and arteriographic findings were similar in the two groups. Eleven patients withdrew from the study before completion and 102 patients could be included in the final analysis. Significantly more patients in the iloprost group (62.5% of 48) than in the placebo group (42.6% of 54) had complete relief of pain without analgesic therapy during at least five consecutive days at the end of the treatment period (p less than 0.05, chi 2-test). Facial flush, headache and nausea were the most common side effects during iloprost infusion. Serious adverse reactions did not occur. Thus, a 2-week iloprost infusion was shown to be safe and effective as a treatment for ischaemic rest pain caused by PAOD.

Adult↗

PubMedDate not supplied

[Surgery in advanced age].

Between 1982 and 1990 724 patients aged between 85 and 102 years were hospitalized (average age: 88.7 years). Operations were performed on 482 of them (66.6%). The surgical mortality amounted to 16.8%. The mortality in conjunction with emergency operation was as high as 28.2%, or as low as 11.4% in the context of elective operations. X-ray findings recorded from heart and lung, and ECG provided reliable criteria for assessment of the surgical risk.

Aged↗