Value of prostaglandins for treatment of peripheral arterial occlusive disease (PAOD)

The aim of this article is to give a review of the clinical relevance of prostaglandins in patients with peripheral arterial occlusive disease with special reference to current guidelines. Intermittent claudication and critical limb ischemia (CLI) are the clinical endpoints of peripheral arterial occlusive disease (PAOD). Although there are limited data on the positive effect of prostaglandin E1 in claudication, there are still no convincing prospective studies to confirm this. In critical limb ischemia immediate treatment is necessary since tissue perfusion is strongly reduced and major amputation is frequently necessary within the following 6 months, when there is no option for surgical or interventional revascularization. Otherwise conservative measures are necessary, in some cases even additionally to revascularization. Conservative treatment includes local wound care, systemic antibiotic treatment and the intravenous use of prostanoids. As with invasive therapy the most important therapeutic goals are limb salvage, healing of ischemic lesions and preservation of the functional status even beyond the time span of prostanoid therapy. These recommendations for treatment are to be found in the majority of current guidelines.