Abstract
Intraarterial and intravenous infusion of prostaglandin E1 (PGE1) is established treatment for severe peripheral arterial occlusive disease, particularly
in Europe and Japan. In this critical appraisal, experimental and clinical studies
are reviewed, with special emphasis on cardiopulmonary effects and drug safety. The
pulmonary data all indicate dose-dependent dilation of the pulmonary vessels with
a reduction in pulmonary resistance. The known hemodynamic effects of PGE1 on the heart include an increase in stroke volume, cardiac index, and left ventricular
ejection fraction, and a reduction in left ventricular filling pressure. Analysis
of clinical trials shows a low rate of adverse effects, in particular a low incidence
of cardiopulmonary side effects. If the recommendations for high-risk patients are
observed, PGE1 is both an efficacious and safe therapeutic principle.
