Eleven patients with severe arteriosclerotic disease of the lower extremities who were unsuitable for surgical bypass procedures or who had surgical bypass failure have been treated with prostaglandin E1. The patients all responded well to the prostaglandin treatment, except for one patient who required an above the knee amputation. Subjective evidence of pain and swelling disappeared and the patients' narcotic requirements were reduced. In those patients who had ulcers of the lower extremities, healing was promoted spontaneously or together with skin grafting. Side effects experienced by some patients, such as diarrhea, joint pain and swelling of the extremities, did not warrant discontinuation of drug therapy. There were no changes in blood chemistry. There was marked inhibition of platelet aggregation, and moderate inhibition of red cell deformability.
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