Optimization of Treatment in Patients With Severe Peripheral Ischemia (Fontaine Stage IIb)

"The study, consists of two substudies, which deal with patients susceptible to medical therapy alone (substudy 1) or treated with classical surgical therapy (substudy 2).~For each substudy, pts will be divided into two groups, one that will receive conventional treatments but not prostanoids, other conventional treatments with addition of iloprost.~The 4 groups:~1A. Pts unsuitable to surgical or endovascular vascular therapy: conventional treatment~1. B. Pts unsuitable to surgical or endovascular vascular therapy: treatment with iloprost plus conventional treatment~2. A. Pts suitable to vascular surgical or endovascular therapy: conventional treatment~2B. Pts suitable to vascular surgical or endovascular therapy: treatment with iloprost plus conventional treatment"

"The standard treatment, as has already been explained in the submission is the best treatment that the guidelines suggest for that specific type of patient with those complications and with stage 2b severe PAD.~correction of concomitant risk factors, physical exercise, antiplatelet, standard heparin /low molecular weight heparin, hemorheological/vasodilators such as pentoxifylline/buflomedil, propionyl-L-carnitine, Defibrotide) but not prostanoids"