We performed a pilot study to evaluate whether portal flow volume (PFV) changed in subjects with chronic hepatitis C virus (HCV) infection with respect to control patients after infusion of iloprost, a prostacyclin ana- log. Six subjects with chronic HCV infection and arteriopathy of the lower limbs (CHCVIA) and 4 control patients affected only by HCV infection (CHCV) were studied with color Doppler sonography. CHCVIA pa- tients were examined before and after 3 days of iloprost infusion, and CHCV patients were examined before and after 3 days with no treatment. In each patient, PFV was obtained after calculating portal flow velocity (PV), portal diameter, and portal vein cross-sectional area. The mean difference between basal and final val- ues of the PFV of CHCVIA patients was significant (p 5 0.03), as was the difference in the PFV (final values expressed as percent of basal values) in CHCVIA patients compared with those obtained in the CHCV pa- tients (p 5 0.01). We have observed significant improvement in hepatic perfusion in CHCVIA patients com- pared with CHCV patients after iloprost infusion. In light of these results, we suggest some possible thera- peutic implications in patients with HCV infection. Further studies are necessary to confirm this hypothesis.