Value of a radionuclide limb blood flow technique in the assessment of percutaneous balloon and dynamic angioplasty.
In a prospective study, a radionuclide technique was used to evaluate the limb blood flow (LBF) changes in 30 patients undergoing dynamic (n = 15) or balloon (n = 15) angioplasty for arterial occlusions or stenoses, respectively. The results were compared with Doppler Ankle Brachial Index (DABI) and treadmill exercise tests. Whilst LBF values (ml of blood flow per 100 ml of limb volume per min) were significantly lower in limbs with arterial occlusion than stenosis (4.5 +/- 0.46 and 6.4 +/- 0.74, respectively; P less than 0.05). DABI provided no discrimination. Immediately after balloon angioplasty, there was a fall in DABI, from 0.60 +/- 0.05 to 0.47 +/- 0.04 (P less than 0.05), which rose 24 h later to 0.73 +/- 0.02 (P less than 0.01). Following dynamic angioplasty, DABI improved from 0.60 +/- 0.05 to 0.66 +/- 0.02 (P less than 0.05). At 3 weeks, the LBF improved from 4.6 +/- 0.66 to 11.1 +/- 0.53 (P less than 0.001) following dynamic angioplasty and from 6.2 +/- 0.68 to 8.53 +/- 0.81 (P less than 0.001) following balloon angioplasty. "Normal" LBF (greater than 10 ml/100 ml per min) was achieved in 80% of patients who underwent successful dynamic angioplasty but in only 36% of the balloon group (P less than 0.05, chi 2-test). Reproducibility of repeated LBF measurements in control limbs was superior to that of DABI. This was indicated by a lower coefficient of variation, 13.8% compared with 25.2%, and a higher correlation coefficient, r = 0.79 compared with 0.27. Treadmill exercise tests were invalid or impossible in 30% of all occasions.(ABSTRACT TRUNCATED AT 250 WORDS)
Gehani
A A
AA
Cardiac Research Unit, Killingbeck Hospital, Leeds, UK.
Thorley
P
P
Sheard
K
K
Ashley
S
S
Brook
S G
SG
Rees
M R
MR
D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D001783:Blood Flow Velocity; D005069:Evaluation Studies as Topic; D005080:Exercise Test; D005121:Extremities / Q000098:blood supply* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011877:Radionuclide Imaging; D014463:Ultrasonography