Quantitative assessment of therapeutic effects in the critically ischemic limb using (99m)Tc-diethylene-triamine-pentaacetic acid human serum albumin.
OBJECTIVE
To investigate the reliability and limitations of a new radioisotope method using (99m)Tc-diethylenetriamine-pentaacetic acid human serum albumin (Tc-99m-DTPA-HSA) and to evaluate the diagnostic ability of isotope infusion for assessing hemodynamic changes in the foot before and after treatment.


METHODS
Hemodynamic changes before and after treatment were assessed in 21 limbs with ulcer or gangrene, by analyzing changes in the time-activity curve, the uptake ratio, and the values obtained with noninvasive techniques.


RESULTS
There were significant differences between each pair of the three types of time-activity curve and their uptake counts. The uptake ratio was correlated with ankle blood pressure (ABP) and toe blood pressure (TBP), but not with transcutaneous oxygen pressure (tcPO(2)) or skin perfusion pressure (SPP). The hemodynamic change induced by pharmacotherapy was subtle, but that induced by arterial reconstruction was remarkable. Although there was not always a good correlation between the degree of hemodynamic change and the clinical outcome in limbs treated with pharmacotherapy, the hemodynamic change was quantitatively assessed.


CONCLUSIONS
Our study suggests that this isotope technique is a useful quantitative method to evaluate hemodynamic change from a different perspective to conventional noninvasive methods.
Kawanishi
Jun
J
Department of Vascular Surgery, Aichi Medical University, 21 Karimata, Yazako, Nagakute-cho, Aichi, 480-1195, Japan.
Ohta
Takashi
T
Ishibashi
Hiroyuki
H
Sugimoto
Ikuo
I
Iwata
Hirohide
H
Takahashi
Masayuki
M
Yamada
Tetsuya
T
Hida
Noriyuki
N
D000328:Adult; D000368:Aged; D001162:Arteriosclerosis Obliterans / Q000150:complications / Q000601:surgery; D001785:Blood Gas Monitoring, Transcutaneous; D001794:Blood Pressure; D005069:Evaluation Studies as Topic; D005260:Female; D005528:Foot / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008833:Microcirculation; D055420:Perfusion Imaging / Q000379:methods; D012307:Risk Factors; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate; D013919:Thromboangiitis Obliterans / Q000150:complications / Q000601:surgery; D016896:Treatment Outcome
D013668:Technetium Tc 99m Aggregated Albumin; C057162:technetium Tc 99m DTPA HSA; D016284:Technetium Tc 99m Pentetate