title: Quantitative assessment of therapeutic effects in the critically ischemic limb using (99m)Tc-diethylene-triamine-pentaacetic acid human serum albumin.
abstract: 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.
authors.affiliation: Department of Vascular Surgery, Aichi Medical University, 21 Karimata, Yazako, Nagakute-cho, Aichi, 480-1195, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Kawanishi
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohta
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ishibashi
authors.forename: Ikuo
authors.initials: I
authors.lastname: Sugimoto
authors.forename: Hirohide
authors.initials: H
authors.lastname: Iwata
authors.forename: Masayuki
authors.initials: M
authors.lastname: Takahashi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamada
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Hida
mesh_terms: 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
chemical_list: D013668:Technetium Tc 99m Aggregated Albumin; C057162:technetium Tc 99m DTPA HSA; D016284:Technetium Tc 99m Pentetate