Untersuchungen zur Quantifizierung der Änderung der Skelettmuskeldurchblutung nach Gefäßrevaskularisationen mit einem 99mTechnetiummarkierten Tracer

1990 ◽  
Vol 29 (05) ◽  
pp. 215-220 ◽  
Author(s):  
R. Benning ◽  
K. Nagel ◽  
M. Jugenheimer ◽  
S. Fischer ◽  
S. Worthmann ◽  
...  

A new 99mTc-labelled tracer (99mTc-Sestanriibi) was used for the first time to demonstrate the perfusion of the skeletal muscle. In 16 patients with obstructive atherosclerosis of the lower limbs the change of perfusion of thigh and lower leg was studied with SPECT before and after vascular surgery (n = 11) or percutaneous transluminal angioplasty (n = 5). Comparative results of scintigraphic measurements and clinical observations (ancle-arm pressure, treadmill test) in 10 surgical patients (14 operated legs) showed correct positive or negative results in 86% (12/14).

2021 ◽  
pp. 20210215
Author(s):  
Nikolaos Galanakis ◽  
Thomas G Maris ◽  
Georgios Kalaitzakis ◽  
Nikolaos Kontopodis ◽  
Nikolas Matthaiou ◽  
...  

Objectives: To emerge hypoperfusion of lower limbs in patients with critical limb ischemia (CLI) using Intravoxel Incoherent Motion microperfusion magnetic resonance imaging (IVIM-MRI). Moreover to examine the ability of IVIM-MRI to differentiate patients with severe peripheral arterial disease (PAD) from normal subjects and evaluate the percutaneous transluminal angioplasty (PTA) results in patients with CLI. Methods: Eight patients who presented with CLI and six healthy volunteers were examined. The patients underwent IVIM-MRI of lower extremity before and following PTA. The imaging protocol included sagittal diffusion-weighted (DW) sequences. DW images were analyzed and color parametric maps of the micro-circulation of blood inside the capillary network (D*) were constructed. The studies were evaluated by two observers to define interobserver reproducibility. Results: Technical success was achieved in all patients (8/8). The mean ankle-brachial index increased from 0.35 ± 0.2 to 0.76 ± 0.25 (p < 0.05). Successful revascularization improved IVIM microperfusion. Mean D* increased from 279.88 ± 13.47 10−5 mm2/s to 331.51 ± 31 10−5 mm2/s, following PTA, p < 0.05. Moreover, PAD patients presented lower D* values as compared to healthy individuals (279.88 ± 13.47 10−5 mm2/s vs 332.47 ± 22.95 10−5 mm2/s, p < 0.05, respectively). Good interobserver agreement was obtained with an ICC = 0.84 (95% CI 0.64–0.93). Conclusions: IVIM-MRI can detect differences in microperfusion between patients with PAD and healthy individuals. Moreover, significant restitution of IVIM microperfusion is found following successful PTA. Advances in knowledge: IVIM-MRI is a safe, reproducible and effective modality for evaluation of lower limb hypoperfusion in patients with PAD. It seems also to be a helpful tool to detect changes of tissue perfusion in patients with CLI following revascularization.


Author(s):  
Zainuddin Wuwu ◽  
Djony Edward Tjandra ◽  
Richard Sumangkut ◽  
Fima L. F. G. Langi

Introduction: Percutaneous transluminal angioplasty (PTA) is the gold standard in the management of AVF dysfunction. On the other hand, the management of stenosis with PTA induces an acceleration of neointimal hyperplasia with the occurrence of restenosis. The aim of this study was to assess the increase of quick of blood (Qb) hemodialysis (HD) patients after venoplasty with AVF dysfunction and its patency within 3 months post procedure, and examine the factors associated with venoplasty failure to maintain optimal Qb. Method: This study used a quasi-experimental design, in which all subjects received the treatment under study without a control group, due to ethical issues; because venoplasty is the standard protocol for AVF dysfunction in the place of this study. Qb measurements were made before and after HD, and 3 months thereafter, to evaluate AVF patency. Result: There were 25 cases that included 23 patients with 2 patients had to be re- venoplasty. An increase in Qb averaged 221.3−196.7 mL / min or about 25 mL / min in the 3-month period after venoplasty with significant results (p = 0.044). The location of stenosis in juxta anastomosis has a 14 times greater chance of venoplasty failure (p = 0.037) than stenosis in the area of draining vein or central vein. Diabetes Mellitus (DM) increased the odds of venoplasty failure 12 times greater (p = 0.038) than cases without this comorbid.. Conclusion: This study proves the increase in Qb of hemodialysis patients after venoplasty for AVF dysfunction, and it was found that the location of juxta anastomosis stenosis and the presence of DM are the two main factors that have the potential to increase the chance of venoplasty failure.


2011 ◽  
Vol 4 (04) ◽  
pp. 173-176 ◽  
Author(s):  
O. Rämö ◽  
Lavonen Juha ◽  
Soiva Martti ◽  
Huusari Hannu ◽  
Rämö Pauliina ◽  
...  

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