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30 November 2010

Influence of pharmacological treatment on blood flow and muscle perfusion in patients with obliterative atheromatosis assessed with isotopic methods. A pilot study

Wieslaw TryniszewskiABCDEF, Dariusz NowakCD, Marian BrockiEF, Zbigniew MaziarzABDEFG, Jacek RyszACD

Med Sci Monit 2010; 16(12): CLR622-627 :: ID: 881300

Abstract

BACKGROUND: Most of the methods don’t give the comparison between blood flow at rest and after exercise. Nuclear medicine allows for such assessment and determination of muscle perfusion indexes. The aim of the study was the comparison of the radioisotopic assessment of lower limbs perfusion at rest and after exercise in patients with obliterative atheromatosis subjected to combined treatment with the standard vascular examinations.

MATERIAL AND METHODS: 35 patients with stage II according to Fontaine and claudication distance 30–500 m, subjected to the combined medical treatment were included to the study. Basic examinations, claudication distance measurements, standard vascular examinations, and radioisotopic examinations of lower limbs perfusion with Tc99mMIBI were performed in all patients.

RESULTS: After 6 months of therapy the results of perfusion scintigraphy showed that combined pharmacological treatment caused the significant improvement of calf perfusion at rest (p<0.05), which justifies its application in chronic ischemia of lower limbs. Such improvement was not observed while analyzing the results of standard vascular indexes.

CONCLUSIONS: The use of perfusion scintigraphy allows for precise definition of the state of the limbs perfusion and shows the improvement of lower limbs perfusion at rest after medical treatment. It is a more precise and sensitive examination, gives more information comparing to the standard vascular examinations, and completes standard vascular diagnostics in patients with obliterative atheromatosis.

Keywords: perfusion imaging, Pentoxifylline - therapeutic use, Organotechnetium Compounds - metabolism, Muscle, Skeletal - drug effects, Leg - blood supply, Intermittent Claudication - physiopathology, Exercise - physiology, Blood Flow Velocity - drug effects, Aspirin - therapeutic use, Arteriosclerosis Obliterans - therapy, Analysis of Variance, Pilot Projects, Pyrrolidines - therapeutic use, Regional Blood Flow - drug effects, Statistics, Nonparametric

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