Intravenous isotope calf scanning in the assessment of intermittent claudication

✍ Scribed by R. A. Hurlow; S. T. Chandler; J. Hardman; C. J. L. Strachan

• Publisher: John Wiley and Sons
• Year: 1978
• Tongue: English
• Weight: 754 KB
• Volume: 65
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800650910

✦ Synopsis

Abstract

A method of hyperaemic calf scanning using a bolus injection of 99Tcm pertechnetate into an arm vein is described and evaluated in 26 patients with intermittent claudication.

From the calf image displayed on a visual display unit after 2.5 minutes' scanning with a gamma camera, an assessment of the patency of the lower popliteal artery and run-off vessels can be made and of the distribution of blood flow to the calf muscles.

The technique enables the measurement of a calf ‘perfusion index’, which was found to be reproducible and to correlate well with the severity of disease in the proximal arteries leading to the calf, as assessed by the resting ankle/brachial pressure index (r = 0.65, P <0.001) and the ankle pressure response to exercise (r = 0.71, P ± 0.001).

The perfusion index correlated with maximum walking time (r = 0.57, P <0.01) but not with claudication time measured on a treadmill (r = 0.30).

Calf scanning is useful in the initial assessment of patients with claudication, and when combined with ankle pressure measurements it can provide objective flow and pressure data for evaluation of the progression of disease in conservatively managed patients with claudication, and for the assessment of the results of operation.