Surgical decision-making in management of patients with lower limb critical ischaemia using radioisotope scintigraphy

Gavrilenko A.V., Sandrikov V.A., Svirchevsky E.B., Omarzhanov O.A.

Department of Vascular Surgery Russian Scientific Centre of Surgery named after Academician B.V. Petrovsky Russian Academy of Medical Sciences Moscow, Russia

Presented herein is a new technique of studying the competence of the microcirculatory bed and viability of appendicular tissues in patients suffering from lower limb critical ischaemia. The competence of the resistive link of microcirculation was determined by means of dynamic scintigraphy based on studying the primary passage of an internally administered radiopharmaceutical along the microcirculatory system. Accumulation of the radiopharmaceutical with an affinity for the sites of necrosis and inflammation was recorded by means of stationary scintigraphy. Based on the findings obtained in studying the outcomes of surgical management of 105 of the 123 examined patients presenting with lower limb critical ischaemia, criteria for microcirculatory competence and viability of the lower extremities were worked out. Reliable significance of these two criteria in assessing the efficacy of the outcomes of various types of revascularizations and amputations was determined.

KEY WORDS: lower limb critical ischaemia, microcirculation, radioisotopic scintigraphy.

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