Contrast-enhanced ultrasonographic study in patients with lower limb arterial lesions

Timina I.E.^1,2, Askerova N.N.¹, Karmazanovsky G.G.¹, Pyatkova I.I.¹, Zotikov A.E.¹

1) Institute of Surgery named after A.V. Vishnevsky under the RF Ministry of Public Health,
2) First Moscow State Medical University named after I.M.Sechenov under the RF Ministry of Public Health, Moscow, Russia

Background. The introduction into clinical practice of contrast-enhanced ultrasonographic examination made it possible to assess patency of tibial arteries and perfusion of crural muscles in patients with occlusive lesions of lower-limb arteries. These findings are important for planning optimal treatment policy and assessing efficacy of operative or medicamentous treatment.

Objective. The study was aimed at investigating a possibility of contrast-enhanced ultrasound examination for assessment of patency of tibial arteries and quantitative assessment of perfusion of crural muscles in patient with occlusive lesions of lower-limb arteries.

Patients and methods. We examined a total of 30 patients presenting with atherosclerotic-genesis occlusive lesions of lower limb arteries and symptomatic intermittent claudication. Five patients were examined in the postoperative period.

All patients were subjected to quantitative analysis of crural muscle perfusion in the pre- and postoperative periods, determining the time of onset of contrast medium accumulation and the time to the peak of intensity.

Results. Contrast-enhanced ultrasound examination demonstrated that in patients with occlusive lesions of lower-limb arteries the start of contrast medium accumulation appeared to occur later than in apparently healthy people: on second 30-88, depending on the degree of limb ischaemia. The contrasting time-to-peak was also increased (from 36 to 120 s). In the postoperative period all patients were found to have improved perfusion of the crural muscles, which was confirmed by a decrease in time-to-peak contrasting.

Conclusion. Contrast-enhanced ultrasonographic examination is currently the only non-invasive, safe method of determining perfusion of crural muscles, which may be used many times for assessment of viability of the ischaemised extremity, as well as for assessment of efficacy of the treatment performed.

KEY WORDS: contrast-enhanced ultrasonographic examination, crural muscle perfusion, occlusive lesions of lower limb arteries.

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