Dynamic contrast-enhanced ultrasound for assessment of therapy effects on skeletal muscle microcirculation in peripheral arterial disease: pilot study

OBJECTIVE: To assess with dynamic contrast-enhanced ultrasound (CEUS) and transient arterial occlusion whether the muscular micro-perfusion in patients with peripheral arterial disease (PAD) is improved after angioplasty or surgery. MATERIALS AND METHODS: This study had local institutional review bo...

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Bibliographische Detailangaben
Hauptverfasser: Amarteifio, Erick (VerfasserIn) , Wormsbecher, Stephanie (VerfasserIn) , Demirel, Serdar (VerfasserIn) , Kauczor, Hans-Ulrich (VerfasserIn) , Böckler, Dittmar (VerfasserIn) , Weber, Marc-André (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2013
In: European journal of radiology
Year: 2013, Jahrgang: 82, Heft: 4, Pages: 640-646
ISSN:1872-7727
DOI:10.1016/j.ejrad.2012.11.022
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1016/j.ejrad.2012.11.022
Volltext
Verfasserangaben:E. Amarteifio, M. Krix, S. Wormsbecher, S. Demirel, S. Braun, S. Delorme, H.-U. Kauczor, D. Böckler, M.-A. Weber

MARC

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520 |a OBJECTIVE: To assess with dynamic contrast-enhanced ultrasound (CEUS) and transient arterial occlusion whether the muscular micro-perfusion in patients with peripheral arterial disease (PAD) is improved after angioplasty or surgery. MATERIALS AND METHODS: This study had local institutional review board approval. Written informed consent was obtained from all 20 patients with PAD, Fontaine stage IIb (mean age, 64 years), who participated in the study. Low-MI CEUS (7MHz; MI, 0.28) was applied to the mainly affected lower leg after start of a continuous automatic intravenous injection of 4.8mL SonoVue(®). Muscle-perfusion was monitored by CEUS before, during, and after provocation by arterial occlusion at the thigh level lasting for 60s. CEUS examination was performed a second time within 14 days after angioplasty (n=15), thrombendarterectomy (n=2), angioplasty and thrombendarterectomy (n=1), or bypass (n=2). Clinical amelioration was re-evaluated within 6 months after the intervention using a 4-point scale. RESULTS: Ankle-brachial-index (ABI) increased from 0.8±0.2 to 0.9±0.3 after treatment (p=0.01). Time to maximum CEUS signal (tmax) shortened from 26±14s to 14±4s (p=0.004). The slope to maximum after transient occlusion (m2) changed to steeper values (6.4±5.8∼mL/s versus 10.2±5.0∼mL/s; p=0.04). Shortened tmax predicted improvement in the patients' intermittent leg pain and therefore successful therapy outcome. CONCLUSION: Dynamic CEUS with transient arterial occlusion can visualize the treatment-induced improvement of muscular micro-perfusion in patients with PAD. 
650 4 |a Angiography 
650 4 |a Angioplasty 
650 4 |a Ankle Brachial Index 
650 4 |a Area Under Curve 
650 4 |a Contrast Media 
650 4 |a Female 
650 4 |a Humans 
650 4 |a Leg 
650 4 |a Male 
650 4 |a Microcirculation 
650 4 |a Middle Aged 
650 4 |a Muscle, Skeletal 
650 4 |a Peripheral Vascular Diseases 
650 4 |a Phospholipids 
650 4 |a Pilot Projects 
650 4 |a Sulfur Hexafluoride 
650 4 |a Thrombectomy 
650 4 |a Treatment Outcome 
650 4 |a Ultrasonography 
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