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Investigating the Capillary Circulation of the Foot with 99m Tc‐macroaggregated Albumin: A Prospective Study in Patients with Diabetes and Foot Ulceration
Author(s) -
Moriarty K.T.,
Perkins A.C.,
Robinson A.M.,
Wastie M.L.,
Tattersall R.B.
Publication year - 1994
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1994.tb00224.x
Subject(s) - medicine , perfusion , diabetes mellitus , diabetic foot , albumin , foot (prosody) , prospective cohort study , nuclear medicine , radiology , surgery , endocrinology , linguistics , philosophy
Macroaggregated albumin has been used to assess capillary circulation for over 20 years. The aim of the present study was to use 99m Tc‐macroaggregated albumin ( 99m Tc‐MAA) perfusion scanning to assess capillary circulation in feet with ischaemic ulcers in patients with diabetes, and relate the appearances to outcome. Twenty‐three patients with diabetes presented with a total of 41 neuroischaemic foot ulcers. Perfusion scanning was performed by direct femoral artery injection of approximately 400 000 particles of 99m Tc‐MAA and imaging with a gamma camera. Patients were followed prospectively for 3 months. Scans were graded independently by a radiologist who was unaware of the site of the ulcers. Significant associations were detected between a radiologist's assessment of increased tissue perfusion and complete healing after 3 months ( p = 0.047) and poor tissue perfusion on the image and failure to heal ( p = 0.0005). This technique may be useful in deciding whether to persist with conservative treatment in patients with diabetes and foot ulceration.