Stein U, Börner C, Wagner E
Vasa. 1989;18(2):112-6.
For radionuclide assessment of AV-shunting Tc99m aggregated albumin microspheres were injected into the proximal femoral artery in 10 patients with chronic peripheral OAD and a visualized proximal AV shunt during percutaneous transluminal angioplasty. Isotope activity in the lungs and the afflicted leg was investigated with a computer-linked whole body scanner. 12 patients undergoing the same treatment but without proximal AV shunt and one healthy volunteer served as control group. In this group 6 patients suffered from longtime diabetes. Patients with visualized AV shunts showed a significant higher isotope activity in the lungs than non-diabetics without proximal shunts. To our surprise diabetics without proximal AV fistula proved to have also a significant augmented pulmonary activity. Pathophysiological conditions for the evolution of proximal and peripheral AV shunts in patients with chronic OAD are discussed. The poor response to local clot lyses in patients with radionuclide prove of AV shunts underlines their hemodynamic importance under clinical aspects.
为了对动静脉分流进行放射性核素评估，将锝99m聚合白蛋白微球注入10例慢性周围性闭塞性动脉疾病患者的股动脉近端，这些患者在经皮腔内血管成形术期间可见近端动静脉分流。使用计算机连接的全身扫描仪研究肺部和患侧腿部的同位素活性。12例接受相同治疗但无近端动静脉分流的患者和1名健康志愿者作为对照组。该组中有6例患者患有长期糖尿病。可见动静脉分流的患者肺部的同位素活性明显高于无近端分流的非糖尿病患者。令我们惊讶的是，无近端动静脉瘘的糖尿病患者肺部活性也显著增强。讨论了慢性闭塞性动脉疾病患者近端和周围动静脉分流演变的病理生理状况。放射性核素证实存在动静脉分流的患者对局部溶栓反应不佳，这突出了它们在临床方面的血流动力学重要性。
