Dynamic isotope aortoiliac assessment. Clinical, doppler, and arteriographic correlation

In the presence of multiple tandem arteriosclerotic stenoses of the distal aorta, iliac, and lower extremity arteries, it may be difficult to ascertain which lesions are clinically and surgically important. Usually the history, physical examination, and arteriogram will resolve this issue. However, a recent report has stated that the rapid transit time of isotope from the distal aorta to the femoral arteries may be helpful. The relevance of this technique in surgical candidates with different clinical stages of vascular disease has yet to be demonstrated. We compared the use of this technique in surgical candidates with their clinical state and assessment of vascular disease by standard angiographic and directional transcutaneous Doppler techniques. Only modest benefit from the isotope transit was found, particularly when compared with the patient's clinical status of asymptomatic, claudicating, or limb salvage categories. We conclude that isotope transit times as currently measured are not as clinically important as previously reported. With further development, some trends may prove to be useful.