[Technical concepts of retrograde venous perfusion with fluorescein]

Regional intravenous drug application has been suggested to increase peripheral tissue concentrations in severe arterial insufficiency. Within this study basic operational characteristics of the retrograde venous perfusion technique (RVP) were evaluated in 10 patients with intermittent claudication. Fluorescein was used to visualize the intracutaneous distribution of the injected fluid. Subjects were divided into 2 groups. The "cocktail-group" received 100 ml of a homogenous fluorescein dilution. To compare the effect of injecting a small sample, 45 ml of unstained solution were given before and after 10 ml of concentrated dye ("fraction-group"). Photographic recording of skin fluorescence distal to the arterial tourniquet revealed a rapid and complete staining of the lower leg including the toes in the cocktail-group. In the fraction-group, however, skin fluorescence appeared markedly delayed and, more over, did not spread down to the toes in 2 cases. In conclusion, drugs can be applied by RVP provided that they are dissolved in a sufficient amount of fluid of 100 ml at least.