Periferik arter hastalığında medikal tedavinin krural ven debisi üzerine etkisi

Ozet Amac: Doku perfuzyonunun renkli Doppler ultrasonografi (RDUS) ile olculmesi invaziv olmayan yeni bir tekniktir ve periferik arter hastaliginin (PAH) siddetini degerlendirmede klinik oneme sahiptir. Biz bu calismamizda, periferik arter hastaligi olan bireylerde RDUS ile debi olcumu yaparak medikal tedavinin doku perfuzyonu uzerindeki etkisini ongormeyi amacladik. Gerec ve yontemler: Calisma kapsaminda, PAH tanisi almis 17 olguya ait yirmialti bacakta ana femoral, popliteal, anterior ve posterior tibial venlere ait akim hacmi, RDUS ile degerlendirildi. Santral venoz basinci notralize etmek icin, olgular yatar pozisyonda iken ayaklar 15 cm yukseltilerek inceleme gerceklestirildi. Tedavi icin silostazol, amlodipin ve dipiridamol kullanildi. Hastalar, tibbi tedavi oncesinde ve 10. haftada RDUS ile degerlendirildi. Bulgular: Tedavi sonrasinda olgularda alt ekstremite ortalama venoz akis hacminde istatistiksel olarak anlamli olmayan artis tesbit edildi. Sonuc: Biz bu calismamizda, doku perfuzyonunun bir gostergesi olarak, venoz akim hacminin RDUS ile olcumunun tibbi tedavi etkisini degerlendirmek icin faydali bir yontem oldugunu vurguladik. PAH olan tum olgular, doku perfuzyonunu ongorebilmek amaciyla venoz akis hacmi olcumu ile ozellikle krural duzeyde tedavi oncesi ve sonrasinda degerlendirilmelidir. Ayrica hastalarin vucut kitle indeksi veya agirliklari RDUS ile karsilastirilmalidir. Anahtar kelimeler: Periferik arter hastaligi; renkli Doppler ultrasonografi; perfuzyon goruntuleme. The effects of medical treatment on flow volume of crural veins in peripheral arterial disease Abstract Background: Measurement of tissue perfusion by color flow Doppler ultrasonography is a new non invasive technique, which has great clinical value for assessing the severity of peripheral arterial disease (PAD) and monitoring the response to medical and interventional treatment. We aimed to investigate the effect of medical therapy measuring flow volume measurement with color flow duplex ultrasonography (CDU) to predict the tissue perfusion in patients with PAD. Methods: Twenty-six legs of 17 patients with peripheral arterial occlusive disease were included the study. Flow volume of common femoral, popliteal, anterior tibial and posterior tibial veins by CDU was obtained in the supine position with 15 cm elevation of foot to neutralize central venous pressure. The patients were examined before and 10 weeks later of the medical treatment. The patients had used the drugs including cilostazol, amlodipine and dipyridamole that currently using for the treatment of PAD. Results: A non significant increasing of mean venous flow volume of lower extremity was found after the treatment. Conclusions: We emphasized that as an indicator of tissue perfusion, venous flow volume measurement with CDU is a useful method for evaluating the effect of medical treatment. All the patients with PAD should be examined with venous flow volume measurement to predict tissue perfusion especially in cruris both before and after the treatment. Also body mass index or weight of patients should be correlated by CDU values. Keywords: Peripheral vascular diseases; colour duplex ultrasonography; perfusion imaging.