[Use of retrograde venous perfusion in patients with advanced peripheral arterial occlusive disease]. 1991

A Scheffler, and E A Friedrichs, and H Rieger
Aggertalklinik, Klinik für Gefässerkrankungen, Engelskirchen.

Bier's method of regional anaesthesia has been proposed to deposit various drugs intravenously distal to an arterial block in legs with severe arterial insufficiency. From the theoretical point of view it is assumed that ischaemic acral skin areas while being cut off the arterial blood supply may still be reached on the venous route. The purpose of this study was to test this hypothesis for different injection techniques using sodium fluorescein as tracer. Measurements were carried out in ten patients with intermittend claudication. After a circulatory arrest according to v. Esmarch had been established a total volume of 100 ml was injected into a peripheral vein at either the calf or foot. In five patients a homogenous fluorescein mixture was prepared prior to the injection ("cocktail"-group) whereas the other five received an isolated fraction of 10 ml fluorescein ("fraction"-group). Subsequently, the fluorescence distribution at the calf and dorsum of the foot was photographically recorded over a period of 20 minutes and evaluated by means of digital image analysis. Fluorescence rapidly and homogeneously spread over the investigated skin areas including the toes in all five cases of the "cocktail"-group. In contrast, a rather delayed and heterogenous fluorescein distribution was observed in the "fraction"-group. Furthermore, in two cases no dye could be detected at the digits after 20 minutes. These results have confirmed the hypothesis of RVP provided that all ingredients are dissolved within an adequate amount of fluid prior to injection.

UI MeSH Term Description Entries
D007262 Infusions, Intravenous The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it. Drip Infusions,Intravenous Drip,Intravenous Infusions,Drip Infusion,Drip, Intravenous,Infusion, Drip,Infusion, Intravenous,Infusions, Drip,Intravenous Infusion
D007383 Intermittent Claudication A symptom complex characterized by pain and weakness in SKELETAL MUSCLE group associated with exercise, such as leg pain and weakness brought on by walking. Such muscle limpness disappears after a brief rest and is often relates to arterial STENOSIS; muscle ISCHEMIA; and accumulation of LACTATE. Claudication, Intermittent
D007511 Ischemia A hypoperfusion of the BLOOD through an organ or tissue caused by a PATHOLOGIC CONSTRICTION or obstruction of its BLOOD VESSELS, or an absence of BLOOD CIRCULATION. Ischemias
D007866 Leg The inferior part of the lower extremity between the KNEE and the ANKLE. Legs
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D012039 Regional Blood Flow The flow of BLOOD through or around an organ or region of the body. Blood Flow, Regional,Blood Flows, Regional,Flow, Regional Blood,Flows, Regional Blood,Regional Blood Flows
D001783 Blood Flow Velocity A value equal to the total volume flow divided by the cross-sectional area of the vascular bed. Blood Flow Velocities,Flow Velocities, Blood,Flow Velocity, Blood,Velocities, Blood Flow,Velocity, Blood Flow
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000765 Anesthesia, Conduction Injection of an anesthetic to inhibit nerve transmission in a specific part of the body. Anesthesia, Regional,Conduction Anesthesia,Regional Anesthesia

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